About Tristate Arthritis And Rheumatology
Tristate Arthritis and Rheumatology is first and largest Rheumatology practice in the Northern Kentucky area. Founded by Dr. Arthur Kunath in 1986, our rheumatology practice now consists of six doctors who are board certified in both Internal Medicine and Rheumatology and a Physician Assistant. Patients see one doctor , thereby assuring continuity of care and an individualized doctor-patient atmosphere giving the physician the ability to establish personalized and detailed relationships. Our doctors have received numerous awards, including being listed as Top Doctors in Cincinnati Magazine, receiving the Patients Choice Award, the Most Compassionate Doctor Award, and the American College of Rheumatologys My Doc Rocks award.
What Is The Surgical Treatment For Shoulder Arthritis
If non operative treatment is not effective, your doctor may discuss surgical options:
Arthroscopy: this is a minimally invasive operation requiring anesthesia, in which a small camera is placed inside the joint through a small incision. Through another incision, small instruments can be brought inside the joint to manipulate tissue.
to remove loose fragments of cartilage and bone in the joint may play a role in early arthritis when there is little damage to the joint surface. This does not eliminate arthritis, but can be helpful in removing loose pieces of tissue which are irritants. The benefits may be minimal, subjecting the patient to an operation and anesthesia, with essentially no role in effectively treating the symptoms when arthritis is advanced.
Shoulder Replacement – A is an operation similar in concept to or , in which implants made of plastic and metal are placed to create new joint surfaces. During this operation, which requires an incision as with all open surgery, the arthritic ball is removed and replaced by a metal ball that attaches to a metal stem that goes inside the upper humerus bone . The arthritic socket is covered by a smooth plastic socket, also called a prosthesis. It is the smooth metal ball moving on the smooth plastic socket that relieves pain.
Other Therapies For Psa
Below are additional ways of managing shoulder pain from PsA.
Transcutaneous Electrical Nerve Stimulation Units
Transcutaneous electrical nerve stimulation units are small, battery-operated devices that use electrical impulses to help reduce pain by stopping pain signals in the brain. One MyPsoriasisTeam member recommended using a TENS unit while exercising: I have a TENS unit that is portable and awesome for keeping the body moving when having severe pain.
Heat and Cold Therapy
Many MyPsoriasisTeam members use heat and cold to help ease PsA pain. One member shared their method for heat therapy: I use a rice-filled sock heated in the microwave for a few minutes. It helps. Others would rather apply ice: I also find that ice packs still help even when Tiger Balm doesn’t. I think the cooling action helps reduce the inflammation.
Topical Creams and Patches
Health care providers like rheumatologists can prescribe topical treatments for pain. As one MyPsoriasisTeam member wrote, If you can get your doctor to prescribe it, there are some creams and patches that work very well .
Other MyPsoriasisTeam members recommend trying over-the-counter ointments, like one who shared, Extra-strength Tiger Balm helped me for a long time.
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How To Know If Your Shoulder Pain Is From Arthritis Or Bursitis
Two common shoulder problems are arthritis and bursitis. Your shoulders are packed with bones, muscles, tendons, and ligaments. Shoulder pain can develop from a variety of conditions that affect one, if not many, of these structures. While this can make it difficult to pinpoint the exact source of your shoulder pain, an accurate diagnosis and proper treatment are the keys to recovery. Arthritis and bursitis are two of the most common causes of shoulder pain however, they can be difficult to differentiate. The following article will help you determine if your shoulder pain is caused by arthritis or bursitis
More About Injections In Shoulder Joint
Usually, we perform injections in shoulder joint to improve pain and function. Injections are performed with or without imaging guidance such as ultrasound or X-ray. Overall, injections without imaging are less accurate. Also, using ultrasound is much cheaper than X-ray and often preferred by patients.
Options for injections into the shoulder joint include cortisone, hyaluronic acid, or PRP. Cortisone is the most common injection and provides short-term relief from pain. Some doctors use hyaluronic acid, a naturally occurring substance in bones and joints. A recent study found that injection of hyaluronic acid into the shoulder joint reduces pain after 6 months. We obtain PRP or platelet-rich plasma from whole blood. We spin the blood and extract the plasma from the cells. Finally, the plasma is then injected into the shoulder joint. While PRP improves pain with knee arthritis, there is little evidence for use in shoulder arthritis.
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Don’t Let Down By The Shoulder Pain
Though once something goes wrong with the shoulder, it hampers our ability to move freely and may cause great pain and discomfort while we are using our arms and fingers.
But our electric heated shoulder wrap aims to help relieve these issues like periarthritis of shoulder, rotator cuff tear, AC joint dislocation, sprain, bursitis, tendinitis, paralysis, strain, stiffness, soreness, etc.
- Please charge the battery fullyï¼at least charge 8 hoursï¼ before first-time use.
- Heating pads are not recommended to touch base skin. Please use the highest temperature of no more than 0.5 hrs.
Osteoarthritis Of The Shoulder
Get information about the causes, symptoms and treatments for shoulder osteoarthritis, which is more common and debilitating than you may think.
In shoulder osteoarthritis also called degenerative joint disease your cartilage and other joint tissues gradually break down. Friction in the joint increases, pain increases and you slowly lose mobility and function. Shoulder OA is not as common as OA of the hip or knee, but it is estimated that nearly 1 in 3 people over the age of 60 have shoulder OA to some degree.
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Shoulder Exercises And Stretches
Regular exercises and stretches can keep your shoulder strong and flexible. A few things to remember before swinging in to exercises:
- Stop any exercise if you have more shoulder pain. It may be too soon for you to try.
- Watch your form. Exercising incorrectly can also cause or worsen shoulder problems.
- Warm up, even before deep stretching. Light shoulder rolls, gentle movements, or even a warm shower are all ways to warm up your muscles before exercise and stretching.
Pendulum stretch for range of motion
- Stand and bend at the waist.
- Let your arm on the injured side hang straight down.
- Keep your neck relaxed.
- Move your arm in a circle up to 20 times.
- Do once or more times in a day.
Overhead shoulder stretch
- Sit or stand to do this shoulder stretch.
- Intertwine your fingers in front of you.
- Bend your elbows and raise your arms above your head. You can also place your hands on your head or behind it.
- Gently squeeze your shoulder blades together to move your elbows back.
- Continue for up to 20 repetitions. Repeat 5 to 10 times a day.
Youll need treatment along with home remedies if you have a serious shoulder injury. See your doctor if you have any of the following:
- pain: especially if the pain does not get better with rest and medication
- repeat problems: if you have shoulder pain more than once
- stiffness: if you cant lift and rotate your arm normally
- weakness: if your shoulder, arm, or hand is weaker than the uninjured side
Shoulder Exercise: Wall Push Up
Strengthens shoulder, arm, and chest muscles
- Stand in front of wall, with your arms straight and hands flat against it.
- Place your feet slightly wider than shoulder-width apart, and tighten your stomach muscles.
- Keeping your feet flat on the floor, bend your elbows and open your chest toward the wall.
- Lower your upper body toward the wall in a slow, controlled motion. Your shoulder blades will come together a bit in the back. Hold for one second.
- Keeping your hands flat against the wall, slowly push yourself back until your arms are straight.
- Repeat 8 times and gradually build up to more reps.
Tip: Make sure your fingers arent bent on the wall, says Shroyer. Keeping them flat and pushing hard against the wall fully engages the muscles in your shoulder, arm, and chest.
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How Do We Treat Shoulder Arthritis
In general, simple treatments are used first. Options include:
- Activity modification: We often limit our activities including sport. Contact sport or sport involving full movement of the shoulder such as tennis is often difficult with shoulder arthritis.
- Physiotherapy: Strengthening of the muscles around the shoulder and shoulder blade can reduce the loads on the joint improving symptoms.
- Anti-inflammatory medications: Tablets such as ibuprofen reduces inflammation and can help pain. However, you need to be careful with side effects such as stomach ulcers.
- Injections in shoulder joint: We know that injections in the shoulder joint provide pain relief and can help with exercise.
- Surgery: In severe cases, a surgical replacement will help. In this procedure, doctors remove cartilage and place a metal and plastic ball and socket implant in the shoulder.
Who Can Help Me Treat Shoulder Arthritis
Your physician may be able to treat initial stages, though if you have severe shoulder arthritis or your condition is deteriorating rapidly, you may want to schedule an appointment with your orthopaedic surgeon at OGrady Orthopaedics. Dr. OGrady and his staff use cutting-edge technology in all aspects of treatment, so they can offer minimally invasive procedures and expert care to help you find relief from your shoulder arthritis pain.
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What Causes Shoulder Osteoarthritis
Shoulder OA is caused by both genetic and behavioral factors.
Genetics predisposes you to wear-and-tear, then its what you do with your life that makes osteoarthritis manifest, explains Dr. Tamara Martin, an orthopaedic surgeon in the Department of Orthopaedic Surgery at Brigham and Womens Hospital. Factors include:
The bones of the shoulder.
- Gender: Shoulder OA is more common in women than men.
- Genetics: Hereditary factors determine the toughness and durability of cartilage, as well as how it attaches to bone. A person with weaker cartilage is more likely to develop OA than another individual, even when participating in similar activities.
- Repetitive stresses: People whose jobs call for repeated lifting or pushing, such as activities performed during manual labor, subject their joints to minor stresses that can accelerate the development of OA.
- Athletic participation, particularly sports that require a lot of shoulder movement. Athletes engaging in repetitive activities are more susceptible to cartilage loss. They are also more likely to injure their shoulder, which can lead to post-traumatic arthritis .
What Causes Shoulder Arthritis
The end of the humerus, or upper arm bone, is shaped like a ball, which normally fits within a socket on the scapula, called the glenoid. The shoulder joint is stabilized by a set of muscles and tendons called the rotator cuff. Symptoms of shoulder arthritis can be felt throughout or stem from issues in these areas. Specific causes include osteoarthritis, injuries, and rheumatoid arthritis.
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Taking Care Of Our Bodies Can Lead To Healthier Joints
Dr. Martin emphasizes the importance of taking care of our bodies.
Be thoughtful, she says. Be aware of how you use your shoulders. Keep your muscles strong and make sure youre using proper techniques, especially in sports training.
Tamara Martin, MD, is an orthopaedic surgeon in the Department of Orthopaedic Surgery at Brigham and Womens Hospital .
Calcific Tendonitis And Calcific Periarthritis
Sometimes pain, swelling and difficulty moving your shoulder is caused by calcium crystals that form insidea tendon. Tendons are the strong cords that attach muscles to bones.
We all need the mineral calcium in the body, as it helps make bones and teeth strong. But sometimes, if you have too much of it in the body, sharp, tiny, crystals can form in the wrong places.
If they form in tendons, this is called calcific tendonitis.
This can happen at various places around the body, including the shoulder.
Calcium crystals can then shed from a tendon and cause pain and swelling around a joint. This is called calcific periarthritis.
Steroid injections often work well to reduce swelling. Butsometimes the calcium deposits mayneed to be removed by keyhole surgery.
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What Is Shoulder Tendinitis/bursitis
Shoulder bursitis and tendinitis are common causes of shoulder pain and stiffness. They indicate swelling of a particular area within the shoulder joint.
The shoulder joint is kept stable by a group of muscles called the rotator cuff as well as the biceps tendon. These muscles and tendons keep the upper arm bone within the shoulder socket . When the rotator cuff tendons or the biceps tendon become inflamed and irritated it is called rotator cuff tendinitis and bicipital tendinitis.
An area called the subacromial bursa lies in the space between the rotator cuff tendons and the part of the shoulder blade bone that hangs over these tendons . The bursa is what protects these tendons. Subacromial bursitis occurs when the bursa becomes inflamed.
Both conditions can cause pain and stiffness around the shoulder and may exist together.
Shoulder Impingement Or Painful Arc Syndrome
The rotator cuff is a group of muscles and tendons that keep the upper arm bone held in the shoulder blade socket.
Pain from a problem with the rotator cuff is often called shoulder impingement. The condition causes swelling, pain or damage to the tendons of the rotator cuff. This can make it painful and difficult to move your arm properly.
You may find it painful and difficult to lift your arm away from your body, particularly if youre trying to lift your arm above your head. Your arm may feel weak or you may have a dull lingering pain in your upper arm.
Really, its nothing to do with your tendons being trapped by bones, as was previously thought. Instead, its caused by overuse or age-related problems with the tendons themselves but the name is still used. This condition can also be called painful arc syndrome.
Rest and physiotherapy are the main courses of treatment for a shoulder impingement. Your doctor may recommend an injection of steroids and a local anaesthetic, to help with the pain.
If the pain doesnt settle, or comes back within a few months of treatment, you may need keyhole surgery.
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Osteoarthritis Of The Shoulder: Diagnosis And Treatment
Many have heard of arthritis. But despite its straightforward definition inflammation of a joint there are more than 100 types of arthritis, each with different causes and treatments. They all have the same symptoms, though: inflamed joints that can lead to pain and stiffness.
Osteoarthritis , the most common type of arthritis, is caused primarily by age-related wear-and-tear and can affect shoulders, knees, hips and other joints. Also known as wear-and-tear arthritis, OA is a condition that involves the deterioration of the smooth outer covering of bone .
If people lived forever, everyone would develop osteoarthritis, since the loss of cartilage occurs from simply using the joint. Shoulders are less susceptible to wear-and-tear compared to other weight-bearing joints, but longer lifespans and an increase in sports participation have contributed to rising numbers of shoulder problems earlier in life.
The shoulder consists of the upper arm bone , the shoulder blade , and the collarbone . The upper arm bone ends in what looks like a ball, which rests against a socket in the shoulder blade. Shoulder OA is the loss of the cartilage that allows this ball to glide smoothly against the socket, which can lead to the bones rubbing against each other.
What To Do If Your Shoulder Hurts
If you do experience shoulder pain, it’s not always possible to figure out the cause. Sometimes problems in other parts of the body are actually the source of the pain, which then radiates to your shoulder. This can happen with certain neck problems, including arthritis and disc herniations, says Dr. Arun Ramappa, associate professor of orthopedic surgery at Harvard Medical School.
In general, if you are experiencing a lot of pain or know you injured yourself, it’s best to see a doctor right away to have your shoulder condition diagnosed.
But if you have general, mild shoulder pain, try adjusting your activities, taking nonsteroidal anti-inflammatory drugs, and performing mild stretches to see if the pain improves on its own. However, if the pain doesn’t go away after a few weeks, you should consult your doctor.
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What Is Shoulder Bursitis
Bursitis occurs when the bursa, a fluid-filled sac that protects the outside of a joint, becomes inflamed. While it can be caused by acute trauma to the shoulder, it is more likely to result from chronic overuse of the joint. Moreover, because the structures of the shoulder are closely packed together, inflammation that begins in one of the five bursae in joint will eventually impact the others. Therefore, shoulder bursitis is often not only the result of an injury but also likely to create additional complications.
Symptoms of Shoulder Bursitis
Shoulder bursitis may cause any of the following symptoms:
- Shoulder pain located at the top and outside of the joint
- Shoulder pain that is triggered by movement or repetitive motion
- Shoulder pain that gradually becomes worse
- Shoulder tenderness and sensitivity to pressure
- Shoulder redness and warmth
- Muscle weakness in the shoulder
The subacromial bursa is the largest bursa in the body and is highly susceptible to bursitis. It is located below the acromion, the large bony projection on the scapula . This is why the majority of pain associated with shoulder bursitis occurs at the top and outside of the joint and radiates down the arm. It should also be noted that, although bursitis is the result of inflamed soft tissue, visible swelling is rare. Shoulder bursae do not have to be much thicker than normal to cause pain and so it is unlikely that you will have any visible signs aside from some minor redness.