Shoulder Conditions: Restoring Everyday Motion

Think about these every day movements: reaching for a can on a supermarket shelf, shampooing your hair, changing the car radio. Consider these tasks with shoulder pain or without fluid shoulder mobility.

The shoulder is the most movable and flexible joint. This very flexibility also makes it one of the most fragile joints, prone to sudden injury—such as that experienced by a major league pitcher who tears a rotator cuff—and wear and tear from every day use.

“Shoulder pain is relatively common,” says William D. Emper, M.D. , orthopedic surgeon at the Bryn Mawr Hospital Orthopedic Center in the Philadelphia suburbs. "Early diagnosis and treatment should be a priority for anyone experiencing persistent shoulder pain or weakness to prevent it from progressing to more serious consequences."

Common Shoulder Conditions
The leading cause of shoulder pain is a group of conditions called shoulder impingement syndrome. With any of these problems, a continuous dull ache can become a sharp pain when you try to move your arm, especially over your head.

Bursitis is an irritation of the bursa, a fluid-filled sac providing a cushion between the rotator cuff tendons and the shoulder bone.

Tendonitis is a swelling of the tendons of the rotator cuff deep in the shoulder that, along with muscles, help stabilize the upper arm bone in the shoulder joint and allow the arm to rotate.

Irritated rotator cuff occurs when excessive wear leads to severe irritation, roughening, and eventually ulceration and tearing of the cuff.

Shoulder pain can also occur with arthritis, cartilage tears, tears of the labrum (soft, fibrous tissue rim that surrounds the shoulder socket), or a dislocated shoulder (when the ball comes partially or completely out of the socket).

Treating Shoulder Injuries
"A large percentage of shoulder conditions are treated conservatively with anti-inflammatory medications, rest, ice, or cortisone injections," Dr. Emper said. "Once the pain and inflammation are under control, a program of physical therapy can help many patients regain motion."

When these treatments don't bring relief, surgery may be recommended. Many shoulder problems -- including impingement syndrome, rotator cuff tears, torn cartilage, and an unstable joint -- can be corrected through arthroscopy, a minimally invasive surgical technique. In some cases, however, if the damage is severe, a shoulder replacement is the only option for pain-free motion.

"People with shoulder pain tend to wait to seek treatment, which is appropriate to some degree," says orthopedic surgeon, Joseph V.Vernace, M.D. "But when rest, ice, and anti-inflammatory medications are not effective, that indicates the need to be evaluated. When necessary, shoulder surgery is highly effective. Many patients, in fact, say that they wish they had sought treatment earlier."

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