Shoulder Replacement
Nerves are ultimately responsible for signaling pain and the shoulder is surrounded by a rich network of nerves- many are on their way to other sites in the body- sometimes pain or injury in one area of the body is actually felt in another area. This is sometimes called referred pain. Some common sources of referred shoulder pain include but are not limited to pain or disease in the gallbladder, liver, lung, diaphragm, heart, and neck (cervical spine). Some diseases-like diabetes- that cause neuropathy or alter the body’s ability to feel pain can also increase the risk for shoulder pain problems. Injury, overuse, arthritis, and genetics along with routine wear and tear can also play an important role in shoulder pain. One of the most common nerves often overlooked as a source of shoulder pain and disability is the suprascapular nerve. Here are two sources for more information on diagnosis and treatment of suprascapular nerve pathology.
Once a working diagnosis is formulated, the appropriate confirmatory diagnostic tests are ordered. Many patients request an MRI for shoulder pain-one of the problems with just with just ordering an MRI of the shoulder for all shoulder pain is that the diagnostic accuracy of an MRI is highly variable depending on the diagnosis. Here is more information regarding MRI for shoulder pain. Especially for tears deep in the shoulder an MRI arthrogram is more accurate. Because no diagnostic test is perfect, it is not unusual to have patient come in with a diagnostic test with a report positive for some sort of tear, but upon performing the history and examination the patient has a completely different cause for the shoulder pain and the diagnostic test results are an incidental asymptomatic finding. The opposite scenario is also common-the history and examination are strongly positive for pathology in a particular region, but the diagnostic report is normal. I always review diagnostic images and tests personally because having the benefit of clinical correlation often indicates pathology on the diagnostic test that would not have been picked up otherwise. Rotator cuff tears, for example, area common cause of shoulder pain, but the MRI appearance and diagnostic accuracy for rotator cuff tears can vary for multiple reasons.
If the diagnosis and decisions for shoulder pain surgery for a relatively common procedure like acromioplasty can be this difficult, consider the complexity involved with the diagnosis and treatment of just a few of the many other shoulder problems we treat like frozen shoulder, SLAP Tear (Labrum Tear), shoulder dislocation, shoulder arthritis, and separated shoulder.
In summary, if your shoulder pain has persisted despite rest and simple common treatments, we highly recommend you discuss the matter with your doctor to start the process of getting you a firm diagnosis and ultimately a solution for your shoulder pain.
If the diagnosis and decisions for shoulder pain surgery for a relatively common procedure like acromioplasty can be this difficult, consider the complexity involved with the diagnosis and treatment of just a few of the many other shoulder problems we treat like frozen shoulder, SLAP Tear (Labrum Tear), shoulder dislocation, shoulder arthritis, and separated shoulder.
In summary, if your shoulder pain has persisted despite rest and simple common treatments, we highly recommend you discuss the matter with your doctor to start the process of getting you a firm diagnosis and ultimately a solution for your shoulder pain.