The shoulder is a common source of disability, often resulting from traumatic and degenerate tears of the rotator cuff or labrum, subacromial bursitis, impingement, and osteoarthritis. Nonoperative management has too often focused on narcotics, other analgesics, anti-inflammatory medications, and steroid injections such as cortisone.
The proper diagnosis of shoulder pain is essential in order to determine the root cause of the problem and the proper method of treatment. Because many shoulder conditions are caused by specific activities, a detailed medical history is an invaluable tool. A physical examination should also include screening for physical abnormalities, including swelling, deformity, muscle weakness, and tender areas, along with the range of shoulder motion.
What about rotator cuff?
There has long been a debate over the effectiveness of rotator cuff tear surgery. Numerous medical studies have shown that the re-tear rate of a surgically repaired shoulder can be anywhere from 20% to 90%, depending on the patient’s particular circumstances. Australian researchers presenting at the American Academy of Orthopaedic Surgeons (AAOS) 2012 Annual Meeting said that the failure rate they measured among 500 patients was 57%.
Researchers say that despite increasing medical knowledge, treating the rotator cuff remains one of the most challenging tasks in medicine. The problem? Continued shoulder tearing and degeneration after surgery.
More articles on shoulder problems
Avoiding shoulder replacement surgery
Here is a new report from doctors at the Mayo Clinic. It was published in the Journal of shoulder and elbow surgery December 18, 2017 edition.
An over-expectation of what shoulder surgery can do
We will see many patients after a shoulder surgery with less than hoped for results. One reason the surgery was not thought to be a success was the patient’s over-expectation of what the surgery could do and how fast they could return-to-play their favorite activity.
Slap Tears and Bicep tendinopathy
A January 2018 study from the Hospital of Special Surgery and the Mayo Clinic discussed the diagnostic and treatment challenges presented by injuries to the biceps and superior labral complex.
Alternatives to shoulder replacement
We do a lot of research in our clinic, one topic we research often is shoulder osteoarthritis. It truly amazes me how many new studies there are on the problems of shoulder replacement and fixing a failed replacement. Here is a February 2018 study from a Swedish research team. It appears in the journal Acta orthopaedica and discusses shoulder hemiarthroplasty.