What Kind Of Physical Therapist Do I Need
All physical therapists are prepared through education and experience to treat patients who have shoulder OA. You may want to consider:
- A physical therapist who is experienced in treating people with musculoskeletal problems. Some physical therapists have a practice with an orthopedic, geriatric, or sports focus.
- A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedic, geriatric, or sports physical therapy. This therapist has advanced knowledge, experience, and skills that may apply to your condition.
You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.
General tips when you’re looking for a physical therapist :
- Get recommendations from family, friends, or other health care providers.
- When you contact a physical therapy clinic for an appointment, ask about the physical therapists’ experience in helping people with shoulder OA.
- Be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.
How Is Osteoarthritis In The Shoulder Diagnosed And When
The shoulders three bones and many tendons and muscles make the shoulder the most mobile joint in the body. But this combination of structures also makes the shoulder vulnerable to problems.
Five major types of arthritis commonly affect the shoulder: osteoarthritis, post-traumatic arthritis , rheumatoid arthritis , avascular necrosis and rotator cuff tear arthropathy. Other common shoulder conditions include bursitis, tendonitis, frozen shoulder and rotator cuff injury.
All of these conditions can produce shoulder pain, but vary in their underlying causes. Because the conditions show similar symptoms, its difficult for a person to know what problem is causing their shoulder pain without a physicians help.
A physical exam and X-ray can help diagnose the problem.
- During the physical exam, a doctor examines the shoulder joint for range of motion, involvement of other joints and tenderness. The exam also includes questions about personal and family medical history.
- X-rays are used to look for a narrowing joint space and damage related to the bones in the shoulder joint, as well as for the formation of bone spurs, which indicate arthritis.
- Other diagnostic tests may be used to rule out causes of joint pain. Blood tests and analysis of joint fluid can rule out rheumatoid arthritis or infection.
- An MRI may also be needed to gauge the condition of the rotator cuff .
Physiotherapy For Shoulder Arthritis
Physiotherapy is a drug-free and non-surgical treatment that has been proven to reduce arthritis pain.
The goal of physiotherapy for shoulder arthritis is to prevent the progression of the disease, reduce pain, regain strength, and increase joint mobility, function, and quality of life.
Depending on your individual needs, physiotherapy for shoulder arthritis can include:
- Stretching, strengthening, and range of motion exercises
- Activity modification and functional retraining
- Patient education so you feel in control of your condition including relaxation and coping strategies
- Cross-disciplinary pain-relieving therapies such as:
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How To Diagnose Of Neck To Shoulder Pain
X-rays can reveal areas in your neck and Shoulder where your nerves or spinal cord might be pinched by bone spurs or other degenerative changes.
CT scan :-
CT scans combine X-ray images taken from many different directions to produce detailed cross-sectional views of the internal structures of your neck.
MRI uses radio waves and a strong magnetic field to create detailed images of bones and soft tissues, including the spinal cord and the nerves coming from the spinal cord.
If your doctor suspects your neck to shoulder pain might be related to a pinched nerve, he or she might suggest an EMG. It involves inserting fine needles through your skin into a muscle and performing tests to measure the speed of nerve conduction to determine whether specific nerves are functioning properly.
Blood tests :-
Blood tests can sometimes provide evidence of inflammatory or infectious conditions that might be causing or contributing to your neck and shoulder pain.
How Will Osteoarthritis Of The Elbow And Shoulder Affect Me
While many people with osteoarthritis of the shoulder or elbow wont have any symptoms, those who do can have a wide range of experiences.
Most commonly the affected joint can feel stiff, swollen and painful.
But being diagnosed with osteoarthritis doesnt mean your condition will get worse. Theres a lot you can do to improve your symptoms. See the section managing osteoarthritis to find out more.
Osteoarthritis wont always affect both of your elbows or shoulders. It may only affect one joint.
You might find it difficult to bend or stretch your arm, and you may feel pain when you move your shoulder. This could mean that simple activities like shaving or brushing your hair can suddenly become much more difficult.
You might hear some crunching or crackling noises, especially when moving your shoulder. But this usually isnt anything to worry about and only sounds loud because this joint is close to your ears.
The pain may feel worse at the end of the day, or when you move your arm, and it may improve when you rest. You might feel a bit stiff in the morning, but this shouldnt last more than half an hour.
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How Common Is Shoulder Arthritis
Due to natural wear and tear that can take place within the shoulder joint with age, shoulder osteoarthritis commonly affects people over the age of 50 years old. Osteoarthritis of the shoulder affects 30 percent of people over the age of 60.
While shoulders are less susceptible to wear-and-tear compared to other weight-bearing joints, longer lifespans and an increase in sports participation have contributed to rising numbers of shoulder problems earlier in life.
Rotator Cuff Tear Arthropathy
Rotator cuff tear arthropathy is a type of shoulder arthritis that can develop after a massive and prolonged rotator cuff tear. The four rotator cuff tendons in your shoulder wrap around the ball portion of the shoulder joint, holding it in place. If one or more of these tendons is heavily torn, this may cause the humeral head to rub against other bones and develop arthritis.
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How Shoulder Pain Feels When Its Actually A Neck Problem
There are eight nerve roots branching from each side of the cervical spine in the neck, and they’re labeled C1-C8. Nerve roots C3 through C8 all pass through a specific part of the shoulder.
Radicular pain and accompanying symptoms can vary and include any or all of the following:
- Pain that feels anywhere from mild or dull to sharp, lancinating or severe
- Pain that comes and goes, or is constant and unrelenting
- Weakness or numbness in the shoulder and/or arm, which could be constant or sporadic
Some research indicates that if shoulder pain symptoms tend to develop with the following pattern:
Pattern of shoulder pain symptoms as a result of problems in the cervical spine.
- C5 radiculopathy tends to lead to pain in the upper shoulder near the neck and could either be sharp pain on the surface or a deep, achy pain
- C6 radiculopathy would be more on the outer shoulder and likely a pain that feels closer to skin level
- C8 radiculopathy, which is less common than the others, would be the lower shoulder and could have pain that is either sharp on the surface or deep and achy.1
Symptoms may vary from the above depending on the underlying pathology, as well as an individual’s unique anatomy and perception of pain. Most commonly, cervical radiculopathy is experienced on only one side of the body.
What Are The Symptoms Of Osteoarthritis
If you google ‘osteoarthritis symptoms’ or some variation of that, you’ll mostly get webpages that have a list of possible symptoms, but that’s about the extent of the content. You won’t learn much more than that list of symptoms.
There’s nothing wrong with lists, but other than helping you identify a possible diagnosis for yourself, it doesn’t give you any access to understand what the problem is or what to do about it.
That’s what this page is for.
But first, here’s a list of some of the symptoms of osteoarthritis:
- joint pain in one or more joints
- joint ache
Ta da, there’s a list of osteoarthritis symptoms!
Now let’s get you some information that’s actually valuable.
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Could That Shoulder Pain Really Stem From The Neck
When a nerve root in the cervical spine is irritated, the symptoms can radiate into the shoulder, arm, and hand. WatchCervical Radiculopathy Interactive Video
When shoulder pain is actually coming from the neck, it is wise to seek treatment as one or more nerves running from the neck into the shoulder could be at risk.
Rotator Cuff Muscle Injuries
Injuries to the rotator cuff muscles, such as a large tear, can also increase the risk of developing osteoarthritis of the shoulder joint. The rotator cuff muscles normally help keep the shoulder joint in place, so an injury to the rotator cuff muscles can cause the bones of the shoulder joint to become misaligned and damage each other as they rub against each other.
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When To See A Doctor
If shoulder pain persists or if range of motion is affected, then a doctor should be consulted.
If cervical radiculopathy is suspected, with radiating pain, tingling, weakness, or numbness, then its important to see a doctor sooner rather than later in order to start treatment. If the condition causing cervical radiculopathy goes untreated and gets worse, it is possiblein some casesfor permanent nerve damage or neuropathy to occur.
History Of Trauma And Injury
A sports injury, such as a fracture, sprain, or strain, may cause shoulder arthritis later on down the road. An athlete has a much higher risk of developing arthritis due to the injuries sustained while playing sports.
Repetitive injuries of the shoulder due to your occupation can also come back to haunt you later on in the form of shoulder arthritis especially if it did not heal properly. Repeated injuries can weaken the soft structures in your shoulder, which can accelerate the development of arthritis.
One thing you can do to protect yourself is to keep your shoulder joints healthy. Dont overuse your shoulders and dont ignore any signs of pain or symptoms. If you play sports or have hobbies, make sure to follow safety precautions, use the right equipment, take frequent breaks, and take your time when increasing intensity of the activity.
While you cannot change whats already happened, seeing a sports medicine doctor can help you delay the progression of shoulder arthritis. A huge part of sports medicine involves working with a physical therapist to strengthen the muscles around the site of injury in order to reduce strain on the joint.
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When The Shoulder Is The Suspect
Shoulder pain is most often caused by an injury to the rotator cuff, a group of tendons and muscles that stabilize the joint. The rotator cuff develops wear and tear with age, and can be easily injured. When this happens, we compensate by using different muscles to pick things up or reach for them. This may cause both shoulder and neck pain, says Dr. Ricchetti. You may have a rotator cuff injury or other shoulder problem if pain:
- Develops in the shoulder itself or on the outside of your upper arm.
- Is dull and aching.
- Improves when you rest your arm.
Shoulder Surgery For Early
If pain persists or conservative treatments fail, shoulder surgery may be helpful. Particularly in surrounding tissue such as bursa sacs, or when the long bicep tendon or tendon sheaths are affected, we can improve these problems by means of minimally invasive arthroscopic surgeries, and significantly reduce the pain caused by arthrosis. Our experts will review in detail, whether there are viable options for minimally invasive joint preservation treatment.
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Understanding The Five Types Of Shoulder Arthritis
Its normal to feel a little stiff or sore after an intense workout or an afternoon of yard work after all, overused muscles usually feel a little achy for a day or two as they recover. But if being active causes you to experience pain, stiffness, or swelling around your shoulder, you may have arthritis.
The term arthritis is used to describe over 100 different conditions that can impact your joints and their surrounding tissues. More than 50 million Americans including 20% of all adults and hundreds of thousands of children have been diagnosed with some form of the disease.
As the American population continues to age in the coming decades, the number of people living with arthritis is expected to increase dramatically. In recognition of National Arthritis Awareness Month, Dr. Drew shares a brief overview of the five types of arthritis that most often affect the shoulder joint.
Fix Your Form To Stop Shoulder Pain
There are a lot of ways to jack up your shoulder in the gym. Kipping before your shoulders are ready is a major one. Im fine with kipping during your gymnastic moves. But you need to have shoulder mobility beyond the normal range and strong shoulder stabilizers before trying it. Kipping is a way to speed up pull ups, not a way to skip the work required to do a strict pull up. A couple other common-problem lifts are highlighted below.
Shoulder position is the most important thing when performing overhead press. Keep them at a 30 degree angle instead of straight out at the side. Click HERE for more details.
Shoulder position is even more important during bench press. But it is a full body lift, and if you are only using the upper body, youre setting yourself up for pain. Check out our complete post HERE for more.
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Symptoms Indicating Osteoarthritis Of The Shoulder
- Limited range of motion
- Grinding or clicking sounds with movement
- Shoulder pain at night
- Pain around the shoulder spreading into the upper arm
- Pain and stiffness are often worse first thing in the morning, or after long periods of rest
- Pain on top of the shoulder or end of the collarbone
- Pain can sometimes be felt in the side of the neck
How Does Shoulder Arthritis Develop
Shoulder arthritis usually results from gradual wear and tear of the cartilage. Cartilage is present in every joint in the body it covers the surface of the bones inside the joints similar to Teflon on a ball bearing. Cartilage is a living tissue 2 millimeters to 3 millimeters thick about the thickness of one or two layers of cardboard. This makes the contact between bones softer. If the cartilage is intact, it can take multiple rotations with no wear of the surface because its smooth.
Shoulder arthritis typically develops in stages. First the cartilage gets soft , then it develops cracks in the surface , then it begins to fibrillate , and finally it wears away to expose the surface of the bone . As a result, it loses its ability to act as a smooth, gliding surface.
The cartilage doesnt wear away all at once over the entire surface of the bone in a joint. Instead, it wears at different rates in different parts. So if you consider the surface of a ball bearing that was covered with Teflon, this type of wear would be as if the Teflon had pits and the surface would now be irregular .
Once the surface becomes irregular, the cartilage may undergo further damage. It may begin to thin out, eventually leading to the bones of the shoulder rubbing against each other . Many people think that arthritis is bone-on-bone traction in the joint, but in reality arthritis is the process that can lead to the bone-on-bone traction.
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Other Possible Causes Of Shoulder Pain
Not all shoulder pain is due to arthritis, of course. Visit our sister site PainSpot to take a personalized quiz to see what else could be causing your shoulder pain.
A condition called frozen shoulder shares several symptoms with osteoarthritis, Dr. Rahmani says, including pain, stiffness, and limited range of motion. Frozen shoulder occurs when the tissue that surrounds your shoulder joint becomes thick and tight. But unlike OA, which is progressive, frozen shoulder resolves over time, usually within one to three years.
Bursitis can resemble rheumatoid arthritis because it causes redness and swelling. However, bursitis is not an autoimmune disease like RA rather, it develops when the bursae become inflamed. Bursitis can often be blamed on overuse or injury of a joint.
Other medical conditions that dont directly affect the shoulder can cause referred pain in the shoulders. Some examples include shingles, cervical nerve impingement, and blood clots in the lungs, says Dr. Rahmani.
In addition, any condition that affects the diaphragm, such as an injured spleen or gallbladder problems, can cause referred pain in the shoulders because they irritate the nerves that run from the diaphragm to the shoulders, he explains.
Doctors may suspect these indirect causes of shoulder pain depending on what they see in your physical exam.
If someone reports pain but has good range of motion, thats when you have to think outside the box, Dr. Rahmani says.
Tendon Tears And Inflammation
The shoulder is particularly prone to injuries due to overuse and repetitive tasks. Overuse and repetitive tasks can result in tendonitis, when the tendons are inflamed, and bursitis, an inflammation of the bursa, a fluid-filled sack that separates the tendon from the bone. Bursitis can lead to tendon damage due to the tendon scraping against the bone. Tendonitis is especially common in the rotator cuff.
If you are dealing with acute or chronic shoulder pain, give us a call to set up a consultation to see what the LOC team can do for you.
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