Mr David Butt is a Consultant Shoulder and Elbow Surgeon and a founding partner at Grosvenor Orthopaedic Partners LLP. His practice encompasses all aspects of shoulder and elbow surgery from minimally invasive keyhole (arthroscopic) surgery to complex reconstructive and revision procedures. Here, David discusses the most common presenting complaint around the shoulder, pain, and the reasons you may be experiencing it.
Shoulder problems are extremely common, but can be very debilitating, and there are many causes because of the complexity of the joint. As we start to move towards a more normal way of life again, many of us are still feeling the effects of delayed investigation or treatment for musculoskeletal issues. These may be problems which have crept up over time, or might be due to a sudden change in our normal activity levels.
The most debilitating symptom is often pain, and although the location of pain can provide clues to the cause, there are several conditions with overlapping symptoms. One of the most common complaints is calledimpingement syndrome, where pain is localised around the tip of the shoulder but can originate from the rotator cuff – a group of muscles that stabilise the shoulder joint – and can be frustratingly persistent and intrusive, interfering with all aspects of life. Other conditions include frozen shoulder, where a painful stiffness develops, and arthritis of the shoulder or clavicle joints where pain typically develops gradually over several years. A sudden loss of strength, swelling, bruising or very severe pain can point to a problem that needs more urgent attention.
The key to getting the right treatment is getting the right diagnosis, which is possible with a combination of a thorough clinical assessment and appropriate investigations, which may include imaging such as ultrasound and MRI scans. In many cases, advice, activity modification, simple pain killers and physical therapy can keep symptoms under control. In some an injection is helpful to rapidly improve pain. If surgery is necessary many interventions can be performed with keyhole surgery, using the most advanced minimally invasive techniques. Followed with a tailored rehabilitation plan, patients can achieve a permanent resolution of symptoms and most importantly, restore normal function.