Shoulder

Are you suffering with shoulder pain?

There are several shoulder related diseases that cause pain, discomfort or inability to move the shoulder properly, thus causing discomfort in day to day activities. Many patients suffer for years due to lack of proper knowledge of shoulder problems and lack of access to a specialized shoulder clinic. Shoulder joint is a ball and socket type of joint similar to the hip joint. Humeral head forms the ball and glenoid forms the socket. The joint is covered by a thin layer called capsule and group of muscles called rotator cuff. The rotator cuff muscles pass under a bony arch called acromion. These muscles are important for the smooth movements of the shoulder. Disease process can affect any of the above structures.

FROZEN SHOULDER:

Frozen Shoulder mostly affects the elderly and diabetics who experience severe pain and stiffness of joint. It occurs due to inflammation and contracture of the capsule portion of the joint. This condition can be treated with good physiotherapy done under the supervision of a shoulder surgeon and shoulder physiotherapist. In severe cases this problem can be treated with advanced key-hole surgery (arthroscopic surgery).

SHOULDER DISLOCATION:

In some patients the ball (humeral head) comes out of the socket (glenoid), a condition called dislocation. It is associated with severe pain and inability to move the shoulder. It may happen due to injury to shoulder during falls, road traffic accidents or while playing sports. This condition commonly affects younger people and these patients stop all sporting activities and other high demand jobs as they develop a fear of repeated dislocations. In many of these, patients this condition can successfully be treated with key-hole (arthroscopic) surgery.

ROTATOR CUFF PROBLEMS:

Rotator cuff can get damaged due to ageing process or due to injury caused by falls, road traffic accidents etc.  In some cases athletes who play sports like cricket, tennis, volleyball etc., tend to overuse their rotator cuff leading to wear and tear which causes severe pain especially with movements of the shoulder and a lack of strength to lift the shoulder. If neglected, patients may develop arthritis of the shoulder over years. In many patients if this condition is identified in time, it can be treated with key-hole (arthroscopic) surgery.

ARTHRITIS OF THE SHOULDER:

Just like hip or knee joints, the shoulder joint can get affected by arthritis. The affected patient will experience pain, restriction of movements and a grating sensation of the joint. Arthritis can be caused due to osteoarthritis (in older population), rheumatoid arthritis, old injury to the shoulder, neglected rotator cuff tears, neglected dislocations of the shoulder etc.

TREATMENT MODALITIES

PHYSIOTHERAPY:

Many of the shoulder problems can be treated with proper physiotherapy exercises done under the supervision of specialist shoulder surgeon and specialist shoulder physiotherapist. Surgical treatment is considered when it is thought that physiotherapy will not improve the patients’ condition.

KEY-HOLE OR ARTHROSCOPIC SHOULDER SURGERY:

Arthroscopic shoulder surgery which is the latest advancement in in the area of shoulder surgery is a boon to patients. In this procedure a key –hole sized (<1cm) incision is made on the shoulder and small telescope is passed into the shoulder joint and the joint is viewed on a television screen. Various defects in the joint can be identified and treated at the same time.

What are the advantages of key-hole surgery over traditional surgery?

Arthroscopic surgery is a very advanced surgery and the entire joint can be examined in one go. It also makes possible correction of multiple defects at one time. It causes very little pain. Patient can be discharged on the same day of surgery or the next morning after surgery. Patients can return to work at an early date.

What are the conditions that can be treated with key-hole surgery?

At present, most of the shoulder problems can be treated with arthroscopy, and only occasionally one has to undergo an open surgery. Frozen shoulder, Shoulder dislocations and Rotator cuff problems etc. are some of the common conditions that can be treated efficiently with present day arthroscopic techniques.

MINI-OPEN OR OPEN SURGERY:

In some patients when the condition of the joint is not suitable for key-hole surgery, a small opening is made into the joint just like traditional orthopaedic surgery and the repair is carried out.

SHOULDER JOINT REPLACEMENT:

On rare occasions when the shoulder joint is severely damaged due to arthritis, fracture etc., the damaged joint is replaced with artificial joints made up of metal and plastic. This procedure is similar to the joint replacement surgery done in knee and hip joints. Different types of artificial joints are available to treat different problems.