With the warm weather, more people are venturing outside to exercise. Many might notice pain in their elbows or shoulders during their favorite outdoor activities, such as tennis, golf, baseball, volleyball and softball. The following are some of the most frequent elbow/shoulder questions I receive from patients.
What causes pain in my shoulder/elbow?
Structures within the shoulder and elbow might tear or start wearing out even at younger ages. Younger people tend to tear bicep or rotator cuff tendons or ligaments. Middle-age people, particularly those with competitive high school/college sports careers or those involved in manual labor, are at risk for wearing out the rotator cuff or joint cartilage surfaces. However, even people who have not been physically active might experience upper extremity problems. Genetics might play a factor.
My shoulder is stiff/I can't straighten my elbow. Why?
Shoulder stiffness can be caused by an underlying soft-tissue injury. It often can be fixed with a good physical therapy program, rarely requiring surgery. Elbow stiffness following a single event or repetitive throwing might be due to capsular scarring or bony growths that prevent full straightening. If it is particularly restrictive, see a doctor.
Will I develop arthritis in an injured shoulder/elbow joint?
Most well-treated injuries do not develop arthritis (post-traumatic osteoarthritis). However, if the joint surface is not smooth, if the joint cartilage was traumatized, or if the joint is stiff or unstable three months after the injury, there is a higher likelihood of developing arthritis. Most people older than 40 will have some form of cartilage wear — it's a normal part of aging. The key is how you take care of and protect your joints as you age.
How can I treat osteo arthritis?
Many early symptoms of osteoarthritis can be improved with a good program of joint flexibility, strengthening and balancing. But if the pain wakes you from sleep, hurts at rest and prevents you from performing regular daily activities, see your physician.
Will I have to have surgery for my shoulder/elbow pain?
Surgery is rarely the first choice. Once your arthritis has been thoroughly assessed and staged in association with your lifestyle and expectations, your physician will formulate a plan.
Arthroscopic or open surgeries, including shoulder and elbow replacements, come in several forms and are appropriate for different patients. That is an important discussion to have with your doctor. Joint replacements are proven to provide pain relief and, if well-treated, will function for 10 to 20 years.
How do I pick a surgeon for my evaluation?
Look for a surgeon who has the ability to perform non-operative, operative and repair of failed surgeries, and someone who understands the entire arm — including the neck and back. This is important because some shoulder pains can come from the neck and spine, or present as neck or elbow pain. Also, some elbow pains can present as shoulder or wrist problems, and some wrist problems might present as hand or elbow pains.