Simon OJ - The Shoulder Specialist
Leading shoulder expert, Mr Simon Owen-Johnstone, better known amongst colleagues as Simon OJ, says, “Even though you consult a shoulder surgeon, the chances are that you won’t actually need an operation! Most of my work doesn’t involve surgery. It’s best to think of a surgeon as a shoulder specialist who can also operate if needed.”
The Shoulder Pain Diagnosis is Critical
In his article, specifically for the benefit of patients who have been suffering for a while with a painful shoulder, Simon OJ provides an in-depth overview. The most important part of the process is the initial diagnosis, because pain can be caused for a number of different reasons and the treatment has to be appropriate.
Anatomical Guide to Shoulder Pain
There are many ways to list the things that can cause shoulder pain, but the easiest simply relates to the anatomy:
Rotator Cuff pain
The tendons of the Rotator Cuff are prone to getting brittle and wearing out. The mildest form of this is called Bursitis. Over time, the bones change shape and rub on the tendons, called Impingement. Eventually, the tendons start to tear, and may rip off entirely.
In a ‘Frozen Shoulder’ the Capsule becomes greatly thickened and stiffened. This limits movement and is exquisitely painful. Untreated, it can persist for a couple of years, before burning out. This condition is more common in people with diabetes, although it’s often triggered by relatively minor injury.
Acromio Clavicular Joint Pain
This little bump on the top of our shoulder contains a little disc of cartilage. Keen users of gym machines commonly damage the disc and wear the joint out. It hurts to sleep on the bad side, with pain very localised to the bump.
Pain caused by a torn Labrum in the shoulder
The little flange around the socket is crucial to stopping dislocations. It can be torn causing pain deep inside, especially when reaching up or back. Sometimes there’s a clunk. A badly torn Labrum can allow the ball to slide forward, making the whole shoulder feel loose and unreliable.
Inflammation of the Biceps tendon
This tendon runs up the front of the ball in a groove where it can catch and become inflamed.
Shoulder ball-and-socket problems
Osteoarthritis is rare in the shoulder. It typically comes later in life, although collision sport players can develop it younger. At first, there is just an ache on reaching. Over years the shoulder gets stiffer and the pain gets worse.