Dealing with Shoulder Pain? AC Joint Arthritis May Be the Culprit

As a shoulder specialist, I often see patients with shoulder pain that is caused by AC joint arthritis. The AC joint is where the clavicle (collarbone) meets the acromion, the bony projection on the top of the shoulder blade. Arthritis in this joint can cause pain and limit shoulder movement, making even simple tasks like reaching overhead difficult.

If you are experiencing shoulder pain, it's important to see a specialist like me for a proper diagnosis. In my practice, I use a combination of physical examination, imaging tests, and medical history to determine the source of your pain.

If your diagnosis is AC joint arthritis, don't worry. There are several treatment options available that can help you manage your symptoms and get back to your normal activities.

One treatment option is to modify your activity level and avoid movements that cause pain. I can work with you to develop a personalized exercise plan to help maintain strength and flexibility in your shoulder while minimizing stress on the joint.

In some cases, over-the-counter pain medications or corticosteroid injections can help alleviate pain and inflammation. I will discuss these options with you and determine if they are right for your specific case.

For patients with more advanced AC joint arthritis, surgery may be necessary. I specialize in minimally invasive surgery techniques that can effectively treat AC joint arthritis with smaller incisions and faster recovery times than traditional open surgery.

If you're experiencing shoulder pain, don't ignore it. Seeking proper medical attention can help you get the relief you need to return to the activities you love. Schedule an appointment with me to discuss your options for managing AC joint arthritis and getting back to a pain-free life.

Rotator cuff tendinitis

If you are experiencing shoulder pain, weakness, or limited range of motion, you may have rotator cuff tendinitis. This condition occurs when the tendons in the rotator cuff become inflamed or irritated, usually as a result of overuse or injury.

To diagnose rotator cuff tendinitis, I will perform a physical exam and may also order imaging tests such as an MRI or ultrasound to determine the severity of the inflammation and any associated damage to the shoulder.

Treatment for rotator cuff tendinitis may include a combination of rest, ice, anti-inflammatory medication, and physical therapy. I may also recommend corticosteroid injections to reduce inflammation and pain.

In more severe cases, surgical intervention may be necessary. Arthroscopic surgery can be used to repair any tears or damage to the rotator cuff, and a complete recovery can take several months.

It is important to seek treatment for rotator cuff tendinitis as soon as possible to prevent further damage and promote healing. If you are experiencing symptoms, schedule an appointment with me to discuss your options for treatment and recovery.

Arthroscopic labral repair (Bankart repair) animation

An arthroscopic Bankart repair (labral repair) for shoulder dislocations is a very common surgery in my practice. I recently found a good animation from Arthrex on YouTube that can be helpful for patients considering undergoing the procedure.

As always, feel free to contact my office with any questions.

Andrew

Reverse shoulder arthroplasty for complex shoulder osteoarthritis

Reverse shoulder arthroplasty has been used more frequently in patients with complex shoulder arthritis. This procedure is designed for patients who have severe arthritis and rotator cuff damage that has led to significant pain, weakness, and limited range of motion in the shoulder joint.

In a healthy shoulder joint, the ball-shaped end of the upper arm bone (humerus) fits into a shallow socket in the shoulder blade (scapula). The rotator cuff muscles and tendons hold the joint together and allow for a wide range of motion. In a reverse shoulder arthroplasty, the traditional ball-and-socket joint is replaced with a prosthetic device that reverses the position of the ball and socket components.

This reversed configuration of the joint allows the deltoid muscle to take over the function of the damaged rotator cuff muscles and tendons. This can provide significant pain relief and improve the patient’s ability to perform daily activities.

The procedure is performed under general anesthesia, and the surgeon makes an incision over the shoulder joint. The damaged bone and tissue are removed, and the prosthetic components are placed in the shoulder joint. The procedure typically takes two to three hours, and patients will need to stay in the hospital for a few days to monitor their recovery.

After the procedure, patients will need to undergo physical therapy to regain strength and range of motion in the shoulder joint. The length of time for recovery varies depending on the severity of the condition and the extent of the surgery.

Reverse shoulder arthroplasty is a safe and effective option for patients with complex shoulder arthritis who have not responded to non-surgical treatments such as physical therapy, NSAIDs, and corticosteroid injections.

If you are experiencing severe pain, weakness, and limited range of motion in your shoulder joint due to complex shoulder arthritis, I encourage you to reach out to our office or click here to discuss nonsurgical and surgical options.

Andrew

Total shoulder vs reverse shoulder replacement

As reverse shoulder replacements become more and more common, patients routinely come in asking about the difference between it and a standard total shoulder replacement. Here goes my explanation:

Anatomic Total Shoulder Arthroplasty:

An anatomic total shoulder arthroplasty, also known as a traditional shoulder replacement, involves replacing the ball-and-socket joint of the shoulder with a metal ball and a plastic socket. This procedure is typically performed when the patient has arthritis of the shoulder joint and has intact rotator cuff muscles.

During the procedure, the surgeon removes the damaged parts of the shoulder joint and replaces them with the artificial joint. The new joint is designed to replicate the natural movement of the shoulder, allowing the patient to regain a significant amount of mobility and function.

Reverse Total Shoulder Arthroplasty:

A reverse total shoulder arthroplasty, on the other hand, is a more recent innovation that was designed for patients with a rotator cuff tear arthropathy or a massive rotator cuff tear with pseudoparalysis. In these patients, the rotator cuff muscles are not functioning properly and cannot support the joint.

During a reverse shoulder replacement, the surgeon reverses the position of the ball and socket joint. This means that the ball is placed on the socket side of the joint and the socket is placed on the ball side of the joint. This changes the mechanics of the joint and allows the deltoid muscle to take over as the main muscle that powers the shoulder.

The purpose of the reverse shoulder replacement is to restore the patient's ability to lift the arm and perform activities of daily living. However, the range of motion may not be as good as with a traditional shoulder replacement.

In summary, anatomic total shoulder arthroplasty is best for patients who have arthritis of the shoulder joint and have intact rotator cuff muscles. A reverse total shoulder arthroplasty is best for patients who have a rotator cuff tear arthropathy or a massive rotator cuff tear with pseudoparalysis or significant deformity. Both procedures can help improve the patient's quality of life and restore function to the shoulder joint, but it is important to consult with your surgeon to determine which procedure is right for you.

As always, please feel free to contact my office with any questions.

Andrew

Elbow arthroscopy for stubborn lateral epicondylitis (tennis elbow)

Lateral epicondylitis (tennis elbow) can be one of the more frustrating conditions that patients come to see me for. It is the most common cause of lateral elbow pain and can lead to significant disability. Luckily, a vast majority of cases do improve without surgery within 3-4 months with rest, bracing, and stretching.

What can be done if the pain does not improve with the common treatment of rest, stretching, and bracing?

If the pain persists greater than 6 months, I generally offer elbow arthroscopy. This quick, outpatient surgery takes approximately 30 minutes and involves making two small skin incisions (approximately 1cm) around the elbow and using a camera and small instruments to remove the damaged portion of the tendon that is causing pain.

Most patients see very good results and have significant improvement in their pain and return of function within 4-6 weeks from surgery.

To learn more, you can schedule a consultation with me here or always feel free to contact the office with questions.

Total shoulder arthroplasty animation

Total shoulder replacement (arthroplasty) for shoulder osteoarthritis is a very common surgery in my practice. I recently found a good animation from the Orthopedic Associates of Wisconsin on YouTube that can be helpful for patients considering undergoing the procedure.

As always, please feel free to contact my office with any questions.

Andrew

Rotator cuff repair animation

Rotator cuff repairs have become more and more frequent over the past several years. I recently found a good animation on YouTube from Dr. Robert Hartzler. This animation can be helpful to patients that are considering undergoing a rotator cuff repair and biceps tenodesis.

as always, feel free to contact my office with any questions.

Andrew

Reverse shoulder arthroplasty animation

Reverse shoulder arthroplasty for rotator cuff arthropathy have become more and more common in my practice. I recently found a good animation from the Orthopedic Associates of Wisconsin on YouTube that can be helpful for patients considering undergoing the procedure.

As always, please feel free to contact my office with any questions.

Andrew

Rehab protocols

Hello all. I have updated my rehabilitation protocols. They can be found here.

Andy

Virtual consultations and second opinions

We have recently updated our virtual visit platform to go through MyChart. I can now offer virtual consultations and second opinions from the comfort of your own home or office. To learn more, check out my virtual consultation page here.

Congratulations to #NASA and #SpaceX!

I want to say congratulations to NASA and SpaceX for the first successful crew launch in the United States since the retirement of the space shuttle program. It's an exciting day for all lovers of space and space travel.

Tips for coping with isolation from @NASA astronaut Scott Kelly (@StationCDRKelly) #covid19

NASA astronaut Scott Kelly has spent 520 days in space, so he knows a thing or two about social distancing. Let’s hear what tips he has for us in the era of COVID-19.

Now offering orthopedic video visits! #orthopedics #covid19

I’m very happy to announce that I, through The Everett Clinic, am now offering orthopedic video visits. If you have an orthopedic condition that you would like to be evaluated, but are doing your part in the COVID-19 crisis to maintain social distancing, a video visit through our VSee app may be the right solution. I can determine if we can treat your condition at home or with physical therapy or if it needs to be seen in the office for an exam and imaging. The setup is incredibly simple and can be done from your phone or home computer. If you are interested in an orthopedic video visit, please call at 425-412-1875 to schedule a visit with me or one of my colleagues. Stay at home and stay safe!

Andrew Pastor

VSee app

Space Medicine update

I have added a new resource for new studies and news concerning orthopedic space medicine on my Space Medicine page today. I hope it will be a nice resource for all of those interested in human space travel. Enjoy!

What are the symptoms of shoulder arthritis?

This is part 2 of our discussion on shoulder arthritis. Previous posts include:

What is shoulder arthritis?

Pain is by far the most common symptom of arthritis of the shoulder.  This pain is normally aggravated by activity and worsens over time.  The pain may be felt as a deep ache or may be centered in the back of the shoulder.  This pain also normally intensifies with changes in the weather.  Night pain is also incredibly common with most shoulder problems.

Decreased range-of-motion is also very common with shoulder arthritis.  This may be secondary to pain or may be from a tight shoulder capsule or bone spurs.

Please stay tuned for more posts on the diagnosis and treatment of shoulder arthritis.

Postoperative rehab protocols

As many of you know, physical therapy offices are temporarily closed around the state due to the ongoing coronavirus pandemic. This has left many patients, who recently had surgery, without the therapy that they need. I have made my rehab protocols available on my website here for patients to follow along on a week to week basis. I will continue to see my recent post operative patients in clinic and encourage them to follow-up with me by phone at 425 – 412 – 1875 or send me a message through the Epic MyChart.

COVID-19 Update

I want to give everyone an update of the situation involving COVID-19 in our clinic. We have canceled all non-emergent or non-urgent surgeries until June 1. We’ve also canceled all non-urgent or emergent orthopedic clinic visits at the Everett clinic. Our Edmonds and Smokey Point locations are temporarily closed. We will be seeing patients in our Everett location daily. We are also trying to implement possible virtual video visits. I will keep you updated with any new information. If you have questions or have an urgent or emergent orthopedic issue, please call our clinic at 425-412-1875.