Where the head, or "ball," of the humerus (arm bone) meets the glenoid "socket," the rotator cuff works to hold these bones in place. In addition to the rotator cuff, which is made up of four distinct muscles, a ligament referred to as the "O-ring" also provides stability in this ball and socket joint.
All of these components together make up what we know as the shoulder joint. When a shoulder becomes painful and stiff due to severe arthritis or another injury or condition, total shoulder replacement surgeons may recommend shoulder replacement.
For many people, their shoulders are able to adequately withstand a lifetime of regular use. However, shoulders that have experienced the extreme stress and impact of years of competitive sports or manual labor may require orthopedic intervention. Non-operative treatment options include rest, exercise, physician therapy, and medication and supplementation.
Although there are other reasons why a patient may be considering shoulder replacement, such as fractures, a torn rotator cuff or repeated dislocation, the primary purpose is to reverse the effects of severe arthritis. Arthritis in the shoulder can occur simply due to degeneration or because of a specific injury or as a result of inflammation in the joint.
Regardless of the root cause, arthritis results in painful, stiff movement. Because the protective cartilage between the bones wears away, the shoulder no longer benefits from the cushion that facilitates the regular movement in a healthy joint. Instead, the shoulder is required to perform with the pain of bone-on-bone contact. In this case, most orthopedic physicians would recommend that a patient begin to look for total shoulder replacement surgeons in their area, as surgery is most likely the best option to relieve that pain.
When a patient's life is being significantly impacted by consistent shoulder pain, it's time to consider the benefits of shoulder arthroplasty. Many people who deal with shoulder conditions live for years with the pain and give up many of the activities they love because of it. In fact, those with severe shoulder arthritis often even lose sleep due to chronic pain.
While there are many cases that certainly call for a surgical approach to fixing a badly injured joint or a joint with little or no cartilage remaining, most patients obviously prefer to first attempt non-surgical treatment options. When you see your orthopedic specialist, they should be able to offer you some initial options, ranging from physical therapy to cortisone injections.
First, a shoulder specialist will have an x-ray done to determine the level of cartilage lost. If the results show bone-on-bone contact, these more conservative treatment options will most likely not be effective. However, if the patient still has a fairly in-tact shoulder joint, the physician may recommend one or more of the following:
Activity Modification: This can range from a period of total rest to conservative modifications to daily activities. For example, a patient who is used to playing basketing 3 days per week may need to switch their exercise routine to treadmill training instead. Or, someone who regularly performs manual labor at their job may need access to better tools to help relieve the burden on their shoulders. A shoulder specialist can help their patient think creatively about how to give their shoulder the rest it needs to heal properly.
Physical Therapy: When a patient experiences pain in the shoulder, they may begin to automatically favor that arm and in doing so, unknowingly contribute to muscle atrophy. Before long, the patient can have a new problem on their hands and in the mean time, the original shoulder condition is made worse.
Every joint of the body must be properly supported by strong, healthy, able muscles. A specific physical therapy routine can help to achieve that goal and promote overall shoulder health. If after time, mere physical therapy proves to be inadequate to address the problem fully, the patient should begin to look for total shoulder replacement surgeons.
Medication & Supplementation: In addition to cortisone shots to decrease inflammation and reduce pain, a simply anti-inflammatory medication can also help. Depending on the patient's situation and the severity of the pain, a physician may recommend one or the other, or a combination of both. In addition, certain supplements, such as Glucosamine, can help to provide some relief.
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