Treatments

Frozen shoulder occurs commonly in people in their middle ages and most commonly in diabetics. A frozen shoulder is what it sounds like. The shoulder does not move as well as it should and progressively stiffens. This situation results in a lot of pain, even at rest and is very amenable to in-office treatment.

Diagnosis of frozen shoulder can be made with physical examination and also an ultrasound to detect the thickness of the capsular structures of the shoulder that are thickened.

Treatment for frozen shoulder is highly successful in the office utilizing a Brisement procedure. Under local anesthesia with ultrasound guidance, the shoulder is effectively anesthetized, and with appropriate ROM and isometric techniques, shoulder motion can be improved dramatically with minimal to no pain.

A rotator cuff tear is extremely common. Approximately 50% of all 50 year olds sustain a rotator cuff tear during that decade and 60% of 60 year olds do.

A rotator cuff tear can occur instantaneously with a violent strain, or progressively over time, with wear and tear caused by pinching of the rotator cuff.

Diagnosis of rotator cuff tears is very efficiently performed with ultrasound technique. Partial tears in the rotator cuff can be diagnosed, measured and appropriate treatment directed from there.

Treatment of rotator cuff tears first involve mobilization of the joint, strengthening of the joint and, in partial tears, multiple trephination technique with ultrasound guidance and platelet rich plasma injections can be employed.

Degenerative arthritis is the wear and tear of the shoulder that occurs either traumatically or with age. Frequently the joint next to the shoulder, called the acromioclavicular joint has degenerative arthritis also.

Diagnosis is easily made with a plain x-ray or ultrasound, demonstrating joint fluid and decreased thickness of the cartilage at the end of the bones.

Initial treatment to degenerative arthritis is strengthening and stretching; and, in more advanced cases, ultrasound guided injections into the shoulder joint, or the AC joint.

Bicipital tendonitis into the anterior aspect of the shoulder from inflammation or dislocation of the bicipital tendon. This produces pain with lifting or doing such things as curling weights.

Diagnosis of bicipital tendonitis is accurately performed with ultrasound technique. The biceps tendon can be seen actively moving in and out of its specific location if it is dislocating, or fluid around the tendon or partial tearing of the tendon can be accurately diagnosed.

Instability of the shoulder occurs when there is frequent dislocation or partial dislocations of the shoulder. The diagnosis of this condition is performed with physical examination and careful attention to the patient’s history.

In complex dislocations that cannot be treated with exercise and stretching, MRI scans are employed to see if a portion of the shoulder complex has been torn.

Treatment to shoulder instability is exercise with appropriate muscle strengthening; and, in severe cases, surgical stabilization is required.