Shoulder Specialist in Singapore

Common Causes and Risk Factors

The shoulder is susceptible to a range of issues due to its wide range of motion and the network of muscles, tendons, and ligaments that support it. Causes of shoulder problems include:

• Repetitive Motion or Overuse of the Shoulder
  Frequent and repetitive movements, particularly in sports or certain occupations, can lead to overuse injuries.
• Direct Trauma to the Shoulder
  Accidents, falls, or direct blows can cause immediate damage to the shoulder.
• Age-Related Wear and Tear
  As individuals age, the shoulder joint can deteriorate, leading to conditions like osteoarthritis.
  
• Stress on the Shoulder
  Chronic poor posture can place undue stress on the shoulder, leading to pain and dysfunction.
• Inflammatory Conditions
  Conditions such as rheumatoid arthritis can cause inflammation in the joints, including the shoulder.
• Genetic Factors
  Some individuals may have a genetic predisposition to certain shoulder problems.

Symptoms and Signs

Individuals experiencing shoulder complications may notice a range of symptoms and signs, which vary based on the specific condition. Common indicators include:

• Pain in the Shoulder: Often the most noticeable symptom, pain in the shoulder can range from a mild, persistent ache to sharp, severe discomfort. The nature and intensity of the pain can offer insights into the underlying condition.
• Reduced Range of Motion: Difficulty in moving the shoulder or performing usual activities like reaching overhead can indicate a problem. This limitation may develop gradually or suddenly.
• Stiffness in the Shoulder: A sensation of tightness or restricted movement in the shoulder joint is common, particularly after periods of inactivity or during the morning.
• Swelling and Inflammation: Visible swelling or a feeling of heat in the shoulder can be signs of inflammation, often accompanying injuries or arthritis.
• Weakness in the Shoulder: A general feeling of weakness or a decrease in the ability to exert force with the shoulder or arm can suggest muscle or joint issues.
• Sounds During Shoulder Movement: Clicking, popping, or grinding noises during shoulder movement might be present, indicating potential joint damage.
• Numbness or Tingling: These sensations, particularly if radiating down the arm, can be indicative of nerve involvement or compression.

Non-Surgical Treatment Options

Non-surgical treatments are often the first line of management for many shoulder conditions. These options aim to relieve pain, reduce inflammation, and improve function without surgery.

• Physical Therapy
  This involves customised exercises to strengthen shoulder muscles, enhance joint stability, and improve flexibility. Techniques such as manual therapy or ultrasound may also be employed to facilitate healing and mobility.
• Medications
  Pain relief and anti-inflammatory medications are often prescribed. These range from non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, to stronger prescription medications for more severe pain. They help manage discomfort and swelling.
• Corticosteroid Injections
  Injecting corticosteroids directly into the affected area can provide rapid and pain relief, as well as reduce inflammation. These are often used for conditions like bursitis or arthritis.
• Supportive Devices
  Shoulder specialists may recommend using slings, braces, or other devices to help immobilise the shoulder. This can provide support and ensure an optimal healing environment, especially in cases of acute injuries or postural issues.
• Shockwave Therapy
  This treatment uses sound waves to stimulate healing in injured soft tissues, such as tendons and ligaments. It is characterised by fast pain relief and mobility restoration.

Surgical Treatment Options

When non-surgical methods do not provide sufficient relief or if the shoulder condition is severe, surgical intervention may be considered. The choice of surgery depends on the specific diagnosis, the extent of the injury or degeneration, and the patient’s lifestyle and goals.

Shoulder Arthroscopy

A minimally invasive procedure where small incisions are made, and a camera (arthroscope) is inserted to diagnose and treat various shoulder problems. Procedures like rotator cuff repair or removal of inflamed tissue are often performed arthroscopically.

Rotator Cuff Repair

This surgery involves repairing torn tendons in the rotator cuff, which is a common cause of pain and disability in the shoulder.

Shoulder Joint Replacement Surgery

In cases of severe arthritis or massive rotator cuff tears, this procedure may be considered. There are three types of shoulder joint replacement surgery:

• Total Shoulder Replacement: For severe arthritis or large rotator cuff tears, this surgery replaces the damaged parts of the shoulder joint with artificial components.
• Partial Shoulder Replacement: In certain cases, only a part of the shoulder joint is replaced, typically the humeral head (ball of the joint).
• Reverse Total Shoulder Replacement: Used primarily for complex conditions, such as a completely torn rotator cuff or severe arthritis with cuff tear arthropathy, this surgery involves reversing the ball and socket’s positions for better stability and function.

Capsular Release

For patients with frozen shoulder, capsular release surgery can be an option. This procedure involves releasing the tight joint capsule to improve the range of motion.

Fracture Repair

In the case of a broken bone in or around the shoulder, surgery may be required to realign and fix the bones with plates, screws, or pins.

Preventing Shoulder Complications

Preventive measures can help maintain shoulder health and avoid complications.

• Engaging in Regular Exercise and Strengthening: Engaging in exercises that strengthen the shoulder muscles can provide better support and stability to the joint. This includes a balanced routine focusing on all muscle groups around the shoulder.
• Reducing Stress on the Shoulders: Maintaining good posture and ergonomic practices, especially during activities involving the shoulder, helps in reducing undue stress on the joint.
• Warm-Up and Stretching Before Exercise: Before engaging in physical activities, especially those involving the upper body, performing a proper warm-up and stretching routine can prepare the muscles and joints, reducing the risk of injury.
• Avoiding Repetitive Stress on the Shoulder: Being mindful of the weight and repetition of movements in activities and exercises can prevent overuse injuries.
• Allowing the Shoulder to Rest: Allowing adequate time for rest and recovery after intense activities helps in preventing overuse injuries and gives the shoulder time to heal from minor stresses.
• Maintain a Balanced Diet: A balanced diet rich in nutrients and proper hydration can lead to better muscle and joint health, aiding in the maintenance of shoulder health.