Elbow & shoulder pain

Shoulder and elbow pain are conditions that ensue mostly due to injury to the area. The shoulder has a wide range of motion, which makes it vulnerable to various injuries and problems. 

Elbows are the next most vulnerable joint and is usually due to repetitive use. Since the shoulder is designed to work in conjunction with the arm and hand, you may experience pain in both the shoulder and the elbow simultaneously.

Possible Causes: 

There are several types of injuries and conditions that can trigger off pain in the elbow and shoulder. 

Rotator cuff injury is the most common cause of shoulder pain. Repetitive shoulder movements can lead to degeneration of the rotator cuff tendons. 
Sprains Labral tears happen when the cartilage that surrounds the shoulder socket tears due to repetitive throwing or overhead activities
Frozen shoulder is a painful condition is characterized by severe motion loss. A frozen shoulder may occur after an injury, or suddenly, for no apparent cause.
Dislocation - Dislocation of the elbow takes place when the elbow bones are pulled apart and the ligaments that keep the bones together get stretched or tear. Shoulder dislocation similarly happens when the upper arm bone pops out of the cup-shaped socket that's part of your shoulder blade.
Fractures - The bones in the shoulder or the elbow can break (or crack) due to a fall or an accident.
Arthritis - Occurs due to the wearing off of the protective layer, which covers the bone ends within your joints
Bursitis - An inflammation in the bursae, which are the small sacs located between your bones and the other moving structures like your muscles, tendons and skin.
Impingement syndrome -  This is caused by pinching of the rotator cuff tendons and the bursa between the bones in the shoulder when raising arms to reach overhead..
Instability - An unstable shoulder can also slip out of its socket completely. It is usually an injury that causes an unstable shoulder.
Osteonecrosis or bone death: This condition occurs when a segment of a bone within your joint loses it blood supply and “dies”.
Osteochondritis Dissecans is caused by excessive throwing. The elbow is compressed and the joint smashes the bones together. This fragments the bone and cartilage. 
Cubital tunnel syndrome - A condition which affects the ulnar nerve, crossing your elbow through the cubital tunnel.
Radial tunnel syndrome - A dull aching pain at the top of the forearm, to the outside of the elbow, or the back of the hand due to pressure on the radial nerve.

Risk Factors: 

The factors that put you at a higher risk for pain in the elbow and shoulder include overuse or repetitive actions due to work or sports, or degenerative diseases such as rheumatoid arthritis.

Signs & Symptoms: 

Signs and symptoms of elbow and shoulder conditions could be:

• Pain - Shoulder pain when lifting the arm or at night, sudden shoulder pain without an injury
• Stiffness and swelling is seen in a condition called ‘Tennis elbow’ due to inflammation of the tendons that join the forearm muscles on the outside of the elbow.
• Reduced range of motion and a feeling of weakness.
• Dislocation of either elbow or shoulder - This type of injury can damage the bone and ligaments that surround the elbow joint and work to keep it stable. Recurrent elbow instability may cause locking, catching, or clicking of the elbow.
• Stiffness and difficulty with movement.
• A bump behind the elbow, outer elbow pain or pain when bending and straightening the arm
• A burning sensation or numbness

Diagnosis: 

The orthopaedic specialist at Medcare will diagnose the cause of your elbow or shoulder pain based on:

• A description of your symptoms.
• The location and type of discomfort.
• What factors trigger the discomfort.
• Imaging tests such as x-rays, CT scans, MRI scans or ultrasound tests. 

Treatment Options: 

At Medcare, the treatment plan drawn up by orthopaedic specialists will be personalised based on your problem and the underlying cause. 

Some components of the treatment may be:

• Medication for reducing pain and swelling.
• Heat or cold therapy is used selectively. Ice packs are used for acute injuries or pain, along with inflammation and swelling. Heat is used for muscle pain or stiffness.
• Bracing or splinting is done for fractures.
• Physical therapy. Therapeutic exercise programme promotes muscle endurance and improves resistance to repetitive stress.
• Minimally-invasive procedures such as arthroscopy may be advised by the doctor if your condition does not respond to nonsurgical treatment. Your surgeon inserts a small camera, called an arthroscope, into your elbow joint to conduct the operation.
• In total elbow replacement surgery, the damaged parts of the humerus and ulna are replaced with artificial components.
• In total shoulder replacement, the options are either replacement of just the head of the humerus bone (ball), or replacement of both the ball and the socket (glenoid).
• Surgeries such as rotator cuff repair, total shoulder and elbow replacement, dislocation repair for shoulder and elbow. The ligament must be reconstructed in order to surgically repair the injury and restore elbow strength and stability. 

  Often, the broken bone fragments are repositioned into normal alignment and then held together with special screws and sometimes a metal plate. 

In total shoulder replacement, the options are either replacement of just the head of the humerus bone (ball), or replacement of both the ball and the socket (glenoid).

Certain new techniques may be used:

• A special device transmits low-level electrical charges into the part of the body that is in pain. This is called transcutaneous electrical nerve stimulation (TENS) 
• To prevent stiffness and increase range of motion, your joint is moved continually in a mechanical splint. This technique is called Continuous passive motion (CPM).
• Often, acupuncture is an effective cure in chronic pain.