Dr James Mclean - Orthopaedic Surgeon
Dr James Mclean - Ortopaedic Surgeon
Dr James Mclean - Ortopaedic Surgeon

Other Shoulder Conditions

Other Shoulder Conditions (diseases and ailments)

 The shoulder joint is the most movable joint in the body and can become injured or unstable as soft tissue breaks down from degeneration, overuse, falls, manual labour or contact sports.

Common shoulder conditions include:


Frozen Shoulder (Adhesive Capsulitis)

A painful condition resulting from chronic stiffness of the shoulder joint and is most common between the ages of 40 and 60. Frozen shoulder often occurs when the shoulder has been immobile for a period of time and when a minor shoulder injury heals with scar tissue that affects the joint movement. Even though the causes are not fully understood, frozen shoulder appears to be more common in patients with diabetes, thyroid disease, heart disease or Parkinson disease.

Symptoms:

There are three phases:

  • Freezing phase (2 – 9 months) – A gradual onset of aching in the shoulder, where the joint tightens up.
    • Lying on the affected side is more painful at night.
  • Frozen phase (4 – 12 months) – Movement in the shoulder is reduced and stiffens up.
    • Everyday activities become more difficult.
    • Shoulder muscles may begin to waste away through lack of use.
  • Thawing phase (5 – 12 months) – Mobility gradually increases.
    • Pain gradually decreases.

Treatment:

Speak to Dr James Mclean as soon as possible as early treatment can help prevent severe stiffness setting in.

It is also advised to keep the shoulder moving even if just small pendulum movements.

Treatment actions may include:

  • Anti-inflammatory medication to reduce pain and swelling
  • Heat
  • Stretching exercises
  • Electrical stimulation of muscles and nerves
  • Cortisone injections
  • Surgery (only if all other treatment fails) – arthroscopic capsular release may be performed using keyhole surgery.
  • It is advised that an aggressive rehabilitation program is followed after surgery.

Most cases will resolve on their own or with physiotherapy over 1-3 years.

 


Rotator Cuff Disease – Tendinitis and Bursitis

When tendons in the shoulder become inflamed and sore from being pinched by other shoulder parts, it is known as tendinitis.

Bursitis is caused by overuse of the shoulder during sports or manual labour which requires overhead reaching as well as rheumatoid arthritis. It causes the small fluid-filled sac that helps protect the shoulder joint, known as the bursa to become inflamed.

Often tendinitis and bursitis can occur at the same time.

Symptoms of Tendinitis

  • Pain and swelling at the front of the shoulder or side of the arm
  • Pain when raising or lowering the arm
  • Stiffness
  • Clicking sounds when moving the arm
  • Difficulty sleeping on the injured shoulder
  • Pain when reaching behind your back

Symptoms of Bursitis

  • Shoulder pain
  • Swelling
  • The affected area feels warm
  • Increased pain at night
  • Pain increased by movement
  • Stiffness
  • Reddening of the skin

Treatment:

  • Rest and Ice
  • Anti-inflammatory medication
  • Ultrasound or infrared treatments to help improve blood flow in the affected area
  • Gentle stretching and strength building exercises
  • Cortisone injection if the shoulder does not improve
  • Surgery after 6-12 months


Arthritis

Arthritis damages your muscles and tendons as well as your joints and ligaments causing joint pain and a limited range of motion.

There are 5 types of arthritis that affect the shoulder:

Osteoarthritis

As we age, the smooth surfaces of the cartilage that line the bones of the shoulder joint begin to wear out and become larger causing osteoarthritis  – mainly caused from overuse. This is most common in people over the age of 50.

Symptoms include:

  • Joint pain
  • Tenderness
  • Stiffness

Rheumatoid arthritis

An autoimmune disease causing one or more joints to become inflamed and may affect both shoulders at the same time. Rheumatoid Arthritis can cause your shoulder bones to erode and become deformed over time.

Symptoms include:

  • Tenderness and warmth in the joints
  • Shoulder stiffness, especially in the morning
  • Fatigue, weight loss or fever

Avascular Necrosis

When blood cannot reach the long bone in your upper arm (humerus), the cells in your shoulder bone begin to die and subsequently destroys the joint tissue in the shoulder. This is a progressive disease and gradually worsens over time. Avascular necrosis can happen due to shoulder dislocations, fractures or high doses of steroids or alcohol abuse.

Post Traumatic Arthritis

Shoulder injuries such as fractures and shoulder dislocations may eventually lead to post-traumatic arthritis which causes fluid to build up in the shoulder joint, pain and swelling.

Rotator Cuff Tear Arthropathy

Generally caused by a rip in the tendons of the rotator cuff commonly causing a form of arthritis to develop.

Symptoms include:

  • Intense pain
  • Muscle weakness that can make lifting difficult

 

Arthritis Treatment:

Depending on the type of arthritis you have, Dr James McLean may recommend:

  • Lifestyle management such as rest, physical therapy or range of motion exercises
  • Anti-inflammatory medication
  • Cortisone injections
  • Surgery (only if all other treatment fails) and may include joint replacement surgery, arthroscopy or resection arthroplasty.

 

When should I book an appointment with Dr McLean?

We recommend booking an appointment if you have any of the following symptoms:

  • Severe pain in the shoulder and are unable to move it after 24 hours
  • Severe swelling
  • Popping or cracking sounds in the shoulder joint area
  • Loss of feeling or pins and needles in the hand or arm
  • Difficulty conducting everyday activities

 

How Dr James McLean can help:

Dr James McLean has extensive upper limb experience, including soft tissue and bone injuries. He will work with you to develop a treatment plan that will have the best possible outcome for your shoulder injury.