Periarthritis shoulder
When a diabetic patient notices pain along with stiffness of the shoulder he must seek early specialist opinion. This condition usually is self-limiting but may take up to a year for full recovery. Initial treatment could involve regular exercises and only in resistant cases surgery would be necessary. Recent advances has allowed us to carry out surgery by keyhole to release the contracted capsule aiding faster recovery.
Rotator cuff tear
Another common problem that middle aged people develop is called Rotator Cuff Tear. Rotator cuff comprises of group of muscles that surround and act on the shoulder. As we age, these muscles undergo degeneration and overhead activities can lead to these tears .Patients with rotating cuff tears complain of pain along with weakness of the shoulder. Leaving the problem unattended may lead to long term disability and persistent weakness. The common scenario is that patient is unable to lift the arm above shoulder level, is to unable to comb the hair or dry clothes .A shoulder surgeon would initially treat this condition by referring the patient to a Physiotherapist. The exercises are designed to strengthen the intact muscles around the torn muscle. If these measures fail key hole repair of the torn muscle /tendon will be needed. Key hole repair is much superior to open repair as it allows better visualization and aids the faster recovery.
Recurrent instability of shoulder
On the other end of the spectrum, young patients can have the feeling of shoulder coming out along with pain. This condition is called recurrent instability of shoulder. In the shoulder joint, the socket is deepened by the presence of bumper like tissues called labrum. During an injury when the patient sustains a dislocation {movement of ball out of the socket) the labrum is injured .Non healing of this tissue leads to persistant feeling of unstableness in the shoulder. Patients with this condition are afraid to continue sports and do overhead activity with the fear that shoulder may come out.
Young patients have around 90 percent chance of developing this problem after dislocating their shoulder. Recent studies have shown that keyhole surgery done to repair the labrum (Bumper like tissue) after the first episode of dislocation can prevent further problems and long term disability. Key hole surgery avoids the scaring and stiffness that is caused by open surgery and also results in faster recovery.
Scapulothoracic Bursitis
Some patients develop pain in the joint between spine and back bone of the joint called scapula. This is due to inflammation of tissue in this joint and this condition is called Scapula thoracic bursitis. This problem is due to continuously adopting a stooped posture commonly seen amongst IT professionals while working. Initial treatment involves adopting correct posture while working and physiotherapy to control the muscle groups of back in a better way. In refractory patients Key hole surgery called Scapulothoracic Bursoscopy can be done to remove the bursal tissue to relieve symptoms.
Most of the shoulder problems needs early recognition to prevent long term problems. With advent of recent advances in shoulder arthroscopy we are able to treat most of these problems effectively with quick recovery.
