Orthopedics

Shoulder and Elbow Treatment

Our expert team of fellowship-trained orthopedic surgeons and sports medicine specialists is dedicated to helping you regain mobility and live pain-free. Discover effective treatment options tailored to your specific needs.

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Assessing shoulder and elbow injuries


Your Riverside orthopedic surgeon can determine the extent of the damage to your shoulder or elbow and to guide you in what type of treatments would be the most effective.

To make an appointment with one of our specialists, please call one of our conveniently located offices:
• Peninsula/Williamsburg: 757-534-9988
• Gloucester: 804-693-0529
• Eastern Shore: 757-302-2700

Orthopedic Shoulder Specialist

 

At Riverside Orthopedic & Sports Medicine Specialists, we know that constant shoulder or elbow pain doesn't have to be a way of life. To relieve your pain and inflammation, your doctor may recommend joint injections, physical therapy and other therapies. But, for some, the nonsurgical route doesn't provide enough pain relief and surgery is the next level of treatment.

  

Understanding Shoulder and Elbow Pain

Shoulder and elbow pain can be caused by a variety of factors, ranging from overuse to underlying medical conditions. Understanding the causes of these discomforts is crucial to effectively manage and treat them. Injuries such as strains, sprains or fractures are common culprits of shoulder and elbow pain.

Shoulder and elbow conditions can cause a range of symptoms that can greatly impact an individual's daily life. It is important to be aware of these symptoms in order to seek appropriate medical attention and treatment. Here are some common symptoms associated with shoulder and elbow conditions:


  1. Pain: Persistent or intermittent pain in the shoulder or elbow area is a common symptom of various conditions, such as tendinitis, bursitis, arthritis or rotator cuff injuries.

  2. Stiffness: Limited range of motion or difficulty moving the shoulder or elbow joint may indicate underlying issues like frozen shoulder or osteoarthritis.

  3. Swelling: Inflammation and swelling around the shoulder or elbow joint can occur due to injuries, infections or conditions like tennis elbow.

  4. Weakness: Weakness in the muscles surrounding the shoulder and elbow joints may be experienced, making it challenging to perform certain activities that require strength and stability.

  5. Numbness or tingling: Some conditions affecting the nerves in the shoulder and elbow region can lead to sensations of numbness, tingling or even radiating pain down the arm.

  6. Instability: Feeling instability in the shoulder or elbow joint, such as frequent dislocations or subluxations (partial dislocations), could be indicative of ligament tears or joint instability disorders.

  7. Clicking sounds: Clicking, popping noises during movement of the shoulder or elbow joints may suggest issues with cartilage damage, labral tears or loose bodies within the joint space.

In this section, we will explore a comprehensive list of common shoulder and elbow conditions. The shoulder and elbow are complex joints that are prone to a variety of injuries and disorders. Understanding these conditions can help individuals identify symptoms, seek appropriate medical treatment and take necessary precautions to prevent further damage.

 

  1. Rotator cuff tear: Your rotator cuff consists of muscles and tendons in your shoulder. Tearing any of these muscles either through overusing the shoulder or falling on it can cause shoulder pain and weakness.

  2. Shoulder arthritis: Shoulder arthritis is inflammation in the shoulder joint that causes pain and trouble moving your shoulder. You can experience multiple types of shoulder arthritis, including:

    a. Avascular necrosis (AVN) where bone cells in your shoulder die due to a lack of blood flow
    b. Post-traumatic arthritis due to injuries or surgeries in the shoulder
    c. Rheumatoid arthritis, also called inflammatory arthritis, is caused by an autoimmune disorder
    d. Osteoarthritis, which can affect the acromioclavicular joint (the joint by your collar bone) or your glenohumeral joint (the joint where your arm meets your shoulder socket) due to wear and tear on your shoulder over time


  3. Rotator cuff arthropathy: If doctors don’t repair a rotator cuff tear, it can lead to rotator cuff arthropathy. In this condition, your shoulder bones rub together, causing irritation, pain and weakness.

  4. Proximal humerus fractures: Proximal humerus fractures are broken bones in your upper arm or shoulder. They can be caused by car accidents or bad falls. If you break your bone, you will feel pain and may not be able to move your arm at all.

  5. Labral tears: Your labrum is the cartilage that lines your shoulder joint. If the labrum tears, it can cause pain, trouble lifting your arm and a grinding or popping feeling when you move your arm.

  6. Proximal biceps tears/tendinopathy: Your bicep muscle connects to your shoulder joint via a tendon. If you overuse this muscle by lifting overhead over and over or making similar motions, these tendons and even the bicep muscle can tear, leaving your shoulder weakened.

  7. Acromioclavicular (AC) joint arthritis: Your AC joint is where your collar bone meets the highest point of your shoulder. Arthritis here most commonly occurs in middle-aged and older adults.

  8. Subacromial impingement: The subacromial area of your shoulder runs beneath your collar bone. Your rotator cuff tendons run through this area. They become “impinged” or pinched if they are irritated or inflamed.

  9. Distal biceps tendon ruptures: Your distal bicep tendon attaches your bicep to the front of your elbow. In the rare case that it detaches from the bone, your bicep muscle can become bunched up around your shoulder, creating a bulge and severe pain.

  10. Triceps tendon ruptures: The muscles that make up your triceps attach to the back of your elbow. If the tendon ruptures, you won’t be able to fully extend your arm.

  11. Frozen shoulder (adhesive capsulitis): Characterized by stiffness and pain in the shoulder joint, often resulting from injury or prolonged immobilization.

  12. Shoulder instability: Refers to a condition where the shoulder joint is prone to dislocation or subluxation due to ligament laxity or trauma.

  13. Tennis elbow (lateral epicondylitis): An overuse injury causing pain on the outer side of the elbow due to inflammation of tendons attached to the lateral epicondyle.

  14. Golfer's elbow (medial epicondylitis): Like tennis elbow but affects the inner side of the elbow due to inflammation of tendons attached to the medial epicondyle.

  15. Bursitis: Inflammation of fluid-filled sacs called bursae that cushion joints, commonly occurring in both shoulders and elbows.

  16. Tendinitis: Inflammation of a tendon, often caused by repetitive motions or overuse injuries, leading to pain, and swelling in affected areas.

When it comes to treating shoulder and elbow conditions, there are several options available. These treatment options aim to alleviate pain, improve mobility and restore function in the affected areas. It is important to note that the specific treatment approach will depend on the underlying cause and severity of the condition. It is important to consult with a health care professional for an accurate diagnosis and personalized treatment plan based on individual needs. Here are some common nonsurgical treatment options for shoulder and elbow issues:

  1. Rest and activity modification: In mild cases, resting the affected joint and avoiding activities that aggravate the symptoms may be sufficient for recovery.

  2. Physical therapy: This involves targeted exercises and stretches to strengthen muscles, improve range of motion, and enhance joint stability.

  3. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to reduce pain and inflammation in the shoulder or elbow.

  4. Corticosteroid injections: In some cases, corticosteroid injections may be administered directly into the joint to provide temporary relief from pain and inflammation.

  5. Bracing or splinting: Depending on the condition, wearing a brace or splint can help support the shoulder or elbow joint, promote healing, and prevent further injury.



When medicines and physical therapy haven’t helped, the expert orthopedic surgeons at Riverside Health System use the latest minimally invasive shoulder surgeries to improve shoulder and upper arm function. Shoulder surgeons can perform dozens of minimally invasive and open surgeries to improve your shoulder function. From repairing tendons to replacing the shoulder joint, these specialized orthopedic surgeons help relieve pain and improve your quality of life.

 

  1. Arthroscopic rotator cuff repair: Arthroscopic surgery uses small incisions and a specialized camera and tools to repair tendons, ligaments or cartilage issues. During arthroscopic rotator cuff repair, shoulder surgeons can insert the camera through an incision near your shoulder and then use special tools to reconnect torn areas of your rotator cuff.

  2. Superior capsular reconstruction: If your doctor can’t fully repair your rotator cuff, you might need arthroscopic superior capsular reconstruction instead. In this procedure, your orthopedic surgeon will connect your arm bone to your shoulder with grafted tissues. This connection helps support your shoulder so it can move as it should.

  3. Acromioplasty: In this arthroscopic procedure, your doctor will look inside your shoulder joint for bone spurs, tissues or other growths that could painfully press against your shoulder tendons. To relieve pain, they can remove the bone spurs and part of the acromion (shoulder bone).

  4. Arthroscopic biceps tenodesis: During biceps tenodesis, a minimally invasive surgery, your doctor can detach your torn bicep tendon from your shoulder and reconnect it to your upper arm. This procedure can help eliminate pain when you move your arm.

  5.  Anatomic shoulder replacement: Shoulder replacement surgery treats severe arthritis pain in your shoulder joint. Your surgeon will place a metal ball at the top of your arm bone and a plastic liner in your shoulder socket. The ball articulates with the liner, mimicking the motion of your natural shoulder joint.

  6. Reverse shoulder replacement: In a reverse shoulder replacement, your surgeon places a metal ball in your shoulder socket and a plastic cup at the top of your arm bone. This type of shoulder replacement might be more effective for people who have suffered rotator cuff tears.

  7. Distal clavicle excision: Sometimes your clavicle (collar bone) can compress the tendons in your shoulder, causing pain. In this procedure, your doctor removes part of your clavicle to relieve pressure and pain.

  8. Distal biceps repair: During distal biceps repair, your surgeon uses minimally invasive methods to reattach your bicep to your arm bone. After the procedure, you will be able to use your arm better and regain your strength.

  9. Triceps repair: Similar to biceps repair, your shoulder surgeon reattaches your triceps muscle to the back of your arm bone during this procedure. As your body heals, you’ll regain function in your arm.




Portrait of a diverse team of doctors working together in a medical institution
Riverside Orthopedic & Sports Medicine Specialists team

Meet our Orthopedic Providers

Providing efficient and effective care for any specialized orthopedic need

Your Orthopedic Team

Total Shoulder Replacement

- Paul McLendon, M.D.

Total Shoulder Reconstruction Surgery

- Paul B. McLendon, M.D.

Rotator Cuff Surgery

- Barbaro J. Perez, M.D.

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