ORTHOPEDICS/SHOULDER & ELBOW/SHOULDER DISORDERS
Shoulder problems are the most Commonly difficulties that people endure all over the world.
Shoulder disarticulation and separation
Tendinitis, Bursitis, Impingement disorder, Torn rotator cuff, Frozen shoulder, Shoulder crack, Shoulder Arthritis and other damages may cause Shoulder disarticulation and/or separation.
Shoulder Problems/Reasons
Knowing that the shoulder is the most flexible joint in the body, a shoulder unsteadiness is common due to its wide motion range.
To keep stability, the shoulder must anchored firmly to its muscles, tendons, and ligaments; therefore, shoulder problemes mostly arise from the disturbance of these soft tissues resulting from a shock and overuse or underuse shoulder activity.
Shoulder Problems/Diagnosis
Here are some of the behaviors performed to diagnose shoulder problems: Listening to patient’s medical history, Physical exam to assessing damage, restraining motion, locating pain and checking joint unsteadiness.
In addition, X-rays, Arthrograms (i.e., contrast fluid and x-rays utilization), MRI and Anesthetic Injection.
Shoulder Disarticulation
Clasically, a shoulder disarticulation occurs due to a strong force that pulls the shoulder outward causing abduction, or an extreme rotation of the joint that blows out the humerus ball of the shoulder socket.
Shoulder unsteadiness is attributed to a disorder of a displacing shoulder.
On the other hand, when the upper arm bone is partially out of the socket, a partial disarticulation known by subluxation, is enhanced
Disarticulation Symptoms
The shoulder can disarticulate either forward, backward, or downward. In case of, the muscle seizures may increase the pain intensity.
Most of the disarticulation Signs include: inflammation, impassiveness, weakness and staining
Shoulder Disarticulation/Therapy
Therapy consist of putting the humerus ball back into the socket joint.
This process is called a reduction. The arm is then immobilized in a device called shoulder immobilizer for several weeks.
Relaxation and ice applying three to four times daily are frequently recommended.
A rehabilitation program (includes some specific exercises) may be followed to restore the shoulder motion range and to strengthen the muscles avoiding future disarticulations.
In some cases, disarticulation is repeated; therefore a time-tested open surgery under direct vision is recommended to restore a recurrent shoulder disarticulation.
Shoulder Separation
A shoulder separation a damage occurring when the collar bone (clavicle) meets the shoulder blade (scapula).
It frequently happen when the ligaments that hold the joint together are partially or completely torn.
Most often, the shoulder separation damage is due to a blow to the shoulder or by a brutal fall on an outstretched hand.
Shoulder Separation/Symptoms
Shoulder pain, tenderness and rarely a collision are the most frequent Shoulder Separation signs.
Shoulder Separation Therapy
Relaxation and sling wearing generally treat a shoulder separation.
Ice applying to relieve pain and inflammation are also performed.
However, if ligaments are severely torn due to shoulder separation injury, a surgical intervention may be performed to maintain the clavicle in the right place.
What Are Tendinitis, Bursitis, and Impingement Syndrome of the Shoulder?
Tendinitis, bursitis, and impingement syndrome of the shoulder are closely related and may occur alone or in combination. If the rotator cuff and bursa are irritated, inflamed, and swollen, they may become squeezed between the head of the humerus and the acromion. Repetitive motion involving the arms may affect shoulder motion over many years. It may irritate and wear down the tendons, muscles, and surrounding structures, too.
Tendinitis is inflammation (redness, soreness, and swelling) of a tendon. In tendinitis of the shoulder, the rotator cuff and/or biceps tendon become inflamed, usually as a result of being pinched by surrounding structures. The injury may vary from mild inflammation to involvement of most of the rotator cuff. When the rotator cuff tendon becomes inflamed and thickened, it may get trapped under the acromion. Squeezing of the rotator cuff is called impingement syndrome.
Tendinitis and impingement syndrome are often accompanied by inflammation of the bursa sacs that protect the shoulder. An inflamed bursa is called bursitis.
Inflammation caused by a disease such as rheumatoid arthritis may cause rotator cuff tendinitis and bursitis. Sports involving overuse of the shoulder and occupations requiring frequent overhead reaching are other potential causes of irritation to the rotator cuff or bursa and may lead to inflammation and.
Tendinitis, Bursitis Symptoms
Early symptoms of tendinitis, bursitis and Impingement appears:
- When a Slow onset of uneasiness accompanied with pain in the upper shoulder occur
- When there is Trouble sleeping on the shoulder
Tendinitis, Bursitis and Impingement/Diagnosis
Diagnosis of tendinitis and bursitis and Impingement classically starts with a medical history and physical exam. X-rays will follow.
In addition, Impingement disorder may be confirmed with the injection of a small quantity of anesthetic (lidocaine hydrochloride) into the space under the acromion get rid of the pain.
Tendinitis, Bursitis and Impingement Disorders/Therapy
Treating these disorders consist of reducing pain and inflammation with relaxation, ice applying, and anti-inflammatory medicines such as:
Aspirin, Naproxen (Aleve, Naprosyn), Ibuprofen (Advil, Motrin, or Nuprin), COX-2 inhibitors.
Torn Rotator Cuff
A rotator cuff is an assemblage of four muscles with tendons that attach the muscles to the bone.
A torn rotator cuff occurs when one of these elements is damaged.
Torn Rotator Cuff/Symptoms
Classically, an individual with a rotator cuff damage feels pain over the deltoid muscle at the top and outer side of the shoulder, expressly when the arm is extended out or raised.
Torn Rotator Cuff/Diagnosis
A rotator cuff tendon is diagnosed when pain or weakness on outward or inward rotation of the arm reflect a tear. The patient also feels pain when lowering the arm to the side after the shoulder is moved backward and the arm is raised.
A physical exam may detect weakness (but may not be able to define the tear location.
X-rays are most of the time unuseful.
MRI can help detect a full tendon tear, (but does not show partial tears).
Finally, these therapies are supposed insufficient and pain persists, reatment, an arthrogram is performed.
Torn Rotator Cuff/Therapy
Typically, surgeons recommend shoulder relaxation, ice applying with intake of classical medicine to relieve pain and inflammation.
Other therapies might be added, such as: Cortisone injection near the the rotator cuff inflamed, and muscles and nerves electrical stimulation.
Ultrasound therapy
Wearing a sling for a few days is sometimes recommended.
In addition, if surgery is not an urgent consideration, physical exercises may be added to rebuild flexibility and strength as also to restore the shoulder’s function.
Torn rotator cuff/Arthroscopic (or open surgical restoration).
Frozen Shoulder
In this case, and as it name indicates, the shoulder motion is seriously limited with “frozen shoulder” disorder resulting from lasting pain without treatment.
Higher risk for frozen shoulder often arises with certain specific conditions including: Diabetes, Hit, Lung disease, Rheumatoid arthritis, and Heart disease.
Note that this disorder is rarely appearing with individuals under 40.
Frozen Shoulder/Symptoms
Joint tightness and stiffness often lead to nearly impossibility to carrying out simple motions with a frozen shoulder, such as raising the arm, enhancing disturbance that it may worsen at night.
Frozen Shoulder Therapy
Frozen shoulder therapy focuses on reestablishing the joint motion and reducing shoulder pain.
Commonly, therapy starts with nonsteroidal anti-inflammatory medications with heat application, followed by smooth stretching exercises.
In some cases, transcutaneous electrical nerve stimulation (TENS) with a small battery-operated unit may be performed to lessen pain by spoiling nerve impulses.
If all these actions are unsuccessful, a shoulder manipulation is recommended under general anesthesia.
In other critical cases, Surgery to cut the adhesions is required.
Shoulder Crack/Signs, Diagnosis Therapy
Commonly, a crack involves a partial or total crack through a bone. It usually involves the clavicle or the neck (the zone below the ball) of the humerus.
A shoulder crack that happens after a brutal shock is usually accompanied by serious pain, followed by redness and bruising around the affected zone.
When a crack happens, the surgeon task will be to bring back the bones into a position that will enhance healing and restore arm motion.
In case the clavicle is cracked, the injured must at first wear a strap and sling around the chest to keep the clavicle in place.
Exercises to strengthen the shoulder and restore movement will follow the strap and sling removal.
Shoulder Arthritis
Arthritis is a disease caused by the cartilage wearing and tearing (osteoarthritis) or inflammation (rheumatoid arthritis).
Note that Arthritis not only affects joints; it may also affect the entire supporting assemblage such as muscles, tendons and ligaments.
Shoulder Arthritis/Signs, Diagnosis and therapy
Pain is the standard symptom of all bones damages, particularly the shoulder arthritis.
Inflammation that may occur to the joints is the second sign.
Diagnosis may be attested by a physical exam and X-rays.
Blood tests will follow to help diagnosing rheumatoid arthritis.
Analysis of the synovial fluid from the shoulder joint may also be helpful in diagnosing some kinds of arthritis. Although
Arthroscopy permits direct visualization of cartilage, tendons, and ligaments damage as it may confirm a diagnosis.
The therapy Mostly performed is the shoulder osteoarthritis that is treated with nonsteroidal anti-inflammatory medicines, such as aspirin, ibuprofen, COX-2 inhibitors