mtomaino
11-22-2010, 01:57 PM
I saw a patient this past week who presented for a second opinion regarding her shoulder pain. Her xray showed osteoarthritis, and her doctor told her an injection would not help and that PT was not indicated. She wanted to know if Shoulder replacement was indeed the only option.
This is a common question----because if you are having pain, and your xray shows arthritis, your doctor may instinctively assume that your pain is coming from the joint. However, this may not be entirely true---which is why it is so important to undergo a thorough and thoughtful exam. If you have reasonable motion, but you have pain as you reach above shoulder level, your symptoms may be coming from your biceps tendon or rotator cuff.
If this is the case, a little PT(physical therapy) and a corticosteroid injection may help---and at least in the short term, you may feel better. The point is---we never want to "treat the xray." Because we really can't predict whether conservative treatment will or will not help, it's often worth trying. It's worth emphasizing that Shoulder Replacement Surgery is "Elective"---thus you should feel completely empowered as to when you decide to proceed. If you can raise your arm above shoulder level (that is, your motion is functional--you're just having pain), arthroscopic intervention may help as well, thus obviating the need for a more major "replacement" surgery.
Visit the link below for more information about the role for Arthroscopic debridement in cases of arthritis. So--before coming to the conclusion that your arthritic shoulder needs a replacement, you may want to consider PT and a cortisone shot. And, if your motion is acceptable, but pain is the problem, you may even be a candidate for minimally invasive arthroscopy, as an alternative to replacement.
http://www.rearmyourself.com/article/Arthroscopic-Debridement-as%20an-alternative%20to%20arthroplasty
This is a common question----because if you are having pain, and your xray shows arthritis, your doctor may instinctively assume that your pain is coming from the joint. However, this may not be entirely true---which is why it is so important to undergo a thorough and thoughtful exam. If you have reasonable motion, but you have pain as you reach above shoulder level, your symptoms may be coming from your biceps tendon or rotator cuff.
If this is the case, a little PT(physical therapy) and a corticosteroid injection may help---and at least in the short term, you may feel better. The point is---we never want to "treat the xray." Because we really can't predict whether conservative treatment will or will not help, it's often worth trying. It's worth emphasizing that Shoulder Replacement Surgery is "Elective"---thus you should feel completely empowered as to when you decide to proceed. If you can raise your arm above shoulder level (that is, your motion is functional--you're just having pain), arthroscopic intervention may help as well, thus obviating the need for a more major "replacement" surgery.
Visit the link below for more information about the role for Arthroscopic debridement in cases of arthritis. So--before coming to the conclusion that your arthritic shoulder needs a replacement, you may want to consider PT and a cortisone shot. And, if your motion is acceptable, but pain is the problem, you may even be a candidate for minimally invasive arthroscopy, as an alternative to replacement.
http://www.rearmyourself.com/article/Arthroscopic-Debridement-as%20an-alternative%20to%20arthroplasty