My “Achy Breaky” Shoulder Shoulder Pain and Treatment

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Presentation transcript:

My “Achy Breaky” Shoulder Shoulder Pain and Treatment Kennedy Club Fitness, Paso Mark G. Kowall, M.D., M.B.A. September 24, 2013

The Orthopedic Specialty Hospital Knee and Shoulder Training

Shoulder Pain Impingement Rotator Cuff Problems Instability Most common sources Impingement Rotator Cuff Problems Instability Labrum Tears Trauma Less Common Sources Arthritis Frozen Shoulder

Anatomy

Impingement Syndrome (“umbrella diagnosis”) Bursitis (25-40 y/o) Tendinitis (40-50 y/o) Rotator Cuff Tear (>50 y/o)

Impingement “Bursitis/Tendinitis”

“Bursitis/Tendinitis” Symptoms Pain with overhead motion Shoulder to elbow location Night time awakening Pain with lifting Occasional neck pain radiation Usually no numbness/tingling

“Bursitis/Tendinitis” Treatment Exam XRays NSAID’s Physical Therapy or Home Therapy Steroid Injection MRI

Surgical Treatment “Decompression”

Rotator Cuff Tear

Rotator Cuff Tear Similar Symptoms as Bursitis More pain More weakness Sometimes specific trauma but More often “age related”

MRI Edge of tendon

Rotator Cuff Repair

Instability (Labrum Tears) S.L.A.P. Lesion Bankart Lesion

Repair of the Labrum through the Arthroscope

Trauma Shoulder Separation AC Joint Fall off Bike onto shoulder Usually no surgery (Depends on severity)

Trauma Shoulder Dislocation “Ball and Socket” Joint Often requires ER visit Can lead to recurrent dislocations

Trauma Fracture Common in older population (Usually no surgery) Younger population (more frequent surgery)

“Arthritis” = “Tread Wear” Cartilage Osteoarthritis is a particular type of arthritis which affects the cartilage in the joints, causing it to breakdown and eventually be lost all together. Healthy Joint Osteoarthritic Joint “tread wear”

Arthritis “Acromioclavicular Joint” Normal Arthritis Common in younger patients “Weight lifters”, construction workers

Acromioclavicular Joint Treatment NSAID’s Activity Modification Steroid injection Arthroscopic Surgery (Removal of arthritic end of clavicle)

Arthritis “Ball and Socket Joint”

Shoulder X-Ray Arthritis Advanced Arthritis Normal Joint Space

Arthroscopy – Microfracture small awl used to make holes in bone promote re-growth of cartilage

Shoulder Replacement

Frozen Shoulder (Adhesive Capsulitis)

Frozen Shoulder Treatment Pain control (NSAID’s, steroid medication and injection) Physical Therapy TIME, TIME, TIME Sometimes manipulation of shoulder under general anesthesia

Information Resource www.ShoulderKneeSpecialists.com