Shoulder, upper extremity injuries are more common than you thought


Shoulder and upper extremity injuries are very common. Many of them result from years of cumulative injuries punctuated by a trauma such as a motor vehicle accident, falls or sports injuries. These injuries cost consumers, their employers and insurance companies billions of dollars a year in treatment and productivity losses.

Cumulative and trauma injuries can result in rotator cuff tears, fractures, bursitis (inflammation of the fluid-filled sac, or bursa, that lies between a tendon and skin, or between a tendon and bone), tendonitis, nerve injuries and even degenerative joint disease.

Symptoms to look for include:
• Loss of range of motion: This can either be cumulative or sudden in nature. Many people lose some range of motion as they age; however, these injuries can begin to affect day-to-day activities in a very painful way
• Pain in the shoulder or upper extremity: How many OTC pain pills did you pop today?
• Weakness: This can be either sudden or gradual
• Ecchymosis: This is found largely in trauma injuries, and is a skin discoloration caused by the escape of blood into the tissues from ruptured blood vessels
• Muscle aches, swelling and numbness or tingling are also key symptoms

In order to diagnose and understand the exact extent of your injuries, our doctors will conduct an assessment, including a thorough physical examination, focusing on the painful area. Through palpation for tenderness, range of motion assessments, focused orthopaedic and neurological exams and other diagnostic tests, a tentative diagnosis can usually be made. After a presumptive diagnosis, treatment may include medications, physical therapy, or in some cases, patients may receive trigger-point injections into muscle spasms with such drugs as Lidocaine, a local anesthetic. For more extensive spinal injuries, physicians also perform a variety of spinal and epidural injections and procedures.

Traditionally, medications such as anti-inflammatories (NSAIDs), muscle relaxants, analgesics, topical creams or neuropathic pain medications have been used. A small percent of patients with the injuries above may ultimately require surgery.

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