Shoulder
Impingement Syndrome
One of the most common shoulder
problems is called shoulder impingement syndrome. This occurs when the
roof of the shoulder rubs on the rotator cuff muscles, which are important
for shoulder movement. Frequently overhead activities and reaching behind,
such as putting an arm in a coat, are quite painful. Another common symptom
is difficulty sleeping because of pain from pressure on the shoulder. Symptoms
usually occur in people in their 40's and usually come on fairly gradually
over several months, but they also can occur suddenly.
Avoiding activities which
require reaching with the elbow away from the body may be one of the first
steps in treatment. Reaching overhead or out away from the body tends to
be painful. An exercise program that helps maintain the range of motion
in the shoulder and also increases the strength of the rotator cuff muscle
should be started. Anti-inflammatiory medicines frequently help decrease
pain and inflammation. If symptoms continue for more than a month, a physician
should be consulted. An injection of cortisone may help alleviate the discomfort.
If symptoms persist, the "bone spur" may need to be removed surgically.
In some cases, the rotator cuff may actually be torn and must be repaired
surgically.
Dislocation
When the shoulder is dislocated,
the head of the upper arm bone or humerus pops out of the shoulder socket.
This can result from a fall on an outstretched hand, a blow to the shoulder,
or extreme rotation of the arm. A dislocation is very painful, and the
shoulder itself appears out of position. The condition is sometimes accompanied
by a fracture, typically of the humerus.
Treatment of the dislocation
includes manipulating the upper arm bone back into the socket and immobilization
of the shoulder with a sling or shoulder immobilizer, followed by rehabilitation.
Depending on the severity of the injury to muscles and other structures
of the shoulder, surgery may be necessary, followed by rehabilitation.
Shoulder
Instability
Once the shoulder has been
dislocated, it may pop out of place over and over again. This tends to
occur most commonly in younger people.
If the shoulder remains unstable
the initial treatment is an aggressive rehabilitation program. If the shoulder
continues to pop out of the socket following rehabilitation, surgery may
be necessary to repair the ligaments and capsule around the shoulder joint.
Frozen
Shoulder
Frozen shoulder is a condition
where movement of the shoulder is seriously limited because of inflammation
in the shoulder joint lining. Lack of use, particularly following an injury,
is one of the factors that contributes to frozen shoulder. People with
diabetes also seem to have a higher incidence of frozen shoulder. However,
many times a frozen shoulder occurs for no apparent reason.
Treatment may include the
application of heat and cold and the use of nonsteroidal anti-inflammatory
medicine or other pain medication. Injections of steroids may also be helpful.
Movement may be restored with exercise or manipulation by a physician.
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