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Understanding the Shoulder

  • Common Conditions affecting the Shoulder

    shoulder

    The shoulder is a ball and socket joint consisting of 3 bones – the upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle) – held in stable position by ligaments, tendons and muscles. The shoulder provides the greatest range of motion in our body. It allows us to lift and rotate our arms in many directions. Here, we explore common shoulder injuries, key medical conditions affecting the shoulder and the treatment options available.

    Common Shoulder Injuries

    shoulder-injury

    Shoulder injuries frequently occur during sporting activities, especially those that require repetitive and excessive overhead motion, such as tennis, badminton, swimming and weightlifting. Injuries may also occur during daily activities such as when hanging the laundry. Most problems develop gradually, and the ligaments, muscles and tendons are the areas that tend to be affected. Shoulder problems may be minor or serious, depending on the severity of the injury and how long it is left untreated. Common injuries include:

    Dislocation

    Being the body’s most mobile joint, the shoulder is susceptible to dislocation. Shoulder dislocation is when the upper arm bone pops out of the socket that is part of the shoulder blade, and is a painful and traumatic injury often caused by a fall or during contact sports.

    If treated immediately, shoulder function can be fully regained. However, in some cases, the shoulder joint becomes unstable after a dislocation event. As a result, the shoulder will become more prone to future dislocations.

    Warning signs and symptoms of a dislocation include swelling or bruising, intense pain, a visibly out-of-place shoulder, numbing sensation along the neck area, and being unable to move the shoulder joint. Seek medical help immediately for a shoulder that appears to have been dislocated.

    Fracture

    Trauma may fracture the bones that make up the shoulder, and the injury may require surgery should impact cause bones to break and displace from their original positions. For minor cases, treatment usually requires immobilisation with a sling support until the bone fragments heal. This normally takes about 6 – 8 weeks.

    The symptoms of a shoulder fracture include pain in the shoulder, tenderness, swelling, discolouration or deformity at the affected area and limits in your movement.

  • Frozen Shoulder

    frozen-shoulder

    Frozen shoulder, also known as adhesive capsulitis, is when the shoulder turns stiff and movement becomes painful and difficult. The condition develops gradually, usually stemming from an injury. It may also be related to diseases such as diabetes. Inflammation to the joint occurs, leading to the formation of scar tissue, causing the tissue around the shoulder joint to stiffen.

    Signs & Symptoms

    Frozen shoulder usually starts with pain, causing the affected person to avoid using the shoulder. This leads to stiffness and further reduction in motion over time.

    Key signs and symptoms are:

    - Pain
    - Stiffness
    - Limitation in movement

    Diagnosis

    Your doctor may check your medical history and examine your shoulder. These diagnostic tests may be used to assess the severity of your injury:

    - X-ray
    - Magnetic resonance imaging (MRI)

    Treatment

    Your doctor may prescribe non-steroidal anti-inflammatory medication (NSAIDS) to help alleviate the pain. Physiotherapy may also help to increase the shoulder’s range of motion over time. In certain cases, your doctor may advise surgical intervention such as shoulder arthroscopy.

    Shoulder arthroscopy, or arthroscopic shoulder surgery, is a minor surgery where a scope at the end of a long, thin tube is inserted into the shoulder area to evaluate the entire shoulder joint. The surgeon may then make small incisions to treat the problem. Speak to your doctor to understand the treatment options available.

  • Rotator Cuff Tear

    rotator-cuff-tear

    The rotator cuff consists of tendons and muscles that work together to hold your arm in place and aid in shoulder rotation and movement. Stress may cause partial tears and swelling, whereas abrupt force may cause one of the tendons to tear in the middle or pull away from the bone. This condition is known as a rotator cuff tear. Athletes in contact sports such as tennis, football, or even swimming are prone to this condition. It may also be caused by accidental falls or lifting heavy weights.

    Signs & Symptoms

    Tears of the rotator cuff are often painful and can lead to potential disability depending on the severity of the injury. The onset of pain can be sudden or gradual, with or without the accompaniment of weakness at the shoulder area. Symptoms include:

    - Weakness or tenderness
    - Pain
    - Limitation in movement
    - Snapping sound when moving the shoulder
    - Not able to sleep on the side

    Diagnosis

    Your doctor may check your medical history and perform a physical examination. These diagnostic tests may be used to assess the severity of your injury:

    - X-ray
    - Magnetic resonance imaging (MRI)

    Treatment

    Rotator cuff tears usually heal on their own. However, surgery may be required if results from the x-ray or MRI suggests that the mechanics of the shoulder are affected by the tear – which may result in irrecoverable damage – or if symptoms do not improve upon appropriate rehabilitation or physiotherapy.

    Arthroscopic shoulder surgery, a minor surgery, can be used to treat a rotator cuff tear. A scope at the end of a long, thin tube is inserted into the shoulder area to evaluate the entire shoulder joint. The surgeon may then make small incisions to fix the injury. Speak to your doctor to understand the treatment options available.

  • Tennis Elbow

    tennis-elbow

    Tennis elbow, also known as lateral epicondylitis, is common in racquet sport players such as tennis and badminton, though the condition is also on the rise outside of sports activities. Any activity, be it sports or recreational, that involves excessive or repetitive turning or lifting of the muscles and tendons of the forearm near the elbow joint, may lead to this condition.

    Tennis elbow occurs when the repetitive motion causes strain to the muscles and tendons attached to the elbow, thereby leading to tiny tears and inflammation near the bony lump (lateral epicondyle) on the outside part of the elbow.

    If your condition is caused by repeated strain on your elbow joint (such as in playing tennis), a hiatus or a change in technique may help alleviate the problem. Avoiding stress on the muscles and tendons surrounding your elbow area may also help prevent the condition from worsening.

    Signs & Symptoms

    People suffering from tennis elbow usually experience pain and tenderness on the outer part of the elbow. Pain may also be felt in the forearm as well as the back of the hand.

    Common signs and symptoms include:

    - Pain on the outside of part of the elbow
    - Tenderness and swelling
    - Pain when bending or lifting the arm, writing or gripping objects
    - Pain accompanied with stiffness upon full extension of the arm

    Diagnosis

    Your doctor may check your medical history and examine for swelling and tenderness. Further diagnostic tests such as ultrasound or magnetic resonance imaging (MRI) scan may be used, especially if there is suspected damage to the nerves.

    Treatment

    With rest and reduction of the activity causing the condition, tennis elbow usually heals on its own. If there is a need, your doctor may prescribe non-steroidal anti-inflammatory medication (NSAIDS) to help alleviate the pain. Physiotherapy may also help to relieve the pain and stiffness, while assisting to increase the range of motion over time. Surgery may be required should there be damage to part of the tendon. Consult with your doctor to understand the treatment options available.

  • Managing Treatment Costs

    Private Hospitals Made Affordable

    If you are covered by an Integrated Shield Plan (ISP), you may not incur out-of-pocket expenses should you require hospitalisation in a private hospital such as Gleneagles Hospital. Here are some examples.

    Shoulder rotator cuff surgery

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