How Shoulder Arthritis Can Be Treated | Ohio State Sports Medicine

How Shoulder Arthritis Can Be Treated | Ohio State Sports Medicine


As a shoulder specialist I do treat a fair
amount of patients with shoulder arthritis. And there are varying degrees of shoulder
arthritis, from very mild to what we call severe – when it’s bone on bone arthritis,
which most people have heard of that term before. When we’re considering the treatment options
for shoulder arthritis, first and foremost the decision is based on how much does the
pain impact a patient’s quality of life? The symptoms that people have when they have
shoulder arthritis tend to be first pain, especially pain at night that prevents them
from sleeping, but also pain with use and pain with activities. Many patients with more advanced arthritis
lose their range of motion and their shoulders become quite stiff, and it’s hard for them
to reach as high as they once did and simple activities such as fastening one’s bra, putting
cups away in the cupboard, washing your hair can become quite difficult. Typically it’s at this point when the pain
and the lack of function are impacting drastically a patient’s life is when they come to see
me as a shoulder specialist. When we first start treating shoulder arthritis
there are a variety of conservative treatment options and this ranges from rest, many patients
try moist heat, a variety of anti-inflammatories can be used. We occasionally do cortisone injections. The relief is temporary from cortisone but
it can provide great relief and can certainly put off the need for more invasive surgery. The definitive treatment for should arthritis
is a shoulder replacement. Now certainly the thought of a shoulder replacement
is very daunting for many patients. It seems quite overwhelming to consider that. However, it is quite a successful surgery
and the outcomes are so good and so predictable, most patients when they finally decide to
have a shoulder replacement typically come back and say, wow why didn’t I do this earlier? But for every patient it’s an individual decision
when you are ready for a shoulder replacement. Of course your x-rays and your physical exam
have to correlate with one who would be ready for a shoulder replacement, but when all the
pieces add up patients do decide to go ahead with the shoulder replacement surgery. Again, shoulder replacement surgery is one
of the most reproducible surgeries that we do as shoulder specialists. It’s very rewarding because the affects are
almost immediate. The goal of shoulder replacement surgery is
not only to relieve your pain but to restore your quality of life and restore your range
of motion. We traditionally see most patients come in
at their first postoperative visit, which is about two weeks out from surgery and can
already say that arthritis pain is gone. So although they have surgical pain, they
can tell the arthritis pain is gone and they are already starting to feel better. It is typically a two-hour surgery. Typically it’s a two-night stay in the hospital. Shoulder surgery is quite painful and we need
to prepare our patients that after shoulder replacement surgery the first few days can
be pretty rough. However, we have a wonderful team at our hospital. We have a shoulder team. We have wonderful anesthesiologists that provide
the latest techniques in anesthesia for shoulder surgery. We do something called a nerve block, it’s
an interscalene nerve block and essentially our anesthesiologists numb up the nerve to
your entire arm and they actually put a little catheter in your neck. It’s about in this area here and while you’re
in the hospital that little catheter bathes the nerves in your arm with a numbing solution
and that really helps take the edge off of your pain. We have a wonderful team of physical therapists
and shoulder physical therapists here at Ohio State. And we use that protocol for rehabbing our
patients after surgery. We have many patients that come from far away
and we absolutely understand that is best to have your therapy close to home, but because
we have such a detailed protocol, we can give our protocol to your therapist and they know
exactly how we like to rehab you. Of course we’re always open to phone calls
so any therapist that has a question can contact our therapists at any time. Your therapy does start in the hospital and
we continue therapy for about three months. Typically patients go to therapy about two
times a week for three months and some patients go for a longer period of time if they so
desire. You do wear a sling for six weeks after shoulder
surgery and that’s primarily for your own protection. All shoulder replacement surgery does require
that we make an incision or we cut your front rotator cuff tendon. We have to do that in order to place the replacement. We do fix that rotator cuff tendon at the
end of surgery. However, it does take three months for that
to heal. So because of that we don’t allow you to go
behind your back with your hand and you cannot push yourself up from a seated position with
your operative side. So that you don’t forget, the sling is really
your reminder and that’s the main reason for the sling. Everyone comes out of the sling at the six-week
mark and you’re allowed to progressively use your hand for activities around the house,
but you’re not allowed to lift anymore than your coffee mug for three months. At the three-month mark most people are ready
for a home physical therapy protocol. Your front rotator cuff tendon is healed and
as long as everything checks out on your three-month visit to me in the office, we let you slowly
go back to your normal activities. A lot of patients do ask, what can I do after
shoulder replacement surgery? And the goal of shoulder replacement surgery
is to let you go back to the things that you like to do. We have many patients that their goal is to
golf, or to play tennis or to swim and certainly we allow that. Now we do have some weight restrictions after
shoulder replacement surgery. We want the shoulder replacement to last so
we really don’t encourage contact sports, we don’t want heavy construction work or heavy
manual labor.

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