The shoulder is the most complex joint of the human body. Since its structure allows movement in all directions, it is extremely prone to discomfort.
What are the Causes of Shoulder Pain?
The most common causes of shoulder pain
- Muscle tears, injuries,
- Bursitis and tendinitis (fluid-filled sacs, tendon inflammation)
- Fractures, dislocations,
- Nerve compression,
- Calcification,
- Rheumatic diseases (especially polymyalgia rheumatica)
- Frozen shoulder (restriction of movement in the joint )
- Cervical disc herniation
Shoulder Pain may originate from the shoulder joint itself, or there may be pain reflected from another region to the shoulder.
Apart from shoulder-related disorders, the disorders that cause shoulder pain are neck-related diseases (for example, cervical disc herniation, nerve compression in the neck and similar)
The treatment of patients with such complaints should be planned after a good physical examination and, if necessary, radiological examinations (MRI, Direct Graph).
Shoulder joint pain can basically be examined in two parts.
1-Acute (New): Pain due to falling, straining, hitting. or may occur after shoulder fractures or dislocations.
Pain may occur immediately after the current trauma, or these complaints may persist even a few weeks later. may occur. This type of pain may begin after a long-term tiring shoulder activity performed with the arms above shoulder level, such as cleaning windows, painting, trying to install curtains, installing light bulbs, or after doing tasks such as lifting a heavy load, cleaning carpets, sheets or clothes.
2-Chronic (long-term): Chronic shoulder pains are pains that, over a long period of time, make them feel mild at first during difficult tasks, wake them up at night, and then force them to do even daily housework.
In what cases should a physician be consulted for shoulder pain?
- Shoulder pain, shoulder joint If it started after physical trauma,
- Shape change in the shoulder,
- Increasing pain in the shoulder,
- Shoulder pain that continues at rest and/or wakes up at night, >
- Although the pain in the shoulder is mild, if it continues despite resting and using painkillers for 3 days,
- Difficulty in lifting the arm,
- Feeling difficulty in lifting any object that can normally be lifted using your arm. ,
- Redness and increased temperature in your shoulder joint.
What kind of tests may be required for shoulder pain?
Direct Radiography (X-ray): It shows the bone structure and is helpful in the diagnosis of fracture, dislocation or calcification.
Ultrasound: With ultrasound, the shoulder and all surrounding soft tissues and joints can be visualized.
EMG (Electro Myelograph): EMG examination may be required in patients with suspected nerve injury.
MRI (Magnetic Resonance Imaging): The majority of shoulder pain originates from soft tissue. MRI is the most useful examination for imaging soft tissue, muscles, ligaments, tendons, shoulder impingement and all similar structures. MRI is still the most used and reliable imaging method in the evaluation of shoulder pain.
Which Treatments Can Be Applied in Shoulder Pain?
The complaint should be addressed while planning the treatment. The person with the disease must be examined and evaluated with the results of the necessary radiological examinations and a decision must be made.
Non-Surgical Treatments:
Rest: In cases of acute severe shoulder pain, protecting the shoulder from challenging movements. It is carried out by resting, using painkillers with edema-resolving properties, and applying ice. Resting in a shoulder strap should be used for as short a time as possible if the patient has such severe pain that he cannot move his arm. Otherwise, it will cause the shoulder joint to freeze.
Physical Therapy: It is a treatment that can be applied to shoulder pain that does not go away with rest. Ten to fifteen sessions of physical therapy are often sufficient.
CORTISONE (Shoulder Injection): Cortisone and turmeric When such a treatment is planned, the relevant injection must be performed by an orthopedic specialist and must be applied meticulously to the area to be applied due to the possible side effects of cortisone. It is not recommended to be applied more than twice a year.
SODIUM HYALURINATE (Shoulder injection): Sodium Hyalurinate (popularly known as rooster's comb). ) injections are a treatment method that can be applied especially in shoulder arthritis, but patient selection and diagnosis are of great importance in the success of the treatment. Application more than once a year is not recommended.
PRP (Shoulder Injection): The basic logic is to repair cartilage, tendons, ligaments, muscles and tissues thanks to platelet-rich plasma, or autologous conditioned plasma (ACP). It even takes advantage of the natural healing properties of blood to repair your bones. Since the application is prepared from the patient's own blood, it has no side effects. The application is carried out 3 or 5 times, depending on the patient's pain complaints, in at least two sessions, one week apart. With correct diagnosis and meticulous application, very successful and clear results are seen in the treatment of shoulder pain.
STAM CELL THERAPY (Shoulder Injection). Although they are found in many tissues in the body, stem cells are most commonly obtained from tissues such as bone marrow, fat tissue or the synovial membrane lining the knee. The tissue sample taken is purified by growing it in cell culture or using special centrifuge systems. It is especially applied in cases where the cause of shoulder pain is due to calcification and cartilage damage. Successful results are achieved with correct diagnosis and meticulous application.
Surgical Treatments:
SHOULDER ARTHROSCOPY: Shoulder arthroscopy is an option that allows diseases of the shoulder joint to be treated with closed camera methods. This surgical method is now widely used in orthopedic surgery for all patients (regardless of young, middle or older age) as it provides short surgery times, short hospital stays (1 day) and allows patients to quickly return to their normal lives and work. Ahi is preferred in interventions. Recurrent shoulder joint dislocations due to shoulder joint disease, shoulder joint pain that keeps you up at night, and many disorders that restrict the movements of the shoulder joint due to trauma or strain can be treated with the arthroscopy method, and postoperative patient comfort is much better than open surgery.
OPEN SHOULDER SURGERY: With the advancement of health technology in shoulder arthroscopy, the requirements for open surgery have decreased. However, it is applied in shoulder diseases that cannot be treated with shoulder arthroscopy. Surgeries mainly performed with open surgery;
– PLATE SCREW SURGERY applications for shoulder fractures
– SHOULDER PROSTHESIS (Partial, Total or Reverse) surgeries due to advanced shoulder calcifications that do not seem to be treated other than surgical treatment.
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–TENDON TRANSFER Surgeries.
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