Knowing When to Consider Shoulder Surgery: Key Indicators

Shoulder pain can be an extremely debilitating condition, particularly because the shoulder plays a crucial role in everyday activities for almost all individuals. Activities like throwing a ball, working out, and lifting a child all require movement from the shoulder. The shoulder is essential even for small day-to-day tasks like reaching on a shelf. While the shoulder is essential for daily activities, shoulder injuries are extremely common, like strains, sprains, and torn tendons and ligaments. In most cases, less invasive treatments like physical therapy, medications, rest, and injections provide the necessary relief. But there are times when shoulder surgery may be the only viable option. 

Understanding Shoulder Anatomy

Shoulder anatomy is composed of several different things, like joints, muscles, tendons, ligaments, and cartilage. The shoulder joint is called a ball-and-socket joint, meaning the upper arm fits into a socket in the shoulder blade. This joint is a mobile joint that allows for a wide range of motion, making it possible to throw, lift, and rotate our shoulders. The rotator cuff plays a crucial role in stabilizing the shoulder. It consists of a group of four muscles and their connecting tendons. 

The shoulder and rotator cuff are especially vulnerable to injury and wear and tear that can lead to a significant amount of pain and reduced range of motion. When injured or torn, you may start looking for treatment options or even surgery.

When to Consider Shoulder Surgery?

Most shoulder injuries can be treated with noninvasive procedures or methods like physical therapy, anti-inflammatory medications, and injections. While this is true, there are several reasons why shoulder surgery may be needed. Depending on the pain level, the reduction in mobility, and stability, you may need to think about shoulder surgery. Here are a few examples of when shoulder surgery may be necessary: 

1. Chronic Pain

When experiencing chronic shoulder pain, it is important you try noninvasive procedures or methods first, like physical therapy, injections, or medications. After a while, if the pain persists or grows, you may need to look into the surgical route. Sometimes the underlying cause of the pain needs to be treated with surgery rather than a conservative treatment. 

An example of this would be a rotator cuff tear. Sometimes people may experience a tear that won’t heal on its own with physical therapy or medication. If you have tried these treatments and there are no signs of improvement, it may be time to consider shoulder surgery. 

2. Severe Rotator Cuff Tears

The rotator cuff plays a huge role in the mobility of our shoulders and consists of muscles and tendons that help stabilize the joint. A rotator cuff tear can occur from an injury or even develop over time from repetitive motions. In severe cases, the tendon is completely torn, causing an extreme reduction in mobility. If a rotator cuff tear is large or the tendon has retracted and cannot be repaired, shoulder surgery may be necessary.

3. Loss of Mobility and Range of Motion

If you experience a sudden loss of your range of motion, this could be an indication that surgery is needed. Being unable to lift your arm, reach overhead, or perform everyday activities due to shoulder stiffness or weakness may signal an underlying issue.

Some conditions like adhesive capsulitis (frozen shoulder) can lead to stiffness, discomfort, and reduced range of motion. Some severe cases may require surgery to restore mobility and function if conservative treatments don’t alleviate the pain.

4. Shoulder Instability or Dislocations

Shoulder dislocations occur when the ball of the upper arm is pulled out of the socket and mainly occur from trauma or sports-related injury. Frequent shoulder dislocations can lead to shoulder instability and may indicate the need for surgery. After being dislocated several times, the ligaments and tendons of the shoulder may need to be repaired to restore the joint. 

5. Fractures

Shoulder fractures are common, particularly in older adults and athletes. Fractures of the humerus, scapula, or clavicle can cause significant pain, swelling, and bruising, and in severe cases, the bone fragments may need to be realigned and secured. 

Shoulder fractures are often common in elders or athletes and can cause a significant amount of pain, especially if the humerus, scapula, or clavicle is damaged. These fractures can cause swelling and bruising, and in severe cases, bone fragments may need to be realigned through surgery. 

6. Arthritis and Degenerative Conditions

Osteoarthritis is a degenerative joint disease that can affect the shoulder joint, leading to pain, stiffness, and loss of function. In advanced cases of shoulder arthritis, non-surgical treatments may offer temporary relief. When the arthritis becomes severe and the joint is no longer able to function properly, surgery may need to be considered.

Types of Shoulder Surgeries

 Depending on the condition or injury, there are several shoulder surgeries you may need to consider; here are a few:

• Arthroscopic Surgery: A minimally invasive surgery that involves small incisions and the use of a camera (arthroscope) to guide the surgeon in repairing or removing damaged tissue. It is commonly used for rotator cuff tears, labral tears, and shoulder impingement. 
• Shoulder Replacement (Arthroplasty): In cases of advanced arthritis or joint degeneration, shoulder replacement surgery may be necessary. 
• Labral Repair or Reconstruction: This surgery is used to treat tears in the labrum, which is the cartilage that helps stabilize the shoulder joint. It may be necessary for individuals with shoulder instability or dislocations. 
• Fracture Repair: For displaced fractures, surgery may involve the use of plates, screws, or rods to align and stabilize the bones during the healing process.
• Rotator Cuff Repair: This surgery is performed to repair tears in the rotator cuff tendons. It may involve stitching the tendon back together or reattaching it to the bone.

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