Shoulder Injuries and Replacement

Shoulder Pain

Shoulder pain may arise from the shoulder joint itself or from any of the many surrounding muscles, ligaments or tendons. Shoulder pain that comes from the joint usually worsens with activities or movement of your arm or shoulder.

Various diseases and conditions affecting structures in your chest or abdomen, such as heart disease or gallbladder disease, also can cause shoulder pain. Shoulder pain that arises from another structure is called referred pain. Referred shoulder pain usually doesn't worsen when you move your shoulder.

To relieve minor shoulder pain you might try:

  • Pain relievers. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) may help.
  • Rest. Avoid using your shoulder in ways that cause or worsen pain.
  • Ice. Apply an ice pack to your painful shoulder for 15 to 20 minutes a few times each day.

Often, self-care measures and a little time could be all you need to relieve your shoulder pain.

Make an appointment with an orthopedic surgeon if your shoulder pain is accompanied by:

  • Swelling
  • Redness
  • Tenderness and warmth around the joint

Rotator Cuff Injury

The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens when you try to sleep on the involved side.

Rotator cuff injuries occur most often in people who repeatedly perform overhead motions in their jobs or sports. The risk of rotator cuff injury also increases with age.

Many people recover from rotator cuff disease with physical therapy exercises that improve flexibility and strength of the muscles surrounding the shoulder joint.

Sometimes, rotator cuff tears may occur as a result of a single injury. In those circumstances, medical care should be provided as soon as possible. Extensive rotator cuff tears may require surgical repair, transfer of alternative tendons or joint replacement.


Shoulder Joint Replacement

In shoulder replacement surgery, the damaged parts of the shoulder are removed and replaced with artificial components, called a prosthesis.

The treatment options are either replacement of just the head of the humerus bone (ball), or replacement of both the ball and the socket (glenoid).

Several conditions can cause shoulder pain and disability, and lead patients to consider shoulder joint replacement surgery. These include:

Osteoarthritis (Degenerative Joint Disease)

This is an age-related "wear and tear" type of arthritis. It usually occurs in people 50 years of age and older, but may occur in younger people, too. The cartilage that cushions the bones of the shoulder softens and wears away. The bones then rub against one another. Over time, the shoulder joint slowly becomes stiff and painful.

Rheumatoid Arthritis

This is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness. Rheumatoid arthritis is the most common form of a group of disorders termed "inflammatory arthritis."

Avascular Necrosis (Osteonecrosis)

Avascular necrosis is a painful condition that occurs when the blood supply to the bone is disrupted. Because bone cells die without a blood supply, osteonecrosis can ultimately cause destruction of the shoulder joint and lead to arthritis. Chronic steroid use, severe fracture of the shoulder, sickle cell disease, and heavy alcohol use are risk factors for avascular necrosis.

There are several reasons why an orthopedic surgeon may recommend shoulder replacement surgery. People who benefit from surgery often have:

  • Severe shoulder pain that interferes with everyday activities, such as reaching into a cabinet, dressing, toileting, and washing.
  • Moderate to severe pain while resting. This pain may be severe enough to prevent a good night's sleep.
  • Loss of motion and/or weakness in the shoulder.
  • Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, or physical therapy.
Consult with an orthopedic surgeon to determine the best treatment options for your shoulder ailments.