Treatment varies to address shoulder pain and injuries

Many years ago I dislocated my shoulder. How it happened is pretty stupid, involving a metal cooler, an icy dock, a boat, a wind storm, Halloween and a few drinks.

I won’t say any more except that it really hurt. It’s the pain, not the event I’ve been thinking about lately as I’ve heard of several friends undergoing rotator cuff surgery. Plus, I’ve been discounting a bit of shoulder pain as being that old fishing injury and arthritis. But is it?

The American Academy of Orthopedic Surgeons website explains that our shoulders are made up of several joints that combine with tendons and muscles to allow a wide range of motion. Actually, the widest range of all our joints. We can scratch our own backs, throw a ball, swing a golf club and lift a baby over our heads. Can’t do that with our knees!

“Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle),” AAOS says. “The head of your upper arm bone fits into a rounded socket in your shoulder blade. This socket is called the glenoid.

“A combination of muscles and tendons keeps your arm bone centered in your shoulder socket. These tissues are called the rotator cuff. They cover the head of your upper arm bone and attach it to the shoulder blade.”

Whew, no wonder so much can go wrong! Most shoulder problems fall into four major categories: tendon inflammation (bursitis or tendonitis) or tendon tear; instability; arthritis and fracture.

Mayo Clinic’s website says to make an appointment with your healthcare provider if pain is accompanied by swelling, redness, tenderness and warmth around the joint. Ask someone to drive you to Immediate Care or Emergency if the joint appears deformed, you can’t use it because of intense pain or if there’s sudden swelling.

The practitioner will evaluate your pain and your general health. You’ll also be asked a lot of questions about when the pain started and all the activities you’ve participated in recently. Any previous pain and treatment will also be discussed.

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Then, you’ll probably undergo tests. X-rays will show if there is an injury to the bone; magnetic resonance imaging (MRI) and ultrasound will look at the soft tissues; computed tomography (CT) scan will give a very detailed view of the bones; an electrical study will evaluate nerve function. You may also need an anthrogram which is a dye injected x-ray study and/or arthroscopy which is when the doctor looks inside the joint with a fiber-optic camera.

That all sounds pretty complicated compared to the first line of treatment that is, you know this is coming, stopping the activity that causes the pain. “Common sense solutions such as avoiding overexertion or overdoing activities in which you normally do not participate can help to prevent shoulder pain,” AAOS advises.

Treatment may also include physical therapy to help improve shoulder strength and flexibility and a prescribed medication to reduce inflammation and pain. Sometimes an injection of numbing medicines or steroids to relieve pain will be recommended.

The good news is that the AAOS says that although surgery may be required to resolve some shoulder problems, “90 percent of patients with shoulder pain will respond to simple treatment methods such as altering activities, rest, exercise, and medication.”

The Mayo Clinic reminds us that “certain diseases and conditions affecting the structures in your chest or abdomen, such as heart disease or gallbladder disease, also may cause shoulder pain. Shoulder pain that arises from some other structure is called ‘referred pain.’ Referred shoulder pain usually doesn’t worsen when you move your shoulder.” That’s when you call 911.

Kathy Hubbard is a trustee on Bonner General Hospital Foundation Board. She can be reached at 264-4029 or kathyleehubbard@yahoo.com.