Shunning shoulder pain can cause more damage in the long run

Apr 7 2004

Senator John Kerry is one of the millions of Americans suffering from shoulder pain.  Depending on the nature of the problem, conservative nonoperative methods of treatment are often recommended before surgery.  However, in some instances such as Kerry’s, surgery is necessary in order to prevent more difficulties later.  The American Academy of Orthopaedic Surgeons (AAOS) advises those suffering shoulder pain to consult their doctor instead of ignoring the pain.  Early, correct diagnosis and treatment of shoulder problems can make a significant difference in the long run.

Although there are many reasons for shoulder pain, a common problem for people over 40 years of age is a rotator cuff tear.  The rotator cuff is comprised of the muscles and tendons that surround the top of the upper arm bone and hold it in the shoulder joint.  A tear may result suddenly from a single traumatic event or develop gradually because of repetitive overhead activities.

“Some people will have a tendency to ignore the pain, especially those who are active, and “play through” shoulder injuries, which only aggravates the condition and possibly causes more problems,” said Anthony Romeo, MD, Associate Professor of Orthopaedic Surgery, Director, Shoulder Section at Rush University Medical Center in Chicago, Ill. and Academy spokesperson.  “People also may underestimate the extent of the injury because steady pain, weakness in the arm, or limitations of joint motion will become almost second nature to them.”

People experiencing pain in their shoulder should ask themselves these questions:

• Do you lack the strength in your shoulder to carry out your daily activities?
• Is the shoulder stiff?  Can you rotate your arm in all the normal positions?
• Does it feel like your shoulder could pop out or slide out of the socket?

If the answer is “yes” to any of these questions, one should consult an orthopaedic surgeon for help in determining the severity of the problem.

Many times orthopaedic surgeons will prescribe a series of exercises aimed at strengthening shoulder muscles.  Anti-inflammatory medication also may be prescribed to reduce pain and swelling.  If those treatments do not alleviate the pain or enable mobility, surgery is usually recommended.  Depending on the size and severity of the tear, surgery options include arthroscopy, in which miniature instruments are inserted into small incisions to remove inflammatory portions or repair lesser tears.  A min-open repair that combines arthroscopy and a small incision can be used to treat full-thickness tears.  In more severe cases, open surgery is required to repair the injured tendon.  Joint replacement is also an option .

For more information on shoulder pain, treatment and exercises, please visit www.orthoinfo.org.

An orthopaedic surgeon is a physician with extensive training in the diagnosis and nonsurgical as well as surgical treatment of the musculoskeletal system including bones, joints, ligaments, tendons, muscles and nerves.

The 27,156-member American Academy of Orthopaedic Surgeons (www.aaos.org) or http://orthoinfo.org, is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade (www.boneandjointdecade.org), the global initiative to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life. President Bush has declared the years 2002-2011 National Bone and Joint Decade, in support of these objectives.