How to Treat Common Shoulder Injuries

Shoulder injuries are more common if our joints are subjected to overuse and repetitive activities. While not all require surgery, to prevent them from getting worse, it is essential to address the problem from the onset of the first symptoms so that the specialist can make an early diagnosis and quickly identify the most appropriate treatment.

Common Shoulder Injuries

One of the most common causes of shoulder injuries are tears in the tendons, those tissues that connect the bones to the muscles and make the joints move when they flex. Other injuries may involve the bones, or the muscles themselves.

The most common shoulder problems that can cause lasting pain in the arm up to the elbow include:

• Atrosis.
• Adhesive capsulitis or frozen shoulder.
• Fractures.
• Overuse injuries, such as tendinitis and bursitis.
• Rotator cuff injuries.
• Dislocations.

Arthrosis (Osteoarthritis)

Arthrosis or osteoarthritis of the shoulder is due to degenerative wear and tear of articular cartilage. This acts as a "shock absorber" for stresses caused by friction between the bony heads of the humerus, scapula, and clavicle during movement. Osteoarthritis is a disease related particularly to aging, but it can also be caused by trauma, such as fractures, recurrent dislocations, and rotator cuff rupture.

This condition causes pain and stiffness, making daily activities difficult and negatively impacting quality of life. The main symptoms are:

• Pain localized to the joint or radiating down the arm to the neck, on movement or at rest.
• Lack of strength.
• Limited joint mobility.
• Loss of function.
• Stiffness.
• Joint rocking, noises due to rubbing of bones where cartilage is worn.

Adhesive capsulitis or frozen shoulder

This is a condition that affects the connective tissue capsule, which along with the ligaments is responsible for the movement of the joint.  The capsule surrounds the joint and is lubricated by synovial fluid, which facilitates its mobility. In frozen shoulder, the capsule thickens and shrinks, leading to the development of adhesions. Its causes are many, and include age, gender, previous medical conditions (diabetes, Parkinson's, heart disease, thyroid disease, etc.), immobilization, and prolonged use of medications. The main symptoms are:

• Difficulty or inability to perform simple daily activities such as personal hygiene, dressing, driving.
• Localized pain over the outer shoulder area and sometimes in the arm, occurring most strongly in the morning and during the night, or when moving the arm.
• Limited mobility.

Fractures

Fractures of the three shoulder bones are especially common in the elderly, but can occur at any age following a fall or other trauma.

Symptoms include:

• Pain when extending the arm above the head.
• Swelling.
• Possible presence of a lump.

In more severe and complex cases, the surgeon may choose to proceed with repair or replacement of the joint. The fitting of a prosthesis can be a good solution in cases of both fractures and arthritis and old injuries.

Overuse injuries

Repetitive overuse of the shoulder can lead to two painful conditions:

• Bursitis: when the protective layer around the joint (bursa) that serves to reduce bone friction during movement becomes inflamed.
• Tendonitis: when tendons become inflamed because they are overstressed. Pain often radiates down the arm toward the elbow is felt during movement.

This type of injury is very common, for example, among people who work out at the gym. In this case, modifying the activities you do allows the tendons to heal. In addition, physiotherapy by going to strengthen specific muscles helps to reduce the pressure on the tendons.

Rotator cuff tears

The rotator cuff is the group of muscles and tendons that hold the shoulder in place and allow movement. Often these injuries are due to wear and tear and are more common after age 50, but they can also incur as a result of a fall. Importantly, if damaged, the rotator cuff is unlikely to heal on its own, and if not properly treated, the injury can worsen.

Symptoms may include perceived weakness of the joint and lasting pain that may worsen over time, even to the point of making it difficult to sleep.

Having determined the severity of the injury through a magnetic resonance imaging (MRI) scan, the physician will identify the most appropriate treatment. Modern minimally invasive surgery methods, even in cases requiring surgery, have faster recovery times.

Shoulder Center at UPMC Salvator Mundi International Hospital

If you have shoulder pain, due to injury or otherwise, you can turn to the Shoulder Center at UPMC Salvator Mundi International Hospital. A multidisciplinary team of specialists will follow you through all stages of your care, from diagnosis to physical therapy, from surgery to assisted rehabilitation, even at home.