Shoulder problems occur commonly within the general population and within the sporting community. An early accurate diagnosis will help to speed recovery and return to normal function. Dr Davies has experience of managing a wide variety of shoulder problems in both the NHS and private sector.
Common shoulder problems include:
Frozen Shoulder (or Adhesive Capsulitis)
This is a painful condition which also involves marked restriction of shoulder movement. If this condition is not recognised or not treated appropriately it can last for several years. Usually this is a clinical diagnosis made by asking appropriate questions about the symptoms combined with a thorough clinical examination. X-rays may occasionally be needed to rule out osteoarthritis of the shoulder joint.
Treatment may involve judicious use of steroid injections into the shoulder joint often combined with a physiotherapy programme working on range of motion.
ACJ (Acromioclavicular Joint) Pain
This joint can produce a local pain on the top of the shoulder where the outer end of the collar bone joins the acromion of the shoulder blade. Pain can occur following falls or in younger people often related to repetitive use of heavy upper body weights.
X-rays may be needed and sometimes an ultrasound scan to confirm the diagnosis. Steroid injections can be very useful in this condition. Dr Davies will oversee the management of this problem in a professional manner.
Rotator Cuff Pain / Shoulder Impingement
This is a common cause of shoulder pain, often starting in middle age. Occasionally an acute injury can cause a traumatic rotator cuff tear which may require early imaging to exclude a surgical problem. However, most rotator cuff pain is due to gradual cuff degeneration often associated with shoulder impingement. Dr Davies has wide experience in managing such problems. Most of these cases can be managed conservatively without surgical intervention.
If a surgical solution for a shoulder problem is required Dr Davies will facilitate your onward referral to the appropriate surgeon.
This problem is more common in younger adults. Acute traumatic shoulder injuries can produce a full shoulder dislocation often requiring hospital relocation. However, partial dislocations (subluxations) of the shoulder can also occur following an injury. These injuries can also cause damage to the shoulder joint including the labrum. Some people have more mobile joints than others and can present with shoulder pain secondary to minor instability often associate with poor shoulder muscle control. Shoulder examinations will routinely include assessment for instability problems. Investigations may include x-rays and often MRI Arthrogram (MRI scan with injection of dye into the shoulder joint) to fully assess the deep shoulder structures. Upper limb rehabilitation concentrating on shoulder stability is often needed. Surgical stabilisation procedures may ultimately be needed in the more problematic cases. Labral tears can be repaired at the same time. Usually this can be performed by keyhole surgery.
Referred Pain from the Neck
The neck can sometimes refer pain to the shoulder and so needs to be considered in all cases of shoulder pain. A full assessment of shoulder problems will include an assessment of the neck movements and often testing the neurological function of both upper limbs (reflexes, sensation and power).