Shoulder pain is painful and annoying. However, the treatment options are varied. “Surgery is not always necessary,” explains shoulder specialist Dr. med. Holger Durchholz.
“Our shoulder is not just a joint, it is an interplay of five joints,” explains Dr. Holger Durchholz, shoulder specialist at Klinik Gut. The large shoulder joint is supported by smaller joints on the collarbone, shoulder blade and sternum as well as numerous muscles, tendons and ligaments. Together, they keep the joint head of the upper arm in the correct position and make the shoulder the joint with the greatest mobility of the human body.
When the shoulder causes problems, this is usually caused by pain that occurs in the joint itself or in the upper arm. They can also radiate to the back or neck. “For shoulder patients, it is not uncommon for the night to be tormented. The usual lateral sleeping position suddenly becomes painful or a twisting movement hurts so much that you wake up.” The causes of shoulder pain can be incorrect and excessive loads, consequences of injuries or signs of wear and tear.
“I wish patients would come to us earlier.”
An examination first checks the full range of motion of the shoulder joint and the muscles, tendons and ligaments in order to more precisely localize the pain and the movements in which it occurs. “The patient's information, together with X-ray or MRI images, makes it possible to diagnose the causes,” explains Dr. Durchholz.
Treatment with physiotherapy is often possible as a first step. “Treating doesn't always mean operating. Many of the symptoms can be alleviated or even completely disappeared with targeted exercises, special training and conscious posture.”
If physical therapy and exercise are unsuccessful, pain management can provide relief. “Pain relievers can be taken as tablets or injected directly into the areas of the joint where the pain occurs. They not only relieve patients of annoying symptoms, but also enable physiotherapy to have a better effect.” Only when conservative methods have been exhausted is surgery considered.
Most procedures can be performed minimally invasively: A camera and probes with miniaturized instruments are inserted into the joint via small skin incisions. They can sew or connect ligaments and tendons to bones, or remove calcium deposits and damaged cartilage.
“If you wait too long, all that's left is surgery.”
In case of severe bone damage, joint parts or the entire shoulder joint can be replaced with metal, ceramic or plastic implants. “The use of implants is appropriate when bones and cartilage are so severely damaged that the movement of the joint can no longer function without pain.”
The aim of all types of treatment is a life without pain, full freedom of movement and strength in the affected joint. “I wish that patients would come to us earlier,” summarizes Holger Durchholz. “Many shoulder problems and injuries are easy to treat at an early stage. If you wait too long, the damage gets worse and there is often only one operation left.”
Although surgery repairs joint damage, it is not the end of the treatment. “A surgical procedure clears the way for the joint to function flawlessly again. But it is only the basis for rebuilding freedom of movement and muscles.” This is often followed by long rehabilitation programs. Physiotherapists and trainers guide patients to return their shoulders to full operational capacity.
“Perseverance and perseverance are definitely worthwhile,” concludes the shoulder specialist. “The vast majority of our patients are able to use their shoulders normally again. This restores them to their full quality of life.” And as a tip, he goes along the way: “Shoulder injuries and complaints shouldn't be taken lightly.”
The shoulder specialist
Dr. med. Holger Durchholz (42) is a specialist in orthopedics and traumatology of the musculoskeletal system at Klinik Gut.
Klinik Gut
St. Moritz, Fläsch, Ascona, Bad Ragaz, Chur, Buchs (SG), Zurich airport.
Specialists for all joints, sports medicine, pain and physiotherapy.
T: +41 (0) 81 836 34 34
E: info@klinik-gut.ch
W: www.klinik-gut.ch
This technical article by Christian Gartmann was published in the health supplement to the SonntagsZeitung on June 17, 2018.