SHOULDER PAIN (PART 3)
The Rotator Cuff consists of four
muscles and their associated tendons that envelop the
upper arm like an upside down shoebox. These important
muscles are responsible for all the movements of the
upper arm and shoulder. They aid in raising your arm
to comb your hair, scratching your mid-back, swinging
a golf club, carrying a suitcase and throwing a ball
overhand.
Rotator Cuff Injuries can result
from several sources. In younger individuals, they
usually are the result of a traumatic fall. In middle
age individuals, they often result from repeated overuse
and end-stage impingement syndrome. In the elderly,
they usually result from attrition and thinning of
the rotator cuff over time. Small partial tears can
cause bleeding and deposits of calcium within the tendon.
Pain and weakness with shoulder
use are the primary symptoms. One of the hallmarks
of rotator cuff tears is pain even when lying down
flat on your back. This is because without gravity
the ball of the upper arm presses into the rotator
cuff tear causing pain. The quality of the pain is
usually sharp. Early evaluation and initiation of a
treatment program is very important. Your physician
will obtain a detailed history of when your shoulder
hurts. He then will do a specific examination to find
the location and cause of your shoulder pain. An x-ray
or MRI may be ordered to evaluate your shoulder in
greater detail.
Treatment initially is aimed at
non-surgical treatment. The rotator cuff has the capacity
to repair itself in certain situations. Resting your
shoulder with a pillow between your arm and your body
when sitting or lying down can help. Do not stop using
your shoulder altogether as this can cause a frozen
shoulder. Gentle pendulum exercises (stir the pot,
bowling, rock the baby and saw wood) can keep your
shoulder active while resting it at the same time.
Cold and heat can sometimes help. Your physician may
prescribe anti-inflammatory medications to control
the pain and inflammation. A formal physical therapy
program with ultrasound treatments and electrical stimulation
can reduce pain levels. If the pain is severe, your
physician may inject cortisone directly into the shoulder.
If conservative treatment fails, surgery may be needed.
Today, many rotator cuff injuries can be treated arthroscopically
through three tiny incisions as same-day surgery. Talk
to your doctor for more information.
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