Naples Orthopedic Surgeon - Dr. Robert J. Zehr » shoulder joint

Shoulder pain caused by bone spurs

admin — Thu, 17 Jun 2010 15:51:57 +0000

What is calcific tendinitis? My mother had an X-ray and this is what they found that’s causing her shoulder pain.

Calcific tendinitis or bone spurs occur when calcium deposits around the shoulder cause pain. The deposits occur most often in the supraspinatus tendon that goes across the top of the shoulder.

The pain is unrelated to shoulder position or activity. Adults between the ages of 30 and 50 are affected most often.

It’s not clear what causes this problem. Scientists aren’t sure if it’s an inflammatory response or caused by tendon injury. Many people have calcific tendinitis without any symptoms.

Others have severe pain made worse by even the slightest shoulder movement. The size of the deposit doesn’t seem to predict the amount of pain.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

What causes total shoulder replacement to fail?

admin — Thu, 10 Jun 2010 01:36:22 +0000

Two years ago, I had a total shoulder replacement. Now, I have painful clicking and popping in that shoulder. The doctor thinks I have a failed replacement. What could have caused this to happen?

In about one-third of all cases, implant failure occurs after some kind of trauma. In other patients, bone loss contributes to joint failure. This may occur as a combination of decreased bone density from osteoporosis and bone removal during the operation.

A recent study at the Mayo Clinic reports results after shoulder replacement. Failures were often caused by more than one factor. Muscle tears, improper position of the implant, and tension in the joint capsule were all listed as possible causes. Soft-tissue imbalance was present in all cases.

Time for total shoulder replacement? Not so fast!

admin — Fri, 04 Jun 2010 13:41:18 +0000

I have arthritis in my left shoulder. It hurts constantly, but I can use it for most things. How can you tell when it’s time for a shoulder replacement?

The first place to start is with a medical exam. An orthopedic doctor is the specialist to see for this kind of problem. In some cases, medications and exercise may be all that’s needed. Muscle weakness can cause pain. A good rehab program can reduce pain, improve motion, and increase strength.

Sometimes, surgery to repair a torn tendon or muscle is advised. Many patients with shoulder pain have undiagnosed soft tissue damage. This could have happened years ago after a fall or other injury. A total joint replacement isn’t always the first answer to shoulder problems.

How late is too late to treat rotator cuff tear?

admin — Thu, 22 Apr 2010 22:17:18 +0000

Years ago, I tore my rotator cuff while lifting and carrying children in a daycare. I couldn’t take time off from work for physical therapy or surgery then. Now, I have chronic pain that’s worse at night. Is it too late for treatment?

Maybe not. Untreated rotator cuff tears can lead to wear and tear on the shoulder joint. A chronic tear with arthritis often results in restricted and sore shoulder motions. Severe pain is reported with daily activities and at night.

Doctors offer several methods of treatment for this problem. The joint can be cleaned out, fused, or replaced. Removing fragments of tissue, scraping off bone spurs, and opening the joint space can help. Fusion eliminates pain, but also restricts motion.

Replacing the joint is a third option. One or both sides of the joint is removed and replaced. If both sides are involved, it’s called a total joint arthroplasty. If only one side is altered, it’s a hemiarthroplasty.

Therapy needed for soldier with shoulder problem

admin — Mon, 12 Apr 2010 12:11:16 +0000

I am a 24-year old soldier in the U.S. Army. During basic training, I did hundreds of push-ups in a single hour. Two days later, I developed a problem called rhabdomyolysis. I’ve been taken off all physical training and go to physical therapy instead. Will I ever be able to do push-ups again?

Yes. Military physical therapists have a special program worked out for soldiers with this problem. Rehab begins with range of motion exercises and works toward getting back full motion. Stretching and resistive exercises are slowly added.

Push-ups are also added slowly and start with a modified form. Modified push-ups include wall push-ups, then push-ups done from a high table top. Before going to regular push-ups, the exercise is done from a low table. When the patient is ready, wide arm, diamond, and single-arm push-ups can be included.

Do you have arthritis of the collarbone? More than 50% of adults over 60 do.

admin — Wed, 31 Mar 2010 13:16:52 +0000

Of all things, I’ve come down with arthritis of the collarbone (where it attaches to the chest). I’ve never heard of this before. Most of my friends have arthritis of the shoulders, hips, or hands. Am I a rare case?

Not too rare. The most common problem affecting this joint (called the sternoclavicular joint or SCJ) is osteoarthritis. Degenerative changes from aging make this a disease of the older adult.

Studies show more than half of all adults age 60 or older have moderate to severe arthritic changes in the SCJ. Part of this may be due to the fact that the SCJ is the only place where the bones attach the arms to the main skeleton. Anyone with a history of manual labor or overuse of the arms is at risk for this condition.

Some have painful symptoms, while others do not. Treatment is only needed when pain and loss of motion occur. Surgery is rarely needed. Most patients do well with rest, anti-inflammatory drugs, or local steroid injection.

Mastectomy could be cause of shoulder pain

admin — Thu, 28 Jan 2010 21:55:01 +0000

I’m a 48-year old woman and I had a mastectomy for breast cancer three months ago. Now that I’m back to swimming, I notice I’m having trouble with my stroke. My husband says when I reach forward to stroke, the shoulder blade pops out noticeably. Could this be caused by the mastectomy?

You may be describing an injury to the long thoracic nerve that controls the serratus anterior (SA) muscle. When there is weakness in the SA the shoulder blade or scapula can’t rotate and slide like it should when the arm is lifted up. The result is called scapular winging.

Mastectomy is one possible cause for this problem. During the surgery for the mastectomy, the nerve can get stretched from the position of the arm. There are many other possible reasons such as a viral illness, working with the arms overhead, or lifting a heavy weight.

The best way to know for sure what’s going on is to have some testing done. Electromyography or EMG studies can find out for sure which muscles are involved. Nerve conduction velocity (NCV) tests can be done to see if the nerve is damaged. Talk to your doctor about these symptoms and see what he or she suggests.

Arthroscopic procedure to relieve frozen shoulder pain described here

admin — Wed, 20 Jan 2010 13:27:23 +0000

I’m going to have an arthroscopic release of a frozen shoulder next week. Can you tell me what is done during this operation?

The basic steps to this operation are the same from patient to patient. There may be some small differences based on what the doctor finds during the procedure.

First you will be anesthetized or put to sleep (some patients have a nerve block and remain awake but feel no pain). The doctor will gently mobilize the shoulder joint. This means while lying on your back, your arm will be lifted and rotated inwardly. This shows the doctor how the back (posterior) half of the joint capsule is moving (or not moving if it’s stuck or bound down).

Then the arm is gently moved out to the side away from the body. This motion is called abduction. Next the arm is rotated outward. This is done first with the elbow bent and then with the elbow straight with the arm down at the side. This gives the doctor information about the front (anterior) half of the joint capsule.

In the final step, the doctor uses a special tool (arthroscope) to look inside the joint for any areas of scar tissue, inflammation, or tears in the capsule. The scar tissue will be released and any rough spots shaved smooth. The doctor may cut and remove the joint capsule from the front and the back. Any other damage will be repaired and space made for all structures to move freely.

Most patients are seen in physical therapy right away. Rehab often continues after discharge from the hospital. A home program is essential.

Thermal energy tightens unstable shoulder

admin — Tue, 12 Jan 2010 16:57:49 +0000

I just had a special heat treatment to tighten up an unstable shoulder joint. Now I’m worried that the joint won’t be able to relax. How do they shrink the capsule but still keep the motion? I’m in a sling so I can’t move it just yet anyway.

Studies using thermal energy to heat the shoulder capsule were first done on animals. There were no obvious problems seen afterwards in relaxation of the tissue. Studies were done next on cadavers (human bodies preserved after death for study) and finally, on live humans. Loss of joint motion hasn’t been reported.

If anything there are some concerns that shrinkage alters the elasticity of the tissue. Under too much load there’s a risk of stretching out the tissues. In this case, the shoulder can become unstable again with too much motion.

Your best bet for a good result is to follow your doctor’s directions and report any problems early on.

For information on total shoulder replacement, please visit www.zehrcenter.com.

Is total joint replacement a preventative option?

admin — Wed, 30 Dec 2009 16:26:36 +0000

I need part of my shoulder replaced (the ball portion but not the socket). Will I just develop arthritis in the socket later and need to have it replaced eventually? Maybe I should just have the whole shoulder replaced now. What do you think?

As the old saying goes, “If it’s not broke, don’t fix it.” Joint replacements don’t last forever. Just removing the damaged part and replacing it can cause problems. The muscles around the joint must be cut and a certain amount of bone removed.

Many doctors would agree when only half the joint is a problem then a hemiarthroplasty is the way to go. This operation only replaces the part of the joint that is damaged. This is usually the head of the humerus or ball portion that fits into the socket. Any part of the joint that is still in good health should be saved.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.