Shoulder & Elbow Treatments

The Shoulder

Shoulder pain is the second commonest joint complaint after back pain. Therefore, it is surprising that the sub-speciality of shoulder surgery is only relatively new.

For many years, shoulder problems were largely ignored and all problems tended to be diagnosed as being a “frozen shoulder”. The situation has changed radically over the last 20 years, and this reflects the arrival of MR and CT imaging, and more recently, the application of arthroscopic (keyhole) shoulder surgery techniques. These advances have allowed surgeons to provide accurate diagnosis of the underlying shoulder problems and to direct treatment specifically at the associated pathology. This has resulted in high levels of patient satisfaction where previously results were indifferent.

The number of specialist shoulder surgeons within the United Kingdom is relatively small. This reflects the developing nature of this subspecialty and the demanding nature of the surgery.

In general terms, shoulder problems can be divided into three main groups, based upon age. In the young, problems tend to related to shoulder instability. In middle age, the commonest problems are pain due to impingement syndrome or pain and stiffness related to a frozen shoulder. Finally, in the older age group, pain and lack of movement commonly reflect rotator cuff disease or osteoarthiritic change.

The Elbow

The elbow joint is a highly complex joint, being in fact not one joint but several joints which act in combination. Despite its complexity, elbow problems are significantly less common than in many other joints. Elbow surgery is highly specialised and tends to be carried out by individuals with a dedicated interest in elbow surgery.

Once again, the problems which occur in the elbow can be divided into groups based upon age. In the young, problems sometimes occur as a result of the formation of loose bodies within the elbow joint and these commonly occur as a result of a condition called osteochondritis dissecans. In middle age, the commonest complaint is of elbow pain as a result of a tennis elbow syndrome (lateral epicondylitis). In the older age group, pain and stiffness may reflect osteoarthritic changes.