Shoulder pain in old age

Dr. Unnikuttan D, Consultant Orthopaedic Surgeon, SUT Hospital, Pattom

Shoulder pain can be due to many reasons ranging from Osteonecrosis to frozen shoulder. As age increases, the risk of shoulder-related problems increases.

Peri Arthritis

Most shoulder pain in old age is caused by the shrinking of capsule, which covers the joint, shrinking. This is called periarthritis or frozen shoulder. This disease is more common in women and is more common in diabetics and thyroid patients. It initially presents as pain around the shoulder. Then there is difficulty in moving the shoulder. It is more difficult to move the arm above the head and behind the body. The condition resolves on its own in most patients. After about two years the disease is at its peak and the difficulties gradually subside and disappear. Treatment consists of medications to reduce pain and exercises to maintain muscle strength. In a few, this condition remains unchanged. Such people should be sedated and sent the capsule. Keyhole surgery is also preferred for this condition.

Rotator cuff

Rotator cuff related problems are the most dangerous of shoulder pains in old age. The rotator cuff is a joint of muscles around the shoulder. Due to the fact that it holds the bones together at the joint, the shoulder can be moved effortlessly in all directions. The rotator cuff can be atrophied in the elderly. This is because the shoulder muscles are less strength and rub against the adjacent bone. Even minor injuries can cause a rotator cuff tear in the elderly. Even casually turning the arm back and forth can cause problems in rotator cuff. Even small tears can cause severe pain and weakness. The pain becomes unbearable at night. If not treated properly, the muscles atrophy and the joint wears down. If not treated on time, subsequent treatment becomes difficult due to the inward enlargement of the tear. This condition is diagnosed by direct examination of the patient. MRI scan is used to determine the extent of the rotator cuff tear. The treatment is to surgically attach the torn part to the bone. Keyhole surgery allows more precise and smaller incisions to be made inside the shoulder. Rotator cuff related problems can be prevented by practicing specific exercises to increase shoulder strength and control. A rupture may be preceded by similar pain and discomfort due to swelling. In such people, the problem can be solved by injecting medicine with a thin needle into the shoulder and then practicing exercises.

Osteoarthritis (wear and tear of bones)

Another cause of shoulder pain in old age is wear and tear of bones. It is a condition in which the cartilage at the ends of the bones in the joint is lost. This can occur due to rheumatic diseases or due to natural wear and tear. Another reason is untreated previous bone fractures. The primary symptom is painful movement of the shoulder. The disease can be confirmed by X-ray. It is impossible to regenerate cartilage through drugs or other means. Joint replacement surgery is the only permanent cure for this. The ends of the bones adjacent to the joint are replaced with metal and plastic. A special type of joint replacement called a reverse shoulder replacement is necessary for those who have a Rotator cuff tear along with the Osteoarthritis.

Other reasons

Like any other body part, the shoulder can be affected by infections, tumors, and fractures. It is of utmost importance to make sure that shoulder pains are not caused by these problems. Shoulder pain can be caused by wear and tear at the joint where the shoulder blade meets the collar bone, inflammation of nearby bursae, loss of flexibility of the muscles, and many other reasons. All of these can be treated with exercise and medication. Use specific exercises prescribed by your doctor. Rarely, these problems require steroid injections into the shoulder. Rheumatic diseases can also affect the shoulders. Since rheumatism can be of many forms, it is important to diagnose it correctly and take medication as early as possible. Apart from this, the wear and tear on the neck can be felt as pain in the arm and shoulder.

Conclusion

Shoulder problems can be caused by a variety of reasons. With advanced knowledge and systems, finding the exact cause and treating it at an early stage can avoid serious illness and surgery.