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Diagnosis & Treatment of Shoulder Disorders
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Diagnosis & Treatment of Shoulder Disorders

Shoulder conditions, although less common than in the knee or hip, affect a large number of people; especially people aged over 50 years. Shoulder problems are associated with ongoing pain and places limitations on a person’s lifestyle, among other negative effects.

One of the most common shoulder conditions is arthritis. This is when the joint cartilage is damaged through wear or inflammation to such an extent that there is friction between the shoulder bones, causing pain and other complications. Similarly, inflammation of the shoulder joint lining can reduce movement, such as in ‘frozen shoulder’.

Other movement disorders include the relatively common ‘rotator cuff injury’, in which there is damage to the muscles controlling shoulder movement.

Depending on the type and severity of the shoulder problem, the treatment options vary greatly, and your doctor will be happy to discuss the next steps. While there are shoulder problems that predominantly involve bones, muscles or tendons, the information here is primarily a guide to disorders of shoulder cartilage (particularly arthritis) and their treatment to help inform your discussion with your physician.

Intended audience

People of all ages can suffer from shoulder complications, whether due to ‘wear and tear’ or injury. While the former is much more common in middle-aged patients, and even more so in women, injuries to the shoulder, such as during active sports, can affect any age group or gender.

Careers requiring repetitive or intense motion can increase the risk of developing shoulder problems, but there are several other risk factors, including age, weight and genetic predisposition.

Who suffers from shoulder complications?

People of all ages can suffer from shoulder complications, whether due to ‘wear and tear’ or injury. While the former is much more common in middle-aged patients, and even more so in women, injuries to the shoulder, such as during active sports, can affect any age group or gender.
Careers requiring repetitive or intense motion can increase the risk of developing shoulder problems, but there are several other risk factors, including age, weight and genetic predisposition.

What is arthritis of the shoulder?

For proper movement, the joints of the shoulder need lubrication, which comes from the cartilage. Arthritis (inflammation of the joint) affects this carefully maintained system, causing discomfort, pain and, in some cases, the need for surgery. Arthritis is further divided into two categories: osteoarthritis and rheumatoid arthritis.

Osteoarthritis, the more common of the two, is due to ‘wear and tear’ of the joint cartilage. It is more likely in older patients, although can develop after fracture. Sufferers have pain and ache in the shoulder joint, often at the top and front. The pain is typically worse in the morning and at night. Reduced range of motion and flexibility makes sleep or daily activities difficult.

Rheumatoid arthritis is caused by an over-active immune response. In other words, the body’s natural defences attack the joint lining. Pain, swelling/inflammation, reduced range of motion, and lumps or tender spots are all symptoms. Over long term, rheumatoid arthritis can cause distortion of the bones.

Although neither type of arthritis is curable, the symptoms can be managed and treated in a number of ways, including physical therapy to improve joint lubrication, medication to combat pain and inflammation, and lifestyle changes such as rest and weight loss. In more extreme cases, other techniques or surgery may be necessary. For osteoarthritis in particular, cartilage restoration is a possibility.

What are the cartilage repair treatments for shoulder conditions?

Your physician will assess the severity of the condition and approach it in several stages. These may include physical therapy, anti-inflammatory drugs and steroid injections. In more extreme cases, there are a number of surgical options, including shoulder replacement, bone reshaping and procedures to reduce tendon problems. These options can be discussed with your orthopaedic surgeon.

There are now many promising methods to restore and repair cartilage in the shoulder. These offer alternatives to synthetic joint replacements and other surgical methods, and help to restore function using more natural tissue. These include:

Outcomes with these techniques will depend on the age of the individual, the size and location of the cartilage defect, and the postoperative rehabilitation.

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