Naples Shoulder Treatment
Shoulder pain can be extremely debilitating, effecting both function and quality of life. Many suffer years of chronic pain and disability before seeking medical attention. Our practice is dedicated to treating shoulder pain and disability using the most cutting-edge practices in orthopedics. The Boca Raton surgeons at Choice Medical Center are specially trained in sports medicine and shoulder disorders from world-renowned institutions around the country. Using evidence-based practice while considering specific patient-centered goals, we can formulate a treatment plan that is unique to every patient.
Assessment and Diagnosis Of Shoulder Issues
Diagnosing shoulder injuries starts by obtaining a history from the patient and examining the shoulder joint. We consider many patient specific factors in formulating a diagnosis including age, physical activity level, injury mechanism, pain intensity and associated symptomatology. Together, this information helps us focus our assessment to the problem at hand.
For many structural conditions a simple patient history and clinical exam may not be sufficient to pin down a diagnosis. In these cases we may rely on imaging or other testing. X-ray radiography is generally the initial imaging tool. Additionally, we may opt to obtain CT or MRI scans of the relevant anatomy to further characterize the problem and help plan for treatment.
Common Shoulder Conditions
The shoulder is more mobile than any other joint in the body. The downside of such impressive range of motion is an increased susceptibility to joint damage and dysfunction. Our practice treats all orthopedic conditions of the shoulder including traumatic and overuse disorders. Some of the common injuries we treat include:
Rotator Cuff Injuries: Rotator cuff injuries are the most common cause of shoulder pain and instability. The rotator cuff is a special group of shoulder muscles that provide stability and power to the shoulder joint. Tearing or inflammation of the muscles can lead to injury over time. Classically, rotator cuff injuries are caused by repetitive overhead motion common in people who play tennis, swim or golf.
Bursitis/Tendinitis: These injuries occur from chronic overuse. Rubbing and squeezing of the rotator cuff muscles or neighboring structures can lead to inflammation and pain, characteristic of this kind of damage.
Instability/Dislocation: The shoulder joint can become unstable over time as a result of normal wear and tear. Moreover, trauma or repetitive overuse of structures within the joint (labrum, fibrocartilage rim) can lead to overall instability as well. In some cases the arm bone (Humerus) is displaced from the joint entirely leading to dislocation.
Shoulder Stiffness: Shoulder stiffness is a common condition often referred to as “frozen shoulder” or “adhesive capsulitis.” The stiffness is normally caused by contracture of the soft tissues of the shoulder, misalignment of the shoulder joint, or inflammation of surrounding tissues. In many cases, especially in elderly patients, there is no known cause for shoulder stiffness.
Fractures: Fractures of the bones that make up and surround the shoulder are often a result of a traumatic event. Clavicle fractures are very common sports injuries, typically seen in young athletes. Fractures of the arm bone (Humerus) generally occur in adolescents with un-fused growth plates or elderly patients with weak osteoporotic bone.
Shoulder arthritis: Arthritis of the shoulder joint is a result of repetitive overuse commonly diagnosed in the elderly. The joint space contains cartilage, which allows for smooth motion and prevents bone on bone contact within the joint space. Years of wear and tear can break down this cartilage leading to pain and disability of the shoulder joint.
Common Shoulder Treatments We Offer
Our treatment strategies are designed to repair the injury with careful consideration to patient specific factors and quality of life goals. We rely on non-invasive therapies including medication management, steroid injections and physical therapy, when appropriate. Some conditions require surgical intervention to relieve pain or prevent long-term disability. Common surgical treatments we offer include:
Arthroscopy involves insertion of a pencil-sized camera into the shoulder joint known as an “arthroscope”. Additional instruments can be inserted into the shoulder as well. With the guidance of the arthroscope the surgeon can repair tears or damage to shoulder soft tissue structures such as the rotator cuff or labrum. Using specialized equipment the surgeon can also debride scar tissue that results from chronic overuse.
Open shoulder repair
Open shoulder repair involves a surgical incision under general anesthesia or sedation. Open procedures are generally reserved for more complex rotator cuff or soft tissue damage. Newer techniques involve less invasive incisions and faster recovery following shoulder repair. Open reduction internal fixation (ORIF) is a form of open shoulder surgery used to fix fractures and realign bones in the shoulder region for proper healing.
There are various forms of shoulder replacement including hemi-arthroplasty, total shoulder arthroplasty and reverse total shoulder arthroplasty. Hemiarthroplasty replaces just the arm bone with an implant and is generally reserved for younger patients. Total shoulder arthroplasty replaces both the arm bone and shoulder socket with implanted hardware. This is a highly effective surgery and the treatment of choice for arthritic pain in the elderly. Reverse total shoulder arthroplasty is a relatively new procedure reserved for severe degeneration in a patient with a non-functional rotator cuff. This involves reversing the normal ball and socket mechanism of the shoulder joint. In effect, the surgery creates an implanted socket on the arm bone over what was the “ball” of the shoulder. Conversely, an implanted ball is surfaced onto what was the shoulder “socket”.