Introduction to the Challenges of Shoulder Pain

Shoulder pain is a common problem in Singapore, and it can affect people of all ages. One of the reasons for this is that our spaces at home or work can be limited. We often have to reach up high to get things from shelves or cupboards. This reaching motion can affect the shoulder for many people who already have pre-existing shoulder issues.

Now, let’s talk about the shoulder itself. The shoulder joint is kind of like a ball and socket joint, where the ball is the top part of your arm bone (humerus), and the socket is a part of your shoulder blade (glenoid). But unlike some other joints, the shoulder is designed to be very mobile, which means it can move around a lot. To make up for this extra movement, the shoulder has some important parts that help keep it stable. One of these is a piece of cartilage called the labrum, which deepens the socket and provides more stability. Five tendons run around the joint. Four of these tendons are part of what we call the rotator cuff, and the fifth is the long head of the biceps tendon. These tendons not only help hold the shoulder steady but also help it move properly.

In addition to the main shoulder joint, there’s another smaller joint called the acromioclavicular joint, which connects a part of your shoulder blade (acromion) to your collarbone (clavicle). This joint allows your shoulder to move smoothly while also keeping your arms away from your body. Now, when it comes to shoulder pain, it can be different depending on your age. If you’re younger and you have shoulder pain, it’s often because you might have injured your shoulder while playing sports or doing physical activities. On the other hand, if you’re older, your shoulder pain could be because of wear and tear on your shoulder joint over the years, which might have caused tears and pain. So, the causes of shoulder pain can vary depending on how old you are.

(image source: https://www.pexels.com/photo/crop-anonymous-osteopath-straightening-shoulders-of-woman-in-doctor-office-4506106/)

Shoulder Pain in Younger Patients & Older Patients

Younger Patients:

• More likely to get shoulder injuries from sports and physical activities.
• Common injuries include shoulder dislocations, collarbone dislocations, and fractures near the shoulder joint.
• They may feel their shoulder popping in and out, especially when reaching overhead.
• In severe cases, the shoulder can dislocate even with minor activity.
• Previous dislocations can lead to nerve damage and ongoing weakness if not treated early.

Elderly Patients:

• Often suffer from rotator cuff tendon degeneration.
• Weakened tendons are more prone to tearing, causing pain.
• Severe cases can involve multiple torn tendons, leading to significant weakness.
• Over time, torn tendons can also damage the shoulder joint cartilage, increasing pain.
• This condition is known as cuff tear osteoarthritis or arthropathy of the shoulder.

Symptoms of Shoulder Pain and Related Orthopaedic Conditions

These symptoms can happen because of different conditions. One common one is a torn rotator cuff, which is like a group of tendons in your shoulder that can be susceptible to injury. Another is arthritis, where your shoulder joint hurts because it’s worn down. There are also conditions like bursitis, which is when the fluid-filled sacs in your shoulder swell up. It’s important to talk to an orthopaedic surgeon if you have shoulder pain, so they can figure out an optimal treatment plan for you.

If the following symptoms do not go away after first aid treatment or rest, you should book an appointment to see an orthopaedic surgeon.

• You may feel pain in your shoulder. It can be sharp or dull and might hurt more when you move your arm. This pain can last up to months at a time.
• Your shoulder might feel weak, making it hard to lift things or do tasks you usually perform daily.
• Your shoulder might feel stiff, and it will be harder for you to move or stretch.
• Sometimes, you might hear or feel your shoulder making clicking sounds when you move it.
• You might feel strange sensations like numbness or tingling down your arm.

(image source: https://www.pexels.com/photo/crop-masseur-preparing-client-for-spine-treatment-5473215/)

The Benefits of Seeking Professional Help for Easing Shoulder Pain

Shoulder pain happens to lots of people, no matter their age or lifestyle. Getting help from an orthopaedic surgeon, or a shoulder pain specialist, can make a world of a difference. Here’s why it’s a good idea to contact an orthopaedic surgeon in Singapore:

• These surgeons are well-equipped and trained to figure out exactly why your shoulder hurts, which can be tricky to do on your own. Knowing the cause is super important because it helps decide how to treat it.
• Once they identify what’s causing your pain, they will create a treatment plan just for you. This plan might include exercises, therapy, medicine, or even surgery – whatever helps you best.
• With their plan, you’ll likely recover quickly and get back to doing your usual routine, which is optimal for your daily schedule and recovery.
• They can also give you tips to avoid hurting your shoulder in the future. It might be exercising or changing the way you do chores, errands, and other activities.

(image source: https://www.freepik.com/free-photo/woman-doctor-osteopath-medical-uniform-fixing-woman-patients-shoulder-back-joints-manual-therapy-clinic-during-visit-professional-osteopath-during-work-with-patient-concept_27156522.htm)

Considering Orthopaedic Treatments for Long-Term Ease and Mobility

Orthopaedic treatments for shoulder pain can include:

Shoulder Artery Embolization: This is a minimally invasive procedure where tiny particles are put into an artery in your shoulder to block it. It’s done with a thin tube called a catheter. This can help reduce shoulder pain, especially if you have a frozen shoulder.

Steroid or APS Injections: APS is a special protein injection made from your blood, and it’s put into your shoulder joint. It can help with pain and slow down the damage from conditions like osteoarthritis. Steroid injections are another option. They can be given either in the fluid sac inside your shoulder (bursa) or the joint itself. These injections reduce inflammation and are used for problems like tendinitis and bursitis.

Suprascapular Nerve Ablation: This treatment uses radiofrequency waves with the help of ultrasound and X-rays to calm down the nerves in your shoulder. It’s a quick procedure and is often used if you have shoulder pain, a rotator cuff injury, or pain in your shoulder blade. It can provide relief that lasts for a while.

There are different ways to deal with shoulder pain. Your orthopaedic surgeon will create a treatment plan and schedule for you, which may include medications, injections, exercise, minimally invasive procedures, and more.

(image source: https://www.pexels.com/photo/crop-chiropractor-massaging-hand-of-patient-5473223/)

Tips on At-Home Treatments and Exercises to Help Ease Your Shoulder Pain Symptoms

There are also simple tips, treatments, and exercises that you can try at home to help with shoulder pain:

• Apply a hot pack or warm towel for 15-20 minutes to relax the shoulder muscles, followed by a cold pack or ice wrapped in a cloth for another 15-20 minutes to reduce inflammation. Repeat as needed but avoid prolonged exposure to extreme temperatures.
• Perform gentle shoulder stretches to improve flexibility and reduce stiffness. Try the “across-the-chest stretch” by bringing your arm across your chest and gently pulling it with your other hand. Hold for 20-30 seconds, then switch sides.
• Stand with your back against a wall and your arms outstretched at shoulder height. Slowly raise your arms as high as possible, then lower them back down. Repeat this motion for 2-3 sets of 10-15 repetitions.
• These are exercises where you push or pull against an immovable object, like a wall. For example, stand facing a wall and push your hands into it at shoulder height for 5-10 seconds, then relax. Repeat for 2-3 sets of 5-10 repetitions.
• Be mindful of your posture, especially if you spend a lot of time sitting at a desk or using a computer. Sit up straight, keep your shoulders relaxed, and avoid slouching.

(image source: https://create.vista.com/unlimited/stock-photos/268396798/stock-photo-selective-focus-patient-sitting-couch-doctor-massaging-patient-shoulder-massage/)

Remember, if your shoulder pain persists or worsens, it’s important to consult a healthcare professional for a proper evaluation and treatment plan. These methods can be helpful up to a certain extent, but they may not be suitable for all types of shoulder pain.

FAQs:

References:

1. https://www.theorthopaedicandpainpractice.com/service/shoulder-pain/
2. https://www.theorthopaedicandpainpractice.com/what-are-some-shoulder-pain-treatments/
3. https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-pain-and-common-shoulder-problems/
4. https://www.versusarthritis.org/about-arthritis/conditions/shoulder-pain/

Dr Yong Ren’s Profile

Dr. Yong Ren graduated from the National University of Singapore’s Medical faculty and embarked on his orthopaedic career soon after. Upon completion of his training locally, he served briefly as an orthopaedic trauma surgeon at Khoo Teck Puat Hospital before embarking on sub-speciality training in Switzerland at the famed Inselspital in Bern.

He underwent sub-specialty training in pelvic and spinal surgery, and upon his return to Singapore served as head of the orthopaedic trauma team till 2019. He continues to serve as a Visiting Consultant at Khoo Teck Puat Hospital.

Well-versed in a variety of orthopaedic surgeries, he also served as a member of the country council for the local branch of the Arbeitsgemeinschaft für Osteosynthesefragen (Trauma) in Singapore. He was also involved in the training of many of the young doctors in Singapore and was appointed as an Assistant Professor by the Yong Loo Lin School of Medicine. Before he entered the private sector, he also served as core faculty for orthopaedic resident training by the National Healthcare Group.

Dr Yong Ren brings to the table his years of experience as a teacher and trainer in orthopaedic surgery. With his expertise in minimally invasive fracture surgery, pelvic reconstructive surgery, hip and knee surgery as well and spinal surgery, he is uniquely equipped with the tools and expertise necessary to help you on your road to recovery.