Shoulder Pain May Be Signal For Replacement
“I had trouble sleeping at night, the pain was with me all the time,” says Mr. Schickli. “I was also having trouble raising my arm above my shoulder.”
Schickli was referred by his orthopedic surgeon in Louisville to Dr. Michael J. Moskal, an orthopedic surgeon at Clark Memorial Hospital specializing in shoulder and elbow treatments. Dr. Moskal diagnosed Schickli with glenohumeral, or shoulder, arthritis.
“The shoulder is a ball-and-socket joint,” explains Dr. Moskal. “The ball of the joint is covered with a thin covering called cartilage. Arthritis occurs when the cartilage begins to break down and flake off into the joint. This causes stiffness in the joint and inflammation of the lining.”
The most common symptom of arthritis in the shoulder is pain, brought on by physical activity or changes in weather. Limited motion is another symptom. If the pain increases, it could affect sleep as well.
A physical examination by your physician or an x-ray evaluation can diagnose the disease. Once diagnosed, the first line of treatment is anti-inflammatory medications, such as aspirin or ibuprofen, along with the modification of certain activities that irritate the joint. Depending on the type of arthritis, a disease-modifying drug, such as methotrexate, or a series of corticosteroid injections may be prescribed.
Physical rehabilitation can also be used to treat shoulder arthritis. Hydrotherapy in a swimming pool tends to soothe the joint and can provide increased range of motion.
If the arthritis is more advanced or causing greater complications, arthroscopic surgery can be used if detected early and the arthritis is mild. Arthroscopic surgery is done on an outpatient basis. A small incision is made in the shoulder, allowing the physician to trim out the inflamed lining and remove stray pieces of cartilage.
“These procedures do not cure the arthritis,” says Dr. Moskal. “However, it does provide relief from the symptoms of arthritis for awhile.”
When Schickli was diagnosed, he opted for total shoulder replacement. During joint replacement surgery, an incision is made across the front of the shoulder from the middle of the collarbone to the middle of the arm bone. Any scar tissue that restricts motion of the joint is removed. Then, the ball portion of the joint is replaced with a smooth metal ball. If the socket portion of the joint has considerable wear and tear, then it is replaced with high-density polyethylene, or plastic.
Once the surgery is complete, physical rehabilitation begins the next morning. Typically, range of motion exercises are started to prevent stiffness of the shoulder. Significant and durable improvements in shoulder comfort and function can be expected.
“Joint replacement surgery should be taken seriously,” advises Dr. Moskal. “The benefits and risks should be weighed carefully before deciding to have this surgery.”
The risks include infection, injury to nerves and blood vessels, fractures, stiffness or instability of the joint, loosening of the artificial parts, pain, additional surgeries, and sometimes death.
Schickli weighed those risks seriously, but decided to continue with his surgery. Now he is happy with his decision.
“I have never been better,” says Schickli. “I have no more pain when I raise my arm and I can play tennis once again.” In fact, he is going to have surgery on the other shoulder in June.
For more information on glenohumeral arthritis or total shoulder replacement surgery, please contact Dr. Michael Moskal at (812) 941-7232, or Clark Memorial Hospital at 285-5893.
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