Shoulder- impingement- syndrome-Treatment in Tamilnadu

Shoulder impingement syndrome is a common cause for shoulder pain. It occurs when there is an impingement of the tendons of the rotator cuff as they pass through the shoulder joint.

Causes and Risk of Impingement Syndrome

Overhead use of the shoulder joint may cause impingement syndrome. The following are some of causes and risk factors of Impingement syndrome:

• Partial tear of a rotator cuff tendon

• Repeated activity using shoulder like tennis, swimming and other overhead sports

• Joint Abnormality

 The following are the Symptoms of Impingement Syndrome

• Weakening  of the shoulder muscles

• Pain in the shoulder that from the top of the shoulder to the elbow

Pain when lying on sore shoulder

• Pain while using arm
• Difficulty in reaching up behind the back
• Muscle pain or weakness when lifting or attempting to reach
• Sharp pain when trying to reach the back pocket
• Diagnosis and Treatment of Impingement Syndrome
• Impingement Syndrome can be diagnosed by an ultrasound scan which helps to visualize the dynamic impingement and detect associated injuries.

Usually, the doctor may suggest a non surgical treatment such as anti inflammatory drugs or cortisone injections while starting the treatment for Impingement syndrome. If the patient have problem after trying non surgical treatments, the doctor may suggest a surgery.  The surgical methods for treating Impingement syndrome are:

• Acromioplasty: Surgery to increase the space between the acromion and the rotator cuff.

• Resection Arthroplasty: In this procedure if there is a arthritic AC joint, the end of the clavicle will be removed

• Arthroscopic Procedure: In this procedure the surgeon look in to the joint using an arthroscope and treat the problems inside the joints

Ortho One by Dr. David V. Rajan is  one of the the most trusted Health Care Centre for a non-trauma Orthopedic Service in Coimbatore, Tamil Nadu.

Visit us:www.ortho-one.in

Mail us:orthocaretamilnadu@gmail.com

Orthopedic Hospital India

Ortho One Orthopaedic Speciality Centre offers excellent services in arthroscopy, joint replacement surgery, paediatric orthopaedics, spine surgery, deformity correction etc. They are giving special care to athletes by providing them with physical medicine modalities education and surgical treatment when necessary. Their main motto is to restore mobility and helps in reshaping  life.

Treatments Offered By Ortho One Orthopaedic Speciality Centre

• Arthritis

Rheumatoid Arthritis is a  common form of arthritis affecting the joints.

Early diagnosis of  this disease have to be done which helps to minimize the disease activity.

The treatment for this type of arthritis includes DMARDS. Biological DMARDS such as Anakinra, Rituximab, Abatacept helps to control various inflammatory mediators in patients.

• Total knee replacement - It helps to replace the diseased ends of thighs and leg bones also the surface of knee cap . Partial knee replacement - The diseased portion of knee joint will be replaced.

• Pediatric orthopaedics

 Cerebral palsy - physiotherapy, botox injections and surgeries for contracture correction, tendon transfer for  balancing  the muscles and bony surgeries for correcting deformities and  stabilizing joints.

Clubfoot - Ponseti technique of serial plastering is used for this disease.

Developmental dysplasia of hip - Re-constructive hip surgeries are done for patients who have had  diagnosis in a later stage. Complex pelvic osteotomies will be required for reconstructing the socket.

Lymph lengthening and deformity correction - Fixators are used for this treatment.

Muscular dystrophy - Surgeries are needed to correct the lymph.

Obstetric Brachia plexus palsy - Re-constructive procedures like contractual release, corrective osteotomies and modified quad procedures have to be done for this.

Ortho One Orthopaedic Speciality Centre also offers treatments for shoulder, spine, pain management, shoulder, spine, sports rehabilitation.

Ortho One Orthopaedic Speciality Centre offers Best Joint Replacement Surgery Tamilnadu  .

They posses an expert panel of Orthopaedics Surgeons India who works to gain patient’s satisfaction by offering best health care services in India at an affordable cost.

For more details visit us on : www.ortho-one.in.

Ouch my Shoulder Hurts!

Got a terrible ache while you lift your arm and rotate it and wondered what was wrong with it? The cause of this pain is often due to the rotator cuff. It commonly occurs in people beyond 40 years.Incidence figures of 0.9-2.5% were found for different age groups. At any given point in time the prevalence figures differ from 6.9 to 26%.The different causes can be anything from periathritis (frozen shoulder), impingement (when the tendons of the rotator cuff are inflamed and irritated) or a tear of the cuff.Impingement and rotator cuff tear can be considered as two ends of a spectrum of shoulder disorders affecting the rotator cuff.Here are some questions and answers that will help you to understand the Rotator Cuff (RC) and its associated pathologies much better.

What is the rotator cuff (RC)?

The muscles controlling various movements of the shoulder (supraspinatus, teres minor and subscapularis) before attaching at the shoulder joint coalesce to form a sheet or cuff like structure known as the rotator cuff.

What is the function of the rotator cuff?

The muscles of the cuff primarily function to stabilize the shoulder joint and to ensure its efficient functioning. The individual muscles also function to move the shoulder in various directions that include elevation, external rotation and internal rotation.The normal functioning of the cuff is ensured by its continuity and integrity as well as by smooth gliding of this sheet in the narrow space of the shoulder joint which in turn is facilitated by lubricating tissues known as the bursa.What can go wrong with the rotator cuff?The pathologies of the rotator cuff can range from inflammation (RC tendinits), degeneration (RC tendinosis) or to tear (partial or complete RC tear). There may be a component of each one in any presenting pathology. Inflammation of the cuff leads to swelling, thickening and micro tears in the cuff interfering with its smooth gliding in the narrow space of the shoulder. This causes pain during shoulder movements especially elevation. This is known as external impingement.

The above figure shows inflamed and swollen bursa and RC cause impingement in smooth gliding of the cuff.

RC Tear

  Loss of continuity of the cuff may be partial or complete. This leads to weakening of the shoulder and the inability of the cuff to stabilize the shoulder joint and perform specific movements caused by the different muscles forming the cuff.

How do I know that there is a problem with my rotator cuff?

Patients with RC pathologies generally present with pain in the shoulder which is aggravated while moving it (most commonly elevation and internal rotation) of the shoulder (Figures 5, 6).The pain may also disturb your sleep. There may also be weakness in certain movements of the shoulder like elevation, external rotation or internal rotation if the pathology involves a tear in the RC. Shoulder pain is the most common symptom in RC problems.

   

The Figure shows pain during overhead activity more commonThe diagnosis can be confirmed after a clinical examination and imaging studies like X ray, ultrasound and MRI/ MRA.

How does the rotator cuff problem develop?

RC tears are uncommon in people younger than 40 years unless the cuff is avulsed or torn with a fragment of bone at its insertion. This usually follows a fall on an outstretched hand or a direct impact on the shoulder. Young patients are more commonly affected with RC tendinitis. Patients older than 40 years especially those with multiple conditions like diabetes mellitus, gout, smoking, alcoholic more commonly have tears of the RC. It occurs with undue rapidity when an already compromised RC (having tendinitis, tendinosis) gets injured directly or indirectly. 

Live snap of arthroscopic shoulder surgery

What are the treatment options available?

Cases of RC tendinitis or tendinosis can be treated conservatively with anti inflammatory medications and rest followed by RC strengthening. Some partial thickness RC tears may heal with rest; others need surgery for repair of the torn cuff. The surgery can be done via open, mini open or the arthroscopic approach .

Schematicdiagram of arthroscopic shoulder surgery

What is the recovery time after an RC repair?

Active shoulder movements including overhead movements may be started after 6 weeks of surgery. Routine office work can be started after 2-3 months from surgery. Return to sports is only advisable after 8 – 9 months provided the proper physiotherapy protocol has been followed.

Do all RC tears need surgery?

A complete tear of RC cannot heal without repair. Some (not all) partial thickness tears of RC may heal with rest. It is advisable for young and active people to get their RC tears assessed by a doctor and most likely repaired earlier (preferably within 3 months) for good results.

 How are the results of surgery?

The results of the surgery are variable and depend on a number of factors. In general individual with healthy tissues, i.e. those not suffering from diabetes, thyroid disorders, rheumatoid arthritis, non smokers etc. have a good to excellent outcome after surgery. On the other hand individuals with poor general health or suffering from or having habits mentioned above may not have equally good results.

Ortho One, the Super Speciality Orthopaedic Hospital, the Best Ortho Hospital in South India offers physiotherapy, knee surgery, joint replacement, arthroscopy, spine surgery, sports injury treatment, shoulder surgery, paediatric orthopaedics etc with affordable cost.

For more information,

Website : www.ortho-one.in

E-mail : orthocaretamilnadu@gmail.com 

This blog is written by,
Dr. David V. Rajan, MS (Orth) MNAMS (Orth) FRCS (G), 
Shoulder arthroscopic surgeon at Ortho One, Centre of excellence shoulder surgery in India.

 

Affordable Shoulder Dislocation Treatment India

 Shoulder dislocations may occur from a traumatic injury or from loose capsular ligaments. Different conditions may affect the stabilizing structures of the shoulder and, thus, negatively affect patients with shoulder dislocations.
  Most shoulder dislocations happen at the lower front of the shoulder, because of the particular anatomy of the shoulder joint. The joint is supported on all sides by ligaments called the joint capsule, and the whole thing is covered by the rotator cuff. The rotator cuff is made up of four tendons attached to muscles that start on the scapula and end on the upper humerus. They reinforce the shoulder joint from above, in front, and in back, which makes the weakest point in the rotator cuff in the lower front.

Subluxation refers to a partial dislocation. A subluxation occurs when the two joint (articular) surfaces have lost their usual contact.

Shoulder Dislocation Symptoms:
    - A visibly deformed or out of place shoulder
    - Swelling or discoloration (bruising)
    - Intense pain
    - Inability to move the joint

Shoulder dislocation may also cause numbness, weakness or tingling near the injury, such as in your neck or down your arm. The muscles in your shoulder may spasm from the disruption, often increasing the intensity of your pain.

 What is the cause?

    - The most common type of dislocation is an anterior dislocation.
    - It can be caused by a fall onto the outstretched hand or shoulder. It may happen if the arm is forced into an awkward position.
    - A posterior dislocation may occur as a result of a powerful direct blow to the front of the shoulder.
    - It may also be caused by a violent twisting of the upper arm, such as that caused by an electric shock or seizure. Dislocated shoulders are  common in contact sports such as football, rugby, hockey, etc.

Shoulder Dislocation Treatment India:

Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small incision (cut) in your skin.
    - Insert the arthroscope into your shoulder through a small incision. The arthroscope is connected to a video monitor in the operating room.
    - Inspect all the tissues of your shoulder joint and the area above the joint -- the cartilage, bones, tendons, and ligaments.
    - Repair any damaged tissues. To do this, your surgeon will make 1 - 3 more small incisions and insert other instruments through them. A tear in a muscle, tendon, or cartilage will be fixed. Damaged tissue may need to be removed.

 What is the prevention?

    - Avoid situations in which you could suffer another dislocation.
    - Wear layers of clothing or padding to help cushion any fall that may be likely.
    - Do not return to sports until you have full recovery of motion and strength in your arm.

Ortho-One Orthopedic Centre use the most advanced and latest techniques to replace the knee joint with an artificial one that relieves pain, allows you to strengthen your legs, corrects the leg deformity and improves the quality of life. Dr.K.Vinodh, One of the leading orthopedic surgeons in India currently working at Ortho-One, Coimbatore in Tamil Nadu. The shoulder disloaction treatment cost is very low in India as compared to other western countries like USA, UK, Canada, Germany etc.

For more details visit us: www.ortho-one.in