Nagging pain in shoulder: Don’t take lightly 

Dipankar Chakraborty

It is the most discomforting when it comes to shoulder pain. Pain levels may vary through different movement types through the day, often reaching unbearable proportions. So do you take shoulder pain as seriously as even mild pain in your chest, which you would waste no time to get treatment for?

 As the old proverb goes, a stitch in time saves nine. Timely medical intervention more often than not makes all the difference to having to live with the burden of shoulder pain or get rid of the pain, which would otherwise appear a normal situation of physical indisposition till it aggravates to a point beyond any repair.

Though the comparison of shoulder pain with that of the chest seems incompatible, untreated shoulder pain is most likely to have a far-reaching consequence for the overall physical well being of the patient.

The pain in the shoulder generally could be due to wear and tear injury to tendons. Shoulder tendons are central to issues like rotator cuff problems, shoulder impingement, osteoarthritis and disorders of pain and weakness.

“The shoulder pain can arise from rotator cuff tear (separation of the tendons of the rotator cuff from the bone due to injury needing surgical intervention), frozen shoulder (adhesive capsulitis: joint capsule becomes inflamed and stiff restricting motion, causing chronic pain), calcific tendonitis (accumulation of calcium within a tendon, especially within the rotator cuff tendons), shoulder dislocation (head of upper arm bone (humerus) being forced out of shoulder socket), arthritis or fracture,” explains says Dr Banerjee BH, renowned Orthopaedic Surgeon specialising in the treatment of Shoulder and Upper limb disorders and Arthroscopy besides the sports medicine at the Sakra World Hospital in Bangaluru.

Injury to the tendon can happen in the unfortunate event of meeting with a traffic accident or because of a fall (accounting for a large number of cases in India), excessive physical movement needing repetitive shoulder movement or due to old age-related problems, etc.

The shoulder injury could manifest in numerous ways such as in the form of inflammation of the tendons (tendonitis), bursitis, bursa (protective sacs that sit like a cushion between shoulder bones allowing for the space necessary for the movement of tendons). The movement is facilitated by a type of fluid known as synovial fluid contained inside bursae or sacs.

It is imperative that tendons are treated at the earliest manifestation of symptomatic pain to let them function normally and more significantly to ensure that the patient gets rid of the pain at the earliest through medication. In cases where surgery becomes unavoidable minimally invasive procedures can be used to rectify the malfunction and alleviate the pain within the shortest possible recovery period,” says Dr Banerjee, one of the first surgeons to perform keyhole surgeries of shoulder and elbow joint in Karnataka.

Today, shoulder Arthroscopy has proven to be the most effective way to help patients get rid of shoulder pain and lead a normal pain-free life. It is also one of the most widely used tools to treat serious shoulder injuries by orthopaedics in India, which has emerged as a prominent destination with world-class treatment facilities for shoulder problems. There are sufficient numbers of cases to establish the obvious advantages of arthroscopy for a patient with recurrent shoulder dislocation. Patients generally complain of swelling, deformity, numbness or weakness in case of shoulder dislocation. “For both the patient and surgeon arthroscopy comes with great advantage. It is less invasive and causes smaller scars, lesser instances of soft-tissue injury, less postoperative pain and morbidity. The arthroscopic stabilization is easier. The surgeon recognizes the pathology, helping in the process of identifying the problem and repairing the injury with precision,” says Dr Banerjee, who has also performed a maximum number of keyhole shoulder joint surgeries having gotten specialised training in France in the field.

The course of treatment for shoulder dislocation, according to Dr Banerjee, is decided after assessing if the patient’s dislocation instability is of traumatic or atraumatic type. In case of traumatic instability, the ligament holding the shoulder ball in its socket gets torn due to trauma or overloading. In the case of atraumatic instability, general laxity in the joint happens. 

The stability to the shoulder joint is provided by strengthening the rotator cuff muscles and periscapular muscles (those around the scapula). Physiotherapy helps the muscles provide stability to the shoulder disabled by the torn ligaments. It helps regain lost motion, reduce apprehension, and restore shoulder function. Lifestyle changes are also recommended to avoid recurring stress to shoulder. Surgery is suggested if the physiotherapy and activity modifications fail to improve the patient’s condition. (Courtesy: Dr Banerjee BH, renowned Orthopaedic Surgeon specialising in the treatment of Shoulder and Upper limb disorders and Arthroscopy besides the sports medicine at the Sakra World Hospital in Bangalore.)

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