Q&A Topic: Shoulder Pain and Advanced Shoulder Surgery

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Evan H. Karas, MD, FAAOS

Q. I’ve been experiencing discomfort when I lift my arm over my head, most often brushing my hair and putting dishes in the cupboard. What could be wrong?

A. Shoulder pain is often because of tendon inflammation or tear, dislocation, arthritis, or a broken bone. If you feel pain when you put on your coat or reach into the back seat of the car from the front, you may have a rotator cuff injury. The rotator cuff is a cradle of muscles and tendons that lets you rotate your arm in a full arc. This intricate structure makes it possible for you to do everyday activities like reaching and lifting; you also rely on your rotator cuff while swinging a tennis racquet or golf club or throwing a ball. Injury can result from a fall or lifting something heavy—or it might just be overuse. I often see rotator cuff problems in patients older than 35, as tendons lose elasticity with age.

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Q. What should I do?

A. If you’re experiencing pain, it’s important to see a doctor. A thorough examination is needed to determine the cause of your pain. An orthopedist will check for symptoms such as swelling, weakness, tenderness, and any deformities. Additionally, imaging with MRI and X-ray will assist in a diagnosis. Treatment options will vary. Most often rest, modified activities, and physical therapy will be needed. To reduce inflammation and pain, medication or injections, such as cortisone shots, may be used. Surgery will be required to resolve some shoulder problems.

Q. What can I expect if I need surgery?

A. If there is a tear, I’ll recommend surgery to repair it. Using a minimally invasive arthroscopic technique, I’m able to repair a rotator cuff as an outpatient procedure and patients can expect to be home within a few hours. For more serious problems, such as severe arthritis, degenerative joint disease, or chronic rotator cuff deficiency, shoulder replacement surgery is often necessary. Patients can expect to leave the hospital after one or two days. Arm movement is limited for about six weeks while the tissue around the new joint heals. Most patients return to normal activities after three months, and shoulder replacements typically last a lifetime.

Northern Westchester Hospital
Co-Chief, Orthopedic Surgery
Co-Director, Orthopedic & Spine Institute

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