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HE A LTHCARE S P OT L IGHT
Understanding Shoulder Pain
Deep, persistent pain in the
shoulder can affect young and old
alike. Young, active patients often
feel that shoulder pain stems from
overuse. Current exercise regimens
usually emphasize strengthening
the deltoid muscles, but the
rotator cuff is largely ignored.
If the pain is a chronic problem,
with no history of a single traumatic
event, the patient will usually
respond to strengthening
therapy.
If pain persists, the current
standard of care does not support
corticosteroid (cortisone type) injections
due to the negative effects
on the integrity of normal tissue.
Pain relief can be dramatic but
often short-lasting and can accelerate
rotator cuff degeneration
and even arthritic changes (loss
of joint lubricating cartilage.)
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Patients often respond well to
PRP (platelet rich plasma) where
growth factors are introduced
into the area to reduce inflammation
but also promote a biologic
healing response. Newer off
the shelf biologic treatments (i.e.
CTM® biomedical) are also available
that are much more concentrated
and avoid need for drawing
blood. Stem cells remain controversial
and in essence simply
provide growth factors which is
already achieved with the above
mentioned techniques.
Persistent symptoms may
require imaging studies such
as an MRI and occasionally arthroscopic
procedure to diagnose
and repair the problem via
mini incisions and surgery via a
fiberoptic camera. Patients with
complete tears of structures such
as the rotator cuff or labrum (stabilizing
soft tissue of socket) can
be repaired with all-arthroscopic
techniques. Partial tears are now
amenable to technologies such as
the arthroscopic introduction of a
collagen patch that relieves pain
and limits propagation of the partial
tear (Regeneten® patch etc)
This leads to rapid recovery and
minimal pain.
Older patients usually suffer
from a bursists stemming from
a partial or complete rotator cuff
tear.
On occasion a primary osteoarthritis
may be the cause and
shoulder replacements are now as
successful as hip or knee. This includes
resurfacing replacements
that are easily performed in an
ambulatory surgery center, virtually
free of hospital acquired infection
risks.
Regardless of cause, shoulder
pain deserves evaluation by an
orthopedic surgeon, particularly
an upper extremity/shoulder specialist
in order to speed recovery
and avoid misdiagnosis.
For more information about
treating pain in the hand,
shoulder and upper extremity,
contact:
Alejandro Badia, MD, FACS
Hand and upper limb surgeon
Badia Hand to Shoulder Centers
Miami (Doral) and NYC (Midtown
Manhattan)
305-227-HAND (4263)
Founder, OrthoNOW® Immediate
Orthopedic Care Centers
www.drbadia.com
Schneps Media February 10, 2022 1 1
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