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Shoulder Injuries

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Recover from the shoulder injury with the latest non-surgical treatment options, including physical therapy, nonsteroidal anti-inflammatory drugs, steroid injections, and regenerative medicine procedures such as Prolotherapy. Our sports medicine physicians are experts in treating shoulder pain and can pinpoint the source of the pain, prescribe a personalized, time-tested treatment plan that works. Visit our sports injury and pain management center to meet our physicians to get the shoulder pain relief you need in the safe, reassuring hands of the best doctors in New York.

Shoulder Injuries


Shoulder-Injuries

The shoulders are joints and a meeting place of the upper-arm bones, or the humerus, the shoulder blades, or the scapula and of the collarbone, or the clavicle. The upper arm bones fit into the rounded socket of the shoulder blades on both sides of the body. A group of four muscles and tendons, other known as the rotator cuff, have the function of holding the shoulder in place, protecting the bones, and allowing us to raise and move our arms.

If the shoulder begins to hurt, it can be due to many causes. You might have suffered a shoulder injury during a fall or an accident, or you might have overdone it with movements, such as painting or certain sports. There are however also cases, where shoulder pain is caused by a condition, such as arthritis. In other cases, you might be feeling pain in your shoulder, but the issue might lay in a different part of the body, a condition known as referred pain.

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In cases where your shoulder rotates too far or is pulled too far, it can lead to the top of the arm popping out of its socket. This shoulder injury, other known as a shoulder dislocation, can result in swelling, numbness, bruising, pain, and weakness in the shoulder.

What are the symptoms of shoulder injuries?

If you’re trying to decide whether you have suffered a shoulder injury, you must ask yourself some questions. Do you still have the same shoulder strength to do the things that you normally would? Are you able to move your arm normally, or does it hurt and feel stiff? Do you feel as if your shoulder is going to pop out of the socket?

Certain shoulder injuries can be treated at home with only resting for a couple of days and icing the area. A bandage can help to hold the shoulder in place, when necessary, and to elevate it above the heart.

However, there are some shoulder injuries, which need to be treated by a medical professional. Some signs show that your shoulder injury needs to be taken care of by a doctor, such as:

  • intense shoulder pain
  • harm or hand feeling weak or numb
  • shoulder joint appears to be deformed
  • sudden swelling
  • not able to use your shoulder at all

What are some common shoulder injuries?

In cases where your shoulder rotates too far or is pulled too far, it can lead to the top of the arm popping out of its socket. This shoulder injury, other known as a shoulder dislocation, can result in:

  • swelling
  • numbness
  • bruising
  • pain
  • weakness

Separation.
If the joint, where the collarbone and shoulder blade come together is injured, you might be suffering from a condition known as separation. It affects the acromioclavicular joint, leading to a tear of the ligament, that holds it together. This can be caused by a hard blow or a fall. In cases where the collarbone is pushed out of its place, you will notice a bump on top of the shoulder. In most common cases, the collarbone, or the clavicle, or the humerus, upper-arm bone, break. This can cause intense pain and bruise.

When the collarbone is broken, you might not be able to lift the arm and the shoulder might sag.

Cartilage tear.
Another common shoulder injury is a cartilage tear. The cartilage is the rubbery padding, which in this case goes around the rim of the shoulder joint. Injuring the cartilage can occur after repetitive motion, a fall, or after a hit. This type of shoulder injury leads to pain whenever you reach the arm over your head and your shoulder will generally feel weaker. You might also feel as if it is locking, grinding, or catching.

The rotator cuff is a group of tendons and muscles in the shoulder, which allow you to lift the arm overhead and has the function of holding the arm in place. However, overuse or a fall might injure it, leading to a rotator cuff tear. Wear and tear of the rotator cuff also occur the older we get. This might lead to pain at night or whenever you try to lift things. It might also cause a crackling sound whenever you move the shoulder.

Frozen shoulder.
A common shoulder injury leads to a limitation on how much you can move your shoulder. An abnormal band of tissue builds up in the joint and prevents it from being able to move as it should. The pain will often make it impossible to move the shoulder, leading to it „freezing“.

Shoulder impingement.
A shoulder condition occurs if the tendons of the rotator cuff get pinched in the bones of the shoulder, leading to pain and swelling. This can for example be caused by lifting the arms over the head a lot.

Shoulder bursitis.
A fluid-filled sac, which has the function of cushioning the joint, other known as the bursa, can lead to swelling and irritation. This typically occurs due to repetitive motion, however, it can also be caused by n injury or a fall. The condition is other referred to as bursitis and can lead to pain, which is mostly noticed whenever you move the shoulder.

Shoulder Tendinitis.
Shoulder Tendinitis is a condition that occurs once the tendons which make up the rotator cuff gets inflamed. This can occur slowly over time or due to a direct hit to the shoulder or a fall. Osteophytes, or bone spurs, are small and smooth pieces of bone rubbing up against and wearing on the rotator cuff. This can prevent your shoulder from moving the way it should move and can lead to tendinitis or a rotator cuff tear.

Shoulder instability may also be caused by an underlying condition, such as osteoarthritis. Osteoarthritis is other referred to as degenerative joint disease and is the most common type of arthritis. Any joint can be affected by it, including the shoulders. When you suffer from osteoarthritis, the cartilage between the bones will break down, so that the bones will end up rubbing together. This can lead to shoulder pain and stiffness.

Rheumatoid arthritis is a condition that leads to the body’s immune system attacking the protective lining of the joints. This leads to pain and stiffness in the shoulder. As previously mentioned, you might experience pain in the shoulder although the cause of the pain might be located somewhere else in the body. Shoulder pain, for example, can be a sign of liver issues, gallbladder issues, or issues in another organ.

If you experience shoulder pain and have issues breathing or you feel tightness in the chest, you might be suffering a heart attack and need emergency medical help immediately.

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How is shoulder pain diagnosed?

Your doctor might begin with a physical exam, which can help to check for any structural issues and rule out anything which might involve the spine or the neck. Your doctor will also test your range of motion to check how flexible and how strong your shoulder is. This means that you might be asked to move your arm in different ways, such as above the head, across the body, rotating it 90 or 180 degrees, or moving it behind you.

To get a closer look at your shoulder and determine the right treatment for shoulder instability, you might also need some imaging tests, including:

  • X-ray – An X-ray can for example help detect bone spurs, arthritis, or other bone-related causes of shoulder pain. You might also need an arthrogram, which uses a shot of dye to make the details show up more clearly on the images.
  • MRI – Magnetic resonance imaging, MRI, can also help to make detailed images of the shoulder with the use of a powerful magnet and radio waves.
  • CT – A computerized tomography scan, or a CT, is several X-rays that have been taken from different angles. Once these X-rays are all put together, they can provide your doctor with a better look at what is happening with the shoulder.
  • Electromyography – Electromyography can check the electrical activity within the muscles, which can help to detect whether there are any issues with the nerves.

Arthroscopy is a surgical procedure, which allows a tiny fiber-optic camera to get high-definition of images of the shoulder. There are cases where an arthroscopy is not only used as a diagnosing technique but can also be used as a shoulder injury treatment option.

Shoulder injuries treatment options

If you’ve suffered a shoulder injury or are in pain due to another cause, you might want to try to manage your symptoms at home first. It is recommended to rest your shoulder for a couple of days and putting ice on the area that hurts for 15 minutes, a couple of times a day.

Over-the-counter medications.
If you’re in pain, it can help to use over-the-counter medication, such as ibuprofen or acetaminophen.

Exercise and stretch.
You must practice good posture, as this can help to keep the tendons and muscles in their right positions, aiding the healing process. There are also many exercises and stretches, which can help your shoulder injury to heal.

Physical therapy.
It is recommended to speak to a physical therapist or your doctor about what kind of stretches and exercises can best help your case. If the pain is severe, you might need prescription painkillers, which are stronger medications that can help you manage the pain and allow you to go on with your daily activities or physical therapy.

Corticosteroid injections.
In many cases, shoulder injuries treatment will involve a corticosteroid injection, for example for a shoulder tendon injury treatment. A corticosteroid injection can be helpful, amongst others, in cases of a shoulder tear, sprain, or strain. Your doctor will typically recommend a corticosteroid injection after all other types of medications have failed to provide you with pain relief. The steroid has a powerful anti-inflammatory property and can be injected directly into the shoulder. This might be done after the doctor has numbed the area of injection with a local anesthetic. An X-ray of ultrasound might be used to help the doctor inject the corticosteroid into the right area.

Another option of a shoulder injury treatment includes mixing a corticosteroid with an anesthetic, which can provide pain relief for a couple of hours after the procedure. Shoulder pain can commonly come back a couple of hours after the injection. The corticosteroid typically takes two or three days before it begins to work.

Prolotherapy.
Prolotherapy is a regenerative medicine procedure that utilizes the body’s healing response to improve injuries, shoulder pain, and other conditions.

Depending on your case, you might need two to three injections within one year. It is usually not recommended to get more than three injections. Side effects of a corticosteroid injection include bruising or tenderness at the injection site.

Surgery.
In cases where you’ve tried physical therapy, changed your lifestyle, had corticosteroid injections, and tried other non-invasive treatment options, but your shoulder is still bothering you, you might need surgery. Depending on the shoulder injury that you are suffering from, there are different surgical approaches available, such as:

  • slap tear surgery
  • torn rotator cuff repair
  • shoulder impingement surgery
  • total shoulder replacement

All surgical procedures come with side effects and risks and recovering from them will depend on the condition and what surgical procedure was done. There are also other factors, which can affect recovery time, such as how well you follow your doctor’s instructions.

Depending on how often you use the shoulder every day, it is recommended that you take precautions to protect it and prevent an injury. You must take a break and move around if you work at a desk, and make sure that your chair encourages proper posture and offers the right back support.

If you need to lift heavy items at work, make sure that you use the proper technique. If you’re reaching something heavy over your head, use a ladder or a stool to get in a better position. Speak to your doctor about a program that can help you learn how to strengthen the muscles around the shoulders and how to keep them flexible.

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976697/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1303129/
https://pubmed.ncbi.nlm.nih.gov/19945585/
https://www.uofmhealth.org/health-library/shoul

For more information about shoulder injury treatment or to schedule an appointment with the top-rated sports medicine physician in Downtown, Brooklyn, and Lower Manhattan, please call our office for a consultation and indicate which location you want to visit.

DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general information. In no way does any of the information provided reflect definitive treatment advice. It is essential to consult a best-in-class pain management specialist in New York regarding ANY questions or issues. A thorough evaluation should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call your pain doctor to schedule a consultation.

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  • Dr. Raj Raval, M.D.

    1. Board Certified
    2. Interventional Pain & Musculoskeletal Medicine Specialist
  • Education & training

    1. SUNY Downstate PMR Residency
    2. Rutgers University Fellowship
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