by guest blogger, Dr. Stephanie Siegrist , author of Know Your Bones [Know Your Bones is a WME publication; Dr. Seigrist was asked to contribute to this blog to add her professional voice in the world of healthcare, something many of us neglect; plus she took care of me when I had a dislocated shoulder! YD]
Women carry the weight of the world on their…shoulders, so take care of yours!
It’s hard to do anything if your shoulder hurts. Each is an intricate piece of machinery with a lot of moving parts:
- Muscles: for support and movement. Strong muscles are stabilizers and shock absorbers.
- Tendons attach muscles to bones. The rotator cuff is made of 4 muscles that merge into 1 tendon to stabilize the ball and socket joint.
- Each has 3 bones: the clavicle (collarbone), scapula (shoulder blade) and humerus (upper arm bone). Joints are formed wherever bones come together; the ends of the bones are covered with cartilage.
- Joints are held together with strong bands called ligaments, and lined with a membrane that lubricates moving parts. Near the rotator cuff, this membrane is called a bursa that helps that tendon glide between bones.
Most problems come from over-exerting a weak shoulder, causing inflammation. They fall into 4 general categories:
- Rotator cuff tendonitis, bursitis and tears. Friction between the shoulder blade and rotator cuff causes irritation, but can wear out the tendon like the sole of a shoe
- Arthritis: wear and tear of the joint cartilage.
- Instability/stiffness: Your shoulder is the most flexible joint in your body, but it’s prone to instability. Scarred, stiff ligaments around the ball and socket cause a Frozen Shoulder.
- Fractures: A broken arm can be the first sign of osteoporosis.
Treatment is geared toward relieving pain and inflammation, restoring range-of-motion, strength and endurance, to return to pre-injury activities or at least maintain function despite worn structures.
- Exercises build resilience and correct the unbalanced biomechanics that caused pain in the first place. Be consistent for the exercises to “work”.
- Tools, like ice or heat and ergonomic desk tools. Alternative treatments like massage and acupuncture might help.
- Medicine: Take only enough to relieve your pain. Once you feel better, take it less often to minimize side effects. Keep track of what you take.
- Injection of cortisone sends medicine right to the problem, quieting inflammation so you can start your exercises. There’s no hard-fast rule about how often you can have it; you may have heard “only 2 or 3 shots per year.” At this rate, you’re getting 4-6 months of relief. If the pain comes back, it might be time for surgery.
- Surgery corrects structural problems that won’t resolve otherwise: smoothing bone spurs, repairing a torn rotator cuff, fixing a fracture or resurfacing an arthritic joint.
How much treatment you need, and how long it takes to feel better, depends on the cause and severity of your pain, your lifestyle and expectations.
Start simple with rest, over-the-counter medications and avoiding painful activities. Correct body mechanics and basic fitness are critical, no matter what else is done. If your painful shoulder keeps you from what you enjoy, you deserve an accurate diagnosis and effective treatment plan to get on the road to recovery!
Stephanie E. Siegrist, MD is an orthopaedic surgeon in Rochester, NY who specializes in elective, outpatient care of “hands, shoulders knees and toes.” Find out more http://www.knowyourbones.com