Shoulder Pain: When Is Surgery Necessary?

By Your Health Magazine

Your Health Magazine

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Shoulder Pain: When Is Surgery Necessary?

Most people are used to living with a certain amount of aches and pains. One of the most common of these is shoulder pain. In many cases, shoulder pain (and the lack of arm mobility that often comes with it) can become unbearable, negatively impacting one’s quality of life. When this happens, medical intervention is necessary. Once people reach this point, there is usually a certain amount of anxiety around whether or not surgery will be needed.

the “Conservative First” Approach

Fortunately, surgery is not always needed. In fact, any worthwhile shoulder specialist is only going to suggest surgery as a last resort. Typically, a “conservative first” approach is used. This means that before surgery is even considered, all conservative treatment options must prove ineffective. These conservative treatments usually include:

• Immobilization through the use of slings or braces.
• Activity modification, which means to avoid any activities that aggravate your shoulder pain.
• Over-the-counter pain medications, such as NSAIDs.
• Ice and heat therapy.
• Physical therapy designed to restore strength and range of motion to the shoulder joint.
• Corticosteroid injections to reduce pain and inflammation.

For many people suffering from shoulder pain, a combination of these treatments will prove to be effective, negating the need for surgery. However, sometimes surgery cannot be avoided.

Signs Surgery is Needed

While you should always get the opinion of a medical professional, there are some signs that surgery is needed that you can recognize on your own. Surgery is usually needed if you have been trying conservative treatment methods, but:

● Pain remains the same or is worsening.

• The range of motion has not improved or has diminished further.
• You are having trouble sleeping due to pain.
• Your shoulder is still too weak to comfortably lift your arm.
• You are having difficulty lifting or gripping things.
• You feel that your shoulder pain is still preventing you from engaging in activities you enjoy.

If any of the above describes you, it is very likely that surgery will be needed in order to properly treat your shoulder pain.

Conditions That Usually Need Surgery

In most cases, shoulder pain is a symptom of a larger condition. Some conditions require surgery more often than others. This includes:

• Adhesive Capsulitis: Also known as frozen shoulder, this condition causes extreme pain and an inability to move the shoulder joint. Surgery for this condition involves the use of extremely small instruments and a camera to cut tight parts of the joint capsule, freeing the shoulder.
• Shoulder Labral Tear: The shoulder labrum provides stability to the shoulder joint. When it is torn, the only way to fully treat it is surgery. A surgeon will reattach the torn labrum with anchors or remove the torn part completely.
• Dislocated Shoulder: A dislocated shoulder can usually be fixed by manually manipulating the joint back into place. Pain relievers and physical therapy then help the patient to make a full recovery. However, if a shoulder is repeatedly becoming dislocated, shoulder dislocation surgery is needed. This surgery involves repairing damaged ligaments, tendons, or bones.
• Rotator Cuff Tears: While partial rotator cuff tears can be successfully treated, full tears often require surgical intervention. In these cases, surgery involves small incisions being made. Cameras and small tools are then used to repair the tear. Recovery is long, usually taking 4-6 weeks to return to light activity and 6-12 months to return to full strength.
• Arthritis: Arthritis that does not respond to less invasive methods often requires surgery. This involves the removal of damaged cartilage and replacing the joint with artificial implants to restore function. Replacement can either be partial or full. While this is a highly invasive procedure and requires a long recovery time, the success rate is extremely high.
• Fractures: While many fractures can be treated by manually manipulating the bones back into place and immobilizing them with a cast, this is not always so with shoulder fractures. The complex structure of the shoulder joint lends itself to extremely misplaced bones when a fracture occurs. These fractures can require surgery to insert screws or plates for full immobilization, allowing the bone to heal in the right position.

These are just some examples of conditions that require surgery. You should always make an appointment with your doctor to know for sure if surgical intervention is required.

The Risks of Delaying Surgery

Understandably, surgery is a scary prospect for many. Oftentimes, this fear leads to people delaying surgery. This is a mistake. Delaying surgery can lead to muscle atrophy from not using the shoulder joint regularly, which makes recovery after surgery much more difficult. Additionally, if your condition involves a torn tendon, delaying surgery gives the tendon time to retract, making it much more difficult to reattach. In general, delaying the surgery makes it more difficult for your surgeon, and recovery more difficult for you.

What to Ask Your Surgeon

Anxiety around surgery is extremely common. People are worried that the surgery will not be successful, that something will go wrong, or that they will come through the other side with more pain than they had before. As you can see, fear of surgery is usually just fear of the unknown.

Fortunately, there is a very simple way to dispel this fear, which is to ask your surgeon questions. Questions you should ask include:

• What is the success rate for my specific age and activity level?
• Will you be usingarthroscopy or making a full incision?
• What does the “failed” version of this surgery look like?
• Is this an inpatient or outpatient procedure?
• How long will recovery take?

Your surgeon will be happy to answer these and any other questions you have. Do not be shy. Surgeons are extremely used to people having anxiety when it comes to surgery. You will likely not be asking any questions that they haven’t heard before. Remember, surgery can be scary, but once it is over, you will regain your strength and range of motion in your shoulder, greatly improving your quality of life.