Signs You May Need Shoulder Surgery

It's one of the most common surgeries performed, but how do you know if shoulder surgery is right for you? While over a million people undergo some type of shoulder surgery in the U.S. each year, it's important to understand the underlying issues that lead to surgery — and the best treatment options for relief.

"Information and knowledge about your condition is the best starting point," explains Thai Q. Trinh, M.D., orthopedic surgeon, Genesis Orthopedic Group. "When a patient meets with a surgeon they often think they're signing up for an operation. When in fact, my goal is to help the patient understand what we can do non-operatively to maximize their outcome and recognize when surgery is needed."

Why your shoulder aches

As the most flexible joint in the body, the shoulder is your arm's link to movement and daily activities. But because it relies on a complex series of tendons, muscles, bones and bursae to function properly, your shoulder is vulnerable to instability and injury. In fact, every year approximately 14 million people in the U.S. seek treatment for shoulder pain.

Although the joint disease osteoarthritis is a leading cause of shoulder pain, another disease may actually be the cause, according to Dr. Trinh.

"Arthritis is a purely degenerative condition and tends to be in the middle age to older population, causing ongoing pain and often preventing activities of daily living and recreational activities," he says. "In a younger patient or those who have suffered an injury it may not be arthritis, but rotator cuff disease causing mild to severe shoulder and upper arm pain."

According to the American Academy of Orthopaedic Surgeons (AAOS), rotator cuff disease ranks among the most prevalent of musculoskeletal disorders, with 50% of rotator cuff tears occurring in those older than age 65. "It's common for many of my patients to have sustained an injury at work where they've torn the rotator cuff," explains Dr. Trinh.

Telltale signs you need surgery

Many can live with shoulder pain when managed with less invasive treatments, including stretching, rest, ice or heat, and physical therapy. An option for almost all patients, a personalized physical therapy treatment plan can be effective for most shoulder issues by improving daily quality of life, decreasing pain and increasing strength and mobility.

"If appropriate, cortisone or other anti-inflammatory treatments, either taken by mouth or injections are also helpful. But there are instances where I would not recommend a cortisone injection, including a traumatic rotator cuff tear," he says. "We know there are detrimental effects to long-term cortisone exposure, potentially increasing your risk of needing a second operation."

The telltale signs shoulder surgery may the best solution for pain relief, include:

• Ongoing pain over a long period of time that limits activities of daily living or recreational activities.
• A new injury, which results in weakness or loss of motion. "This can be an indication of a more serious injury that should be evaluated and may require surgery," Dr. Trinh says.
• An unstable shoulder that 'pops' in and out; if this is a recurring problem, patients typically require an operation, according to Dr. Trinh.

High-tech surgery for relief

Whether it's to treat arthritis or a rotator cuff tear, Genesis Orthopedic Group relies on state-of-the-art, live imaging through a 4K surgical camera for precise diagnosis. "It provides a much clearer picture when we're operating, allowing us to see really fine details of the shoulder's pathology to address it correctly," explains Dr. Trinh.

Shoulder replacement surgery is completed with minimally invasive technology, eliminating pain and restoring function. "I usually tell people that by six months postoperatively they're satisfied with the operation, but it does require physical therapy to get their motion and strength back," he says. "Patients usually feel much better very quickly - and they notice a difference between that chronic, aching pain associated with arthritis and postsurgical pain.

"By spending time educating our patients on their shoulder problem and what they might expect with both non-operative and operative treatment, they come away feeling educated enough to play an active role in the decision on which way they'd like to go," states Dr. Trinh.