Shoulder

Arthritis

Arthritis occurs when cartilage is damaged or decreased over time. Cartilage is the smooth covering over bones that allows joints to glide. This covering can become damaged due to traumatic injury or can just degenerate over time.

With severe and untreated arthritis the joint becomes inflamed and extra bone can form as your body attempts to protect the joint which causes even more pain.

Types

There are different types of arthritis. The primary reason for arthritis is “wear and tear,” and is caused over time. This is osteoarthritis. Other types of arthritis can occur due to trauma or illness such as rheumatoid arthritis or septic arthritis. Systemic psoriasis or lupus can also cause joint degeneration.

Symptoms

  • Joint pain
  • Grinding/clicking/locking sensation
  • Loss of motion
  • Trouble with tasks that use the arm

Diagnosis: How is my shoulder arthritis diagnosed?

  • Physical exam by your physician
    • Range of motion
    • Amount of pain with motion
    • Strength
  • X-rays
  • Possible CT/CAT scans
  • Possible MRI

Possible Treatment: Non-Operative

  • Physical therapy to strengthen the muscles around the joint
  • Anti-inflammatory medication
  • Injection
  • Platelet Rich Plasma (PRP) Injection
  • Nutritional supplements

Possible Treatment: Operative

  • Minimally invasive (arthroscopic) surgery to remove bone spurs
  • Replacement Surgery with metal and plastic implants

Inflammation

Subacromial Bursitis (Rotator Cuff Impingement Syndrome)

Bursa is a fluid filled sac that helps reduce the friction. The subacromial bursa is between the top of the rotator cuff, below your acromion. Bursa can cause pain when it thickens or becomes inflamed. This is often the result of overuse or repetitive overhead motion. Jobs that require consistent overhead motion such as painters, electricians, carpenters, or athletes can suffer from subacromial bursitis.

Symptoms:

  • Pain on the side of the shoulder
  • Joint pain
  • Pain while sleeping
  • Increased pain when reaching overhead
  • Clicking or popping

Diagnosis:

  • Exam by your physician
  • X-rays
  • Possible MRI if rotator cuff tear is also suspected

Possible Treatment: Non-Operative

  • Anti-inflammatory medication
  • Physical Therapy
  • Cryotherapy
  • Injections

Possible Treatment: Operative

  • Subacromial decompression
  • AC joint resection

Subcapsular Bursitis

Bursa is a fluid filled sac that helps reduce friction. Subcapsular bursa cushions the space between your shoulder blade and rib cage in your back. Bursa can cause pain when it becomes thickened or inflamed. This is often the result of overuse or repetitive overhead motion. Jobs that require consistent overhead motion such as painters, electricians, carpenters, or athletes can suffer from subacromial bursitis.

Symptoms:

  • Pain on the inside of the shoulder blade and upper back
  • Clicking

Diagnosis:

  • Exam by your surgeon
  • X-rays

Possible Treatment: Non-Operative

  • Anti-inflammatory Medication
  • Physical Therapy
  • Injections

Possible Treatment: Operative

  • Bursa excision

Biceps Tendinitis

The biceps muscle can become injured/inflamed and cause pain near your shoulder joint toward the front. It is often caused by overuse or an injury such as a fall. Biceps tendinitis is often injured along with the rotator cuff due to the proximity and function of this muscle.

Symptoms:

  • Pain in the front of your shoulder
  • Pain that radiates down your arm
  • Tender to touch
  • Difficulty raising arm overheard and forward

Diagnosis:

  • Exam by your surgeon
  • X-ray
  • Possible MRI
  • Possible Ultrasound

Possible Treatment: Non-Operative

  • Anti-inflammatory medication
  • Physical Therapy
  • Cryotherapy
  • Avoiding activities that cause pain
  • Injections

Possible Treatment: Operative

  • Tenotomy (release of biceps from attachment with possible cosmetic deformity- “popeye deformity”)
  • Tenodesis (release of biceps from attachment and re-attachment for no cosmetic deformity)

Adhesive Capsulitis (Frozen Shoulder)

Adhesive capsulitis is caused by the thickening of the tissue surrounding your glenohumeral joint. This can occur after an injury where the patient is unable to move for an extended time. Many cases also occur without cause. Higher risk of frozen shoulder include: thyroid disease, diabetes, recent viral infections, and women between 40-60 years old.

Symptoms:

  • Pain with or without movement
  • Night pain
  • Progressive loss of motion/rotation
  • Severe loss of motion

Diagnosis:

  • Exam by your surgeon
  • X-rays
  • MRI

Possible Treatment: Non-Operative

  • Anti-inflammatory Medication
  • Physical Therapy
  • Cryotherapy
  • Injections

Possible Treatment: Operative

  • Manipulation under anesthesia
  • Tissue excision

Instability

Glenohumeral (shoulder) Dislocation

Your shoulder is a ball and socket joint. The ball (humeral head) sits inside the socket (glenoid) to allow for normal range of motion (movement). When the ball is no longer inside the socket or has come out of the socket and returned. This usually occurs due to trauma such as falling with the arm extended, collision during sports such as football or rugby, and any time the arm may be forced away from the body. Seizures and electrocution may also cause shoulder dislocation.

Symptoms:

  • Pain
  • Inability to move the arm
  • Numbness, tingling in arm and hand

Diagnosis:

  • Exam by your surgeon
  • X-rays

Possible Treatment: Non-Operative

  • Reduction (placing the shoulder joint back in place)
  • Immobilization in a sling
  • Anti-inflammatory Medication
  • Cryotherapy
  • Activity Modification/Reduction
  • Physical Therapy

Possible Treatment: Operative

  • Reattachment of the ligament
  • Tightening of the soft tissue around the joint
  • Latarjet
  • Remplissage

AC Joint Sprain (separated shoulder)

AC joint sprains are identified by a classification system and graded 1-5. This sprain is a stretching of ligaments between the collarbone and the shoulder blade. In a grade 5 sprain, the bones no longer touch each other and this is known as an AC separation. This occurs due to trauma like a fall or a sports injury.

Symptoms:

  • Pain surrounding the joint
  • Elevated collarbone
  • Pain with most movement

Diagnosis

  • Exam by your surgeon
  • X-rays
  • Possible MRI if rotator cuff damage is also possible

Possible Treatments: Non-Operative

  • Grade 1 and 2
    • Sling
    • Anti-inflammatory Medication
    • Cryotherapy
    • Injections
  • Grade 3
    • See grade 1 and 2 treatment
    • Possible surgical recommendation based on patient’s age, activity level, and participation in sports

Possible Treatments: Operative

  • Some Grade 3 and all Grade 4 and 5
    • Repair to reconstruct ligaments

Tears

Labral Tear

Your labrum is the soft cartilaginous structure on the glenoid (socket) of your ball and socket shoulder joint. This is the cushion for your shoulder and attachment point for ligaments. A labral tear is caused by shoulder dislocation or chronic and repetitive stress on the joint. Labral tears can also be caused when the arm is forced away from the body such as in a fall or during sports with repetitive motion such as baseball or volleyball. SLAP tears are at the top of the labrum.

Symptoms (depending on the area of the tear):

  • Pain
  • Laxity (looseness)
  • Weakness
  • Bicep pain
  • Clicking

Diagnosis

  • Exam by your surgeon
  • X-rays
  • MRI (with contrast dye)

Possible Treatment: Non-Operative

  • Physical Therapy
  • Anti-inflammatory Medication
  • Cryotherapy
  • Activity Modification
  • Injections

Possible Treatment: Operative

  • Excision of damaged tissue
  • Reattachment
  • Biceps Tenodesis

Rotator Cuff Tear

Your rotator cuff is four muscles that surround your shoulder joint. The muscles are attached to bone with tendons. Any of the four tendons can tear either partially or completely. Rotator cuff tears may be caused by trauma or repeated motion and degeneration.

Symptoms:

  • Pain on the side of the shoulder
  • Nighttime pain
  • Difficulty lifting arm to the side
  • Difficulty lifting arm overheard
  • Difficulty lifting arm toward the back
  • Pseudoparalysis (inability to move arm)
  • Pain radiating into neck

Diagnosis

  • Exam by your surgeon
  • X-rays
  • MRI
  • Possible CT/CAT scan

Possible treatment: Non-Operative

  • Physical Therapy
  • Anti-Inflammatory Medication
  • Cryotherapy
  • Activity Modification
  • Injections

Possible Treatment: Operative

  • Debridement (cleaned up torn tissue)
  • Repair
  • SCR (superior capsular reconstruction)
  • Reverse total shoulder replacement

Proximal Biceps Rupture

Your biceps have two heads, the long and short head that attach around the shoulder. The long head is injured more often and a proximal rupture is the tearing of this long head located in the front of your shoulder. This often occurs with trauma such as falls or sudden lifting. A rupture may occur in a patient who has tendinitis or a rotator cuff tear.

Symptoms:

  • Pain in the front of the shoulder
  • Swelling in the front of the shoulder
  • Bruising in the front of the shoulder
  • Bruising that travels down the front of the arm
  • A bulge in the front of the arm
  • Muscle spasm
  • Weakness

Diagnosis

  • Exam by your surgeon
  • X-rays
  • MRI
  • Ultrasound

Possible Treatment: Non-Operative

  • Physical Therapy
  • Cryotherapy
  • Anti-inflammatory Medication
  • Activity Modification

Possible Treatment: Operative

  • Biceps Tenodesis

Office Location

Gitelis Orthopedics office

Hoffman Estates

1800 McDonough Road
Suite 202
Hoffman Estates, IL 60192

Located in the Ashton Center for Day Surgery building.

(847) 807-7770
fax: (847) 807-7771

Download Patient Forms


Barrington

27401 W. Hwy 22
Suite #6
Barrington, Il. 60010

Second office near Good Shepherd Hospital in Barrington, Il.

(847) 807-7770
fax: (847) 807-7771

Download Patient Forms