Bimillahirahmanirahim,
Shoulder pain is one of the common problem in attacking around shoulder region
and it will affected your activity and also your emotional ,today i would like to share
the info about of this unique joint
What is the shoulder and anatomy around it ?
The shoulder is
a complex joint made up of the humerus (upper
arm bone),
scapula (shoulder blade) and clavicle (collarbone),
along with
tendons, muscles and ligaments. These help us lift,
carry, throw and
reach up or backward. The shoulder is the most
mobile – and
least stable – joint in the body, because it is not
anchored firmly
to the skeleton by surrounding muscle.
Type of injuries of shoulder
Here i will show a common injuries is always happen around the shoulder and also the mechanism of the type of injuries ,it will give you the idea when you meet the Dr and
this explanation will help you to understand about your condition.
Rotator Cuff Injuries
The rotator cuff comprises four
muscles and cord-like tendons,
tightly enclosed
within the shoulder joint. Rotator cuff injuries are
the most common
causes of shoulder pain and activity restriction
at all ages.
·
Rotator cuff tendonitis. The
mildest rotator cuff injury is tendonitis
(tendon
inflammation). Tendonitis can develop with repetitive overhead
activities such
as playing tennis, pitching, raking, shoveling or
painting.
Tendonitis can also arise from joint degeneration due to
osteoarthritis.
It produces pain like a toothache radiating through
the upper arm
that can awaken you from sleep. Reaching overhead
or behind your
back is painful.
·
Shoulder bursitis. Bursitis,
which often accompanies rotator
cuff tendonitis,
involves painful inflammation of one or more bursa
(fluid-filled
sacs that surround our joints to provide lubrication
and protection).
·
Impingement syndrome. Swelling
and inflammation of tendons and/
or bursa can
place undue pressure on tendons as they pass
between the
upper arm bone and the shoulder tip, called the
scapular
acromion. In its cramped space, blood flow to the swollen
tendon is
reduced, and it begins to fray. The resulting pain intensifies
when reaching
overhead or backward. Ongoing impingement
may produce a
torn rotator cuff.
·
Rotator cuff tears. A torn
rotator cuff, sometimes called “pitcher’s
shoulder” or
“tennis shoulder,” is the most common cause of shoulder
pain. The
rotator cuff tendons can split or tear suddenly with
injury, or
slowly by rubbing bone spurs. Untreated tears can weaken
the arm, inhibit
its overhead elevation and visibly shrink muscles.
Pain occurs
during motion and also at night
Other Common injuries at the shoulder
Labral tears
The labrum, a
cartilage cuff around the socket that encircles the
head of the
upper arm bone to hold it within its shallow bony
socket, can tear
with injury to the shoulder. It also becomes more
brittle with age
and thus susceptible to fraying. Aching in the shoulder,
“catches” in the
shoulder when moved, and pain with some
activities may
signal a torn labrum
Instability and dislocation
When one of the
shoulder bones moves or is pushed out of place
due to injury,
the shoulder becomes unstable and is at risk for
partial or
complete dislocation. Recurrent dislocations cause pain
and unsteadiness
when raising the arm or moving it away from the
body, and a
feeling that the shoulder is “slipping out of place” when
reaching
overhead.
Frozen Shoulder
Between ages 40
and 60, the joint capsule surrounding the shoulder
can shrink,
making movement painful and stiff. Reluctance to
use the shoulder
brings increasing stiffness, restricted motion and a
persistent, dull
aching. This condition is most frequently associated
with diabetes,
but in more than half the patients has no known
cause. Pain
fades after several months, but the shoulder becomes
“frozen” and may
take two to three years to “thaw” without treatment.
Treatment is
directed at pain relief until the acute phase
passes, followed
by therapy and even surgical intervention to regain
motion if it
does not return spontaneously.
Fractures
Shoulder
fractures are usually caused by trauma: a fall while
skiing, a
collision during football, a car accident. A fracture of the
“ball” at the
top of the arm bone or its socket, or of the collarbone,
can disable the
shoulder. Bruising, pain and swelling, and pain or
a deformed
appearance can indicate a shoulder fracture. Most
fractures are
effectively treated by immobilizing the arm in a sling
until the bone
fragments “knit together,” which takes about six
weeks. All
fractures should be assessed; some require surgery
Arthritis
Osteoarthritis is the
wearing down of cartilage that allows bones to
glide smoothly
within the joints, and can occur with aging, trauma or
overuse injury.
The bones in the shoulder begin to rub against each
other, and
growths called bone spurs can develop. Stiffness, swelling,
pain and reduced
range of motion can occur, along with a “catching”
sensation in the
joint.
Rheumatoid arthritis, a
disorder of the immune
system, produces
chronic, painful inflammation of the joint’s lining,
and eventual
joint deterioration. Severe osteoarthritis or rheumatoid
arthritis in the
shoulder may necessitate joint replacement.
Other causes
Less common
causes of shoulder pain include infection
(osteomyelitis),
soft-tissue or bone tumors and nerve problems.
A shoulder
specialist can help pinpoint the reason. When
shoulder pain is
intense, it’s important to seek help promptly.
What is the necessary action you need to take for managing this shoulder problem ?
Evaluating shoulder pain
Your doctor will
thoroughly examine your shoulder, take your health
history and
order imaging. X-rays detail bone changes from arthritis
and fractures.
Magnetic resonance imaging (MRI) reveals soft-tissue
injuries.
Computed tomography shows 3-D images of bony abnormalities
and tendon
problems. Advanced centers will offer techniques such
as ultra-fast,
high-resolution CT to reveal the source of shoulder pain,
and
single-sequence MRI to confirm rotator cuff injuries.
Management and shoulder therapy
Conservative care
Rest, ice and
heat are essential. Fortunately, most shoulder problems
do not require
surgery, and respond to a directed physical therapy
exercise program
and anti-inflammatory medication.
Rest
When your
shoulder hurts, it’s important to rest it, and refrain from
reaching upward,
carrying heavy objects and using heavy shoulder
bags. Pain and
inflammation will not subside if repetitive activities
such as
vacuuming, raking or car-washing continue to stress the sore
shoulder.
Keeping your elbow below shoulder-level is important. To
prevent frozen
shoulder after an injury, however, early movement is
important
Ice and heat
Icing the
shoulder with cold packs (or bags of frozen peas or corn)
when pain is
severe reduces inflammation and swelling, and the
discomfort they
cause. Taking hot showers and doing recommended
stretches first
thing in the morning also help
Physical therapy
Orthopaedic
specialists prescribe physical therapy to help you
recover from
shoulder injury. Physical therapists tailor range-of-motion
exercises to
increase flexibility in the shoulder. They will also show
you
strengthening exercises that help prevent muscle shrinkage, and
good body
mechanics to help you avoid shoulder strain. Ultrasound
or massage may
be used for bursitis. In frozen shoulder, anesthesiologists
can perform a
nerve block to allow for more aggressive physical
therapy.
Anti-inflammatory medications
Non-steroidal
anti-inflammatory (NSAID) medication can be purchased
over the counter
to relieve shoulder pain. If aspirin, ibuprofen (Advil®),
naproxen
(Aleve®) and acetaminophen (Tylenol®) do not provide adequate
relief,
prescription-strength NSAIDs can be prescribed.
Injections
When other
treatments don’t help severe shoulder pain, cortisone (corticosteroid)
injections may
temporarily help to “settle down” inflamed
tissues within
the cramped joint, reducing pain. However, cortisone is
a potent drug,
and potential side effects should be discussed with your
physician.
Surgical options
When shoulder
problems do not respond to any conservative care,
your orthopaedic
specialist may recommend surgery. Options range
from minimally
invasive arthroscopic surgery to total shoulder replacement.
Arthroscopic Surgery
In arthroscopic
surgery, only a few small incisions are required,
making recovery
quicker and less painful. A viewing camera is inserted
through one
incision, and slender telescopic instruments are inserted
through others.
This allows surgeons to inspect and repair labral
tears and
rotator cuff tears, and remove spurs and bony growths to
allow inflamed,
cramped tendons to move more freely. They can also
remove
thickened, inflamed bursa and bone to create space around
the rotator cuff
and relieve painful impingement (arthroscopic decompression),
and can cut
through tight sections of the joint capsule to
release a frozen
shoulder.
Arthroscopic
surgery can be combined with standard “open” surgery
when a larger
incision is required to properly view and repair a more
complex problem,
or with forcible stretching of a tight joint capsule
under anesthesia
to free up frozen shoulder.
Rotator cuff surgery
Torn rotator
cuffs do not heal by themselves and require surgery when
pain persists.
Repairing the torn muscle and tendon, and removing
bone spurs
restores comfort and function to the shoulder after several
months of
healing.
Surgery for shoulder fractures
Severe
osteoarthritis or rheumatoid arthritis can cause painful, debilitating
shoulder
deformity. In these cases, or when trauma crushes the
“ball” of the
shoulder joint, then shoulder replacement surgery can relieve
pain and improve
quality of life. Any damaged cartilage or bone in
the shoulder’s
ball and socket are removed, and replaced with a metal
“ball” and a
plastic “socket.” This artificial shoulder always relieves
pain and usually
improves motion, strength and function.
Recovery from surgery
Physical therapy
is essential to regaining your range of motion and
strength, which
relieves pain. Your therapist and surgeon will prescribe exercises that
will tailor to your needs. Your therapist will ensure
that you perform
your exercises correctly, give you advice on body
mechanics so
that you avoid straining your shoulder, and check your
progress wallahuaklam...
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