Shoulders might be the unsung heroes of your body. They’re involved in some way in nearly every move you make, though you may rarely think about them. Until they hurt. They are a complex combination of muscles, tendons and ligaments that factor heavily into our mobility, so shoulder problems can have a serious impact on daily life.
Taking care of your shoulders includes taking action when you experience persistent or recurrent pain. There are treatments that can relieve pain and restore range of motion, but you’ll have more options if you take prompt action to have your pain evaluated by a specialist or a team of professionals—therapists, allied health professionals, athletic trainers—working together.
If you have pain at rest and grinding in the shoulder or limited range of motion, it’s a good idea to have it evaluated with an x-ray. Arthritis is often found to be the culprit. Depending on your diagnosis, age, and other factors, your specialist may recommend medication, physical therapy, or even surgery. If you’re referred for surgery, it’s important to understand potential risks of putting it off or observing and monitoring the progression of arthritis. If you wait too long, risks may include wearing away valuable bone that can improve your recovery and outcome. Many problems can be treated arthroscopically with a minimally invasive approach using small incisions and without an overnight hospital stay. More advanced arthritis problems may require an open surgical approach with a one-night hospital stay.
Many people are finding relief, even for advanced arthritis in the shoulder, with two relatively new and constantly evolving procedures:
- Reverse Shoulder Replacement—a total shoulder replacement in which the position of the ball and the socket in the shoulder joint are reversed. It’s a good solution for people who have both arthritis in the joint and a tear or other problem with their rotator cuff, and a good option for people with rotator cuff problems who are not good candidates for traditional shoulder replacement. It can alleviate pain and improve range of motion, and it allows people to return to a relatively active lifestyle. Reverse shoulder replacement is performed primarily on people age 65 or older.
- Resurfacing Shoulder Arthroplasty—a minimally invasive procedure in which a metal cap is placed on the ball of the patient’s shoulder joint, akin to a thimble worn to protect the finger that pushes the needle while sewing, and the “cup” portion of the shoulder is resurfaced. It can be done on an outpatient basis, often with less bleeding and shorter operative time. It is appropriate for middle-aged, athletic patients with severe arthritis who want to return to their athletic activities.
If you’re considering surgery, ask your doctor about consulting with a shoulder specialist. Studies show that surgeons who do many of these specialized surgeries have the best outcomes.
Ilya Voloshin, M.D., is director of the Shoulder and Elbow Surgery Division, which performs more than 200 shoulder replacement surgeries every year. The Division is part of UR Medicine Orthopaedics and Rehabilitation, with most surgeries performed at Highland Hospital’s Evarts Joint Center.