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

Can a small business owner save money on shoulder surgery?

admin — Wed, 14 Jul 2010 14:00:45 +0000

As a small business owner, I am self-insured. Is there any way I can save money on my upcoming shoulder repair surgery?

You’ll want to bring this up with your surgeon. Perhaps your injury can be treated with a more conservative, less expensive approach. If not, then you may want to look at the differences in cost for an open versus closed operation.

With an open repair, the patient has general anesthesia. The surgeon makes an open incision to make the repairs. The operation is done in the hospital. There is often an overnight stay required.

With the closed (arthroscopic) method, regional anesthesia is used. The patient goes home the same day. There is usually a charge associated with pain relievers used for a few days.

All of these decisions are based on the type of problem you have and what your surgeon can do.

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.

Is it ever too late for surgery to repair torn rotator cuff?

admin — Tue, 22 Jun 2010 11:36:31 +0000

I have a large rotator cuff tear in my left shoulder. I’ve been putting off surgery and trying everything else first. I’m ready to throw the towel in and have the surgery. How do you know when it’s too late for an operation to help?

There’s nothing wrong with trying conservative care before going for a rotator cuff repair. In some cases, anti-inflammatory drugs help. In other cases, cortisone injections or physical therapy can make a difference.

But for patients who still have pain, loss of motion, and reduced function, surgery may be the best option. Many patients put it off for months and even years. They still report a good result after the operation.

New methods using arthroscopic surgery and tiny incisions have changed the results of this operation. Even full-thickness tears or tendons that have retracted far away from the place where they normally attach can have a good outcome.

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.

Baseball injury leaves one shoulder higher than the other

admin — Mon, 14 Jun 2010 19:37:25 +0000

I injured my right shoulder playing baseball last year. It gradually got better, but now I notice my right shoulder is higher than my left. What could be causing this?

The specific cause can’t be determined without an exam by a physical therapist or medical doctor. There is a wide range of possibilities from posture to nerve damage to muscle tear. Shoulder injuries are almost always accompanied by changes in the posture and movement of the wing bone called the scapula.

Once the cause of the problem has been identified, a physical therapist can set up a rehab program. This will restore normal motion and posture.

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.

Shoulder surgery complications perhaps caused by fluid

admin — Thu, 06 May 2010 17:29:38 +0000

My father-in-law had surgery on his shoulder to repair a torn rotator cuff. Afterwards he had a lot of swelling on the back of his neck down into the back of his shoulder. What could cause this problem?

Swelling of the neck, nerve problems, and even death of skin tissue can occur after arthroscopic surgery. Evidently the surgeon pushes fluid into the joint during the operation. This helps keep the joint open. It also washes away any blood that might keep the surgeon from seeing what he or she is doing.

The longer the surgery takes, the more fluid is forced into the joint. This increases the chances of problems occurring. Surgeons are encouraged to shorten the operating time as much as possible to reduce the amount of fluid put into the joint.

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.

Shoulder can dislocate even after surgery

admin — Tue, 20 Apr 2010 12:39:01 +0000

I have a chronic dislocating shoulder that needs fixing. The doctor told me there’s still a 25 percent chance the joint can dislocate again even after repair. Why is that?

Studies show that shoulder dislocation after repair occurs anywhere from 12 to 24 percent of the time. There are different reasons for this. Sometimes it depends on the type of surgery done to repair the problem.

For example, an open incision allows the surgeon to repair the tear in the cartilage and tighten up the joint capsule at the same time. Arthroscopic surgery may only include repair of the damaged soft tissue while leaving the capsular laxity alone.

Another factor in repeat dislocations after surgery is the patient. It’s important to follow the surgeon’s instructions. A shoulder sling may be needed for up to four weeks. Exercises must be done daily. Doing too much too soon is a common way to undo the benefits of the surgery.

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.