Shoulder injuries can occur from a variety of reasons and can be of very different types. From Fractures and dislocations to muscle tears a lot of things can happen in case of shoulder injuries. Since there are such a large variety of injuries, the ways of treating these injuries also vary a lot. In case of shoulder, bone fractures can usually occur in the collarbone, shoulder blade and the upper arm bone. The reasons of these fractures are traumas due to falls and accidents, etc. The shoulder joint also can get dislocated due to trauma and gradual weakening of the ligaments and cartilages supporting the shoulder from old age. Apart from bone injuries, wear and tear in muscle tissues is also common. The most common muscle injuries are rotator cuff tears and rotator cuff tendinitis. Rotator cuff refers to a group of four muscles that from a covering on the head of the upper arm bone and help in raising and rotating your arm. In case of rotator cuff tear, one or more of the muscles may get torn partially or fully from the upper arm bone due to reasons like lifting heavy things with jerks or muscle degeneration from old age, etc. In case of rotator cuff tendinitis the muscle may get inflamed due to variety of reasons like overuse or keeping the shoulder in lifted position while sleeping everyday. Shoulder injury treatments are aimed towards repair of these muscles and bones through medications, exercises or surgeries.
While bone fractures and dislocations can be identified easily from the X-rays, swelling near the joint or spot of fracture, inability to lift or rotate the arm, etc. . Identification of muscle tears or tendinitis is done by checking the strength of the shoulder joint through lifting activities, etc. if X-ray scans report no problems in the bones and joints. Once the problem has been identified, the treatment varies accordingly.
For bone fracture and dislocations, the bones are moved into the right place by putting force externally and then plaster of Paris and splints are put in place so that the bone holds in this position and reattaches normally. These procedures are followed by gentle exercise to relieve pain and once the pain has ebbed, exercises to build arm strength are prescribed. In rare cases where bone instead of having hairline fracture has splintered or broken in pieces, surgery is required. In such cases using metal plates, pins or rods as required the doctors connect the bone fragments. Additionally in case of repeated shoulder dislocations, a surgical procedure known as Bankart repair is done wherein ligaments and the shoulder joint capsule are reattached.
In case of rotator cuff injuries usually physiotherapy and medication is used. However, if the severity of the injury is very high or it persists for a long time then surgery might be required. In the surgery, the torn tendons of the rotator cuff muscles are reattached to the head of the humerus. Surgery for rotator cuff tendinitis involves removal and replacement of the inflamed tissue or muscle areas through muscle grafting. Surgeries are only done in very severe cases of shoulder injuries. Usually the doctors try to treat shoulder problems through physiotherapy and medications.
In case of shoulder injuries you should immediately go for physiotherapy treatment and medications if prescribed. Not doing so may aggravate the muscle tear and tendonitis further in case of shoulder muscles and deform the bone structures in case of bones. However, you should go for surgeries only when there is severe damage like bones being splintered or muscles having tears that may be more than 3 cm and/or persist for more than 6 months.
Mostly shoulder problems are treated with physiotherapy so almost everybody is eligible. However in case you have a more severe problem that requires surgery or require additional medications you must first consult with a doctor familiar with your medical history before going for the treatment
Apart from stiffness in the shoulders generally there are no other side effects of the treatments. This stiffness in shoulders is there no matter how well the bones or the muscles heal up. However it is mostly temporary and vanishes in a year or so after the surgery. Very rarely also due to lack of precision, the surrounding deltoid muscle's nerves may get damaged during the surgery. Additionally, the side effects common to that of surgeries for people with bleeding disorders or having a history of complication with general anesthesia, are some side effects that can occur during these surgical procedures.
Usually doctors prescribe post surgery as well as post therapy instructions that you should follow during recovery from the injury. These include recommendations related to your diet, exercises, etc. You should follow these instructions to recover faster. Apart from that few things you can do are – 1. Avoid lifting or carrying heavy things as this will put stress on the shoulder and may even cause the muscles to rupture or bones to break, again. 2. Take breaks between tasks that involve repetitive movement of the shoulders as well as avoid sleeping on the same side every night 3. In case you have a desk job, then maintain a good and ergonomic sitting posture. Additionally take breaks between work and do stretches and shoulder rolls to release any tension and stiffness in the shoulders.
Recovery from shoulder injury treatments usually takes around 1 – 2 months as bones as well as shoulder muscles like rotator cuff require some time to gain back strength once they heal.
While Splint and Plaster of Paris treatment for bone fractures usually cost around Rs 500 – 1000, the cost of shoulder injury surgeries can go up to as high as 5,00,000 and averages around 3,50,000. Rotator cuff surgeries usually fall in the range of 1,50,000 – 2,50,000.
Shoulder injuries usually result from traumas like accident, repetitive lifting of heavy weights, etc. If the person is able to avoid such circumstances, then there is no need for any other future treatments. However in case the person experiences these traumas again, the problems may resurface and the person may need to undergo the treatment procedures again
Physiotherapy, steroid based medications, etc. can also be used to treat shoulder injuries. In case of rotator cuff injuries, Arthroscopy a minimally invasive surgical procedure is used sometimes. It requires minimal incision as compared to open shoulder surgery and uses very small medical instruments for the surgery.