Shoulder Pain

The shoulder joint is one of the most complex and mobile joints in your body, it is a ball and socket joint with a combination of muscles and tendons keeping your arm bone centered in the socket. Shoulder Injuries are common in Athletes who regularly overuse their shoulder joints with repetitive overhead movements such as Weightlifting, Tennis, Golf, Basketball, and Baseball Players, In addition to the masons, the builders, the gardeners, the carpenters, among other occupations, are also on the list.

You probably don’t think about your shoulders much, until you suddenly experience pain in one of them. But the shoulder is essential for many activities in our daily lives.Shoulder pain, rigidity or weakness can make it difficult to carry out everyday tasks, such as reaching something on a high shelf, driving a car, scratching your back or brushing your hair. 

If you have pain that won’t go away, it’s time to come to Regenecare see Dr. Gehad and our team.

Ultrasound shoulder examination

X-Rays of the shoulder

 

What are the most common causes 

of shoulder pain?

The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens with use of the arm away from the body.

Rotator cuff injuries (shoulder injuries) are common and increase with age. These may occur earlier in people who have jobs that require repeatedly performing overhead motions. Examples include painters and carpenters. Rotator Cuff tear can be partial tendon tear, whereby only part of the tendon is ripped away from the bone it is attached to. Or there can be a full tendon tear, causing the tendon to completely separate from the bone. Although younger people can have rotator cuff tears, they become more common as people age, possibly because the interface between the tendon and the bone weakens and becomes more susceptible to injury.

The pain associated with a rotator cuff injury may: Be described as a dull ache deep in the shoulder, Disturb sleep, Make it difficult to comb your hair or reach behind your back or Be accompanied by arm weakness

Without treatment, rotator cuff problems may lead to permanent loss of motion or weakness, and may result in progressive degeneration of the shoulder joint. Although resting your shoulder is necessary for your recovery, keeping your shoulder immobilized for a prolonged time can cause the connective tissue enclosing the joint to become thickened and tight (frozen shoulder).

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and shoulder pain. It is a glenohumeral joint disorder that restricts movement as a result of adhesion and existence of fibrosis in the shoulder capsule. Signs and symptoms typically begin gradually, worsen over time then resolve usually within one to three years.

The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement. Medical community aren’t sure why this happens to some people, although it’s more likely to occur in people who have diabetes or those who recently had to immobilize their shoulder for a long period, such as after surgery, arm fracture, rotator cuff injury or stroke.

Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months:

  1. Freezing stage. Any movement of results in shoulder pain, and the mobility range starts to become limited. This can last anywhere from 6 to 9 months.
  2. Frozen stage. Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and using it becomes more difficult. This stage can last 4-12 months.
  3. Thawing stage. The range of motion in your shoulder begins to improve. This can take anywhere from 6 months to 2 years.

Most of the frozen shoulder treatment involves controlling the shoulder pain and preserving as much movement in the shoulder as possible. Recently, regenerative therapies, especially based on orthobiologic treatments, have shown magnificent results in the recovery of range of movement of the frozen shoulder and the reduction of pain.

When people think of Osteoarthritis they may think of the knee and the hip, which are common sites for arthritic pain. But while osteoarthritis affects the shoulder less often, it’s not uncommon. The glenohumeral joint (shoulder joint) ranks third on the list of the most commonly affected large joints after the knee and the hip. 

Osteoarthritis of the shoulder is a disease that involves breakdown of the articular cartilage that normally allows the joint to glide smoothly with each other. Loss of cartilage is seen on X-ray as loss of the joint space. Cartilage breakdown may be caused by wear and tear over time, but the key point is that cartilage does not heal when damaged. Instead, the body tries to heal by making more bone and this results in bone spurs called osteophytes. The result is loss of motion due to irregular joint surfaces. In addition, the inflammation caused by the arthritis results in thickening and scarring of the joint capsule which also contributes to loss of motion.

Loss of motion may also be accompanied by a feeling of grinding, catching, clicking or snapping within the shoulder joint. Weakness is usually due to pain inhibiting shoulder power. As shoulder arthritis progresses to an advanced stage, many patients will also experience pain that wakes them up at night.

In order to reduce pain, enhance functionality, and potentially minimize disease progression, a nonoperative management approach should be adopted before considering other invasive alternatives. Regenerative Medicine, especially PRP and cell therapies, has demonstrated to have favorable clinical outcomes in patients with osteoarthritis making orthobiologic therapies a promising alternative.

Rotator cuff injury video animation

Video Animation of Shoulder Osteoarthritis

So…How can we help you?

At Regenecare Pain Clinic we aim to improve the quality of life of our patients, freeing them from the pain that afflicts them and preventing future complications. We base our treatments on Regenerative Medicine, but we also carry out the rest of the conventional treatments according to the needs of each of our patients for the management of their pain. We have developed a comprehensive method of care for our patients, based on wellness goals, with close monitoring and always seeing the patient as a whole and not just as a disease. 

Regenerative therapy is an alternative treatment option for patients with shoulder pain. Minimally invasive procedures like stem cell and platelet-rich plasma therapies |(PRP) involve an outpatient procedure performed under local anesthesia in our clinic, using the patient’s own adult stem cells or patients own blood to help the shoulder heal.

Platelet Rich Plasma (PRP)

The human blood contains red and white bloods cells, platelets and plasma. PRP refers to blood plasma that contains a large  concentration of platelets. Platelets contain the necessary bioactive proteins and growth factors to repair and regenerate human tissue. PRP injections produce regeneration and repair of damaged tissues. At Regenecare Pain Management Clinic we obtain great results of pain relief and improvement of function with our PRP treatment protocol.

Part of the PRP preparation process

Part of the stem cell separation process

Stem Cells

Stem cells are found throughout the body and have the potential to become any type of cell, including those found in cartilage. They can help the body regenerate tissue by stimulating healing and reducing the painful effects of osteoarthritis. And furthermore, researchers believe adult stem cells can repair and replace cartilage as well as other tissue damaged by arthritis. In the same way, this treatment prolongs the longevity of the joint.

Steroid Injection

Steroid injections generally help relieve pain and swelling and make movement easier. Steroids are powerful anti-inflammatories that, when injected directly into the pain site, greatly reduce inflammation and thus pain. In the case of the Shoulder, the steroid is injected directly into the painful joint or tendon. The benefits can last for several months and the side effects are minimal with proper administration.

Steroid Injection – Ultrasound-guided

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