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The well trained orthopedic surgeons at Cedars-Sinai Marina del Rey Hospital evaluate patients with shoulder and elbow disorders and provide an individualized treatment option for each patient. They can choose from the various non-surgical and surgical treatments available. The treatment that works best for your symptoms and severity of disorders involving your shoulder and elbow is considered.
Shoulder and elbow pain is more often seen in people of the age group of 25 and above. Painful shoulder limits your day to day activities. These injuries most commonly affect athletes, laborers, homemakers, and people working continuously on a computer device. Shoulder and elbow pain develop when the muscles and ligaments of the shoulder get stretched beyond their limits due to frequent repetitive activities. Prevention is always considered to be far better than curing these disorders.
If medications and non-surgical treatment do not resolve the problem, surgical intervention will be necessary. Your doctor will conduct thorough diagnostic tests that are necessary to confirm and determine the extent of the shoulder pain and decide the need for surgery. Surgical techniques, either a keyhole surgery called arthroscopic surgery or open surgery that requires a larger incision are chosen.
Fracture repair surgery: Fracture repair is done if the proximal humerus, glenoid, scapula, clavicle, humerus bones of the shoulder are broken. The surgical incision is made and the broken ends of the bone are realigned together and stabilized with the help of metallic plates, screws, wires, and rods.
Rotator cuff repair: This surgery is done to repair the torn rotator cuff in which the tendons get pulled away from the humerus bone. It is a minimally invasive technique to reattach the torn rotator cuff tendons back to the bone.
Labral repair: In this surgery, your surgeon will reattach the torn labrum cartilage with the help of stitches or entirely remove the torn part of the cartilage.
Arthroscopic capsular shift: This surgery is performed to tighten the shoulder joint. With the help of an arthroscope and other instruments the bottom and top part of the shoulder as well as the capsule is brought together and stitched.
Arthroscopic acromioplasty: In this surgery, a part of the acromion surface that is damaging the tendon is removed. This is usually done to rectify severe cases of impingement syndrome seen in elderly patients.
Arthroscopic capsular release: This is usually performed in patients with frozen shoulder. The tight capsule of the shoulder is released surgically with the help of an arthroscope. Scar tissues and adhesive substances restricting the shoulder’s movements will also be removed during the surgery.
Distal clavicle resection: In this surgical procedure, a small portion of bone at the end of the clavicle, which is close to the acromion is removed to create more space and reduce painful movements.
Bankart, capsular shift surgery: With the help of screws or anchors, the lesion of Bankart is resolved by getting together the labrum cartilage.
Acromioclavicular joint surgery: In this surgery, the acromioclavicular joints are stabilized with the help of screws or suture loops. At times, artificial ligaments are also used.
Tendon transfer surgery: The tendon attached to the bone is detached and reattached to a different bone or tendon.
Nerve decompression surgery: This surgery is usually done to resolve the compression of the ulnar nerve. An incision is made along the elbow to explore the ulnar nerve from the upper arm to the triceps muscles and forearm and it is decompressed. The connective tissues and skin are sutured back.
Shoulder replacement surgery: This surgery involves replacement of the ends of the damaged upper arm bone called humerus, shoulder bone called scapula with an artificial cap and ball structure made of plastic or metal.
Nonunion and malunion surgery: In conditions where nonunion or malunion of fracture occurs, open surgery is done to realign the fractured bones to its normal position and stabilized with the help of rods, plates, screws, or wires.
The symptoms of shoulder and arm disorder may vary depending on the nature of the injury, and the common symptoms include:
Physical examination: Your doctor will ask certain questions related to the symptoms of the shoulder or elbow disorder. The region of pain or discomfort will be physically examined for stiffness, swelling, tenderness, pain, bruises and bone damage.
Laboratory tests: Laboratory tests including blood and urine test will be conducted to find out the level of uric acid and rheumatoid factor to preclude arthritis. Tests will be performed on the fluid withdrawn from the bone joint space to find the bacteria infecting the joints or to understand the abnormal chemical composition.
X-ray: Using an X-ray, the condition of the bones and joints can be determined.
Computed tomography scan: Specialized X-rays are targeted to the affected area, and the image is visualized on a monitor. This is better than X-rays as soft tissues, bones, muscles, ligaments, tendons and cartilage can be viewed.
Bone scan: A radioactive material called contrast dye is injected into the blood stream. As it is absorbed by the bone, with the help of X-rays the images can be examined for damages.
Videofluoroscopy: With the help of the X-Ray and the injected dye as a contrast material, the internal structure of the joints and their movements can be visualized on a monitor screen in the form of a video.
Magnetic resonance imaging (MRI): It is the best of the imaging tests as MRI scanning produces more sophisticated images than a CT scan. A combination of magnetic field, radio waves, and contrast dye are used to view a specific body structure.
Age: As the age progresses, people become more prone to weak bones and diseases such as arthritis leading to joint disorders.
Sports activity: Active participation in sports increases the risk of falls and injury. Playing sports such as tennis, badminton, and baseball exerts a lot of repetitive straining of the hands, shoulders, and wrists.
Overuse: Excessive use of hands and wrist such as while using the keyboard, playing musical instruments, cooking for a long duration can result in soft tissue damages.
Occupation: People who are required to perform repetitive hand and wrist movements at their workplace are at an increased risk of shoulder and elbow disorders.
Shoulder and elbow pain are typically caused due to a combination of weak muscle as well as straining. Straining the weak muscles by lifting heavy weights and applying pressure during daily activities can cause shoulder and elbow pain. Arthritis is one of the conditions in which the bones become weak and start wearing out quickly, resulting in damage to other structures around.
Other causes of shoulder pain are:
Application of cold packs: Minimizing the temperature at the affected area by placing packs of ice cubes may alleviate pain and swelling.
Acupressure: Applying gentle pressure at specifically identified points on the shoulder and neck has given relief from many of the shoulder and elbow symptoms.
Massage: Gentle massage of your hands, shoulders, and neck may be beneficial as it improves blood circulation and reduces pain.
Although shoulder and elbow injury cannot be prevented, you may follow these steps to reduce your risk of getting injured:
Exercise: Regular exercises make the muscles and bones strong, and your body becomes more flexible.
Warm-up activity: Warm-up exercises such as stretching should be a regular practice before starting and after any physical activity.
Sportswear: Wear comfortable and suitable clothing and protective gears while participating in sporting activities to prevent any untoward incidents.
Diet: Eating a healthy balanced diet helps in maintaining yourself physically fit, and enables quick recovery from injury.
Safe surroundings: To avoid injuries, keep your surroundings safe from potential hazards of injury. Use seat belts and follow other safety measures while traveling or at work.
Support: While performing hazardous activities, it is better to get some help and support from other people and use appropriate equipment.
Keep to your limits: Do not try to exceed your limitations, which means carry out only those activities in which you are well-versed, capable, strong, and only if you have the right tools to perform the task.
Are you suffering from shoulder or elbow pain? For any questions, information or guidance related to shoulder and elbow disorders, consult our orthopedic specialists, at Cedars-Sinai Marina del Rey Hospital.
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