Shoulder & Elbow

Cubital tunnel syndrome is a condition caused by pressure on the ulnar nerve at the elbow. When a nerve is compressed, it cannot function properly. Cubital tunnel syndrome is the second most common nerve entrapment syndrome, after carpal tunnel syndrome.

The ulnar nerve carries signals for sensation in one half of your ring finger, your pinkie finger, and the muscles that perform fine motor movements in the hand. Individuals with cubital tunnel syndrome have difficulty handling objects and performing gripping motions. Symptoms include pain, numbness, and a tingly sensation, similar to when the funny bone is hit.

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Golfer’s elbow is a type of tendonitis that occurs where the tendons of the forearm muscles attach to the inner (medial) side of the elbow bone (epicondyle). Also called medial epicondylitis, golfer’s elbow is caused by the cumulative stress of repetitive motions, such as those that occur while playing golf, which can cause the tendon to degenerate.

Symptoms of golfer’s elbow include pain and tenderness at the inner side of the elbow that increases during wrist flexion or when making grasping motions. The pain may radiate down the forearm. Treatment typically includes rest or activity modification, ice, pain relievers, physical therapy, and ultrasound. A splint, brace, or elbow wrapping may also be useful. Surgery is considered only if significant pain continues after at least six months of treatment.

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Pitcher’s elbow causes pain on the inner side of the elbow and occurs in athletes who participate in sports that require repetitive throwing, such as baseball. Pitcher’s elbow is also known as Little League Syndrome because it often occurs in children and teenagers that play sports. The condition is especially concerning for this population because their bones are growing and injuries can affect the growth process.

Pitcher’s elbow results when repetitive throwing puts an excessive strain on the tendons and ligaments in the elbow, causing the ligaments and tendons to stretch, tear, or pull away from the bone. If some of the bone is also torn away in the process, it can interfere with normal bone growth and cause deformity.

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The rotator cuff, which is made up of four shoulder muscles and the associated tendons, allows the arm to rotate and move upward to the front, back, and side. The risk of rotator cuff damage increases with age as the muscles and tendons begin to degenerate and weaken. Rotator cuff tears can occur in younger people following a shoulder injury, such as a fracture or dislocation. Overuse or repetitive activity can also cause rotator cuff tears.

Treatment may include rest, over-the-counter prescription pain relievers, corticosteroid injections, limiting overhead arm movements, wearing a sling, physical therapy, or surgery.

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Osteoarthritis, a degenerative joint disease, is the most common type of arthritis in the shoulder. It typically occurs in adults over the age of 50, although younger adults may develop arthritis after some kind of shoulder trauma, such as a fracture or dislocation.

The shoulder actually contains four joints. The two joints most often affected by osteoarthritis include the glenohumeral joint and acromioclavicular, or AC joint. The glenohumeral joint is made up of the head of the upper arm bone (humerus) and the socket it fits into (glenoid cavity). The AC joint connects the collarbone (clavicle) to a part of the shoulder blade called the acromion. Osteoarthritis occurs when the cartilage that lines these joints begins to wear away, causing the bones to rub against each other.

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Impingement syndrome is a painful condition in the shoulder. It occurs when the tendons in the shoulder are irritated, inflamed, or degenerated from repetitive overhead motions or structural abnormalities in the shoulder. Symptoms include a generalized aching pain in the shoulder and upper arm, weakness and pain when you raise your arm, and pain at night.

Shoulder impingement syndrome is treated with activity modification, medication, and physical therapy. When nonsurgical options fail, surgical treatment may be used to relieve symptoms and restore function.

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Tennis elbow is a type of tendonitis that occurs where the tendons of the forearm muscles attach to the outer (lateral) side of the elbow bone (epicondyle). Also called lateral epicondylitis, tennis elbow is caused by chronic stress to the forearm muscles. Repeated motions and stress, such as those that occur while playing tennis, can cause the tendon to degenerate.

Symptoms of tennis elbow include severe, burning pain and tenderness at the outer side of the elbow and forearm. Treatment typically includes rest or activity modification, ice, pain relievers, physical therapy, and cortisone injections. Surgery is considered only if significant pain continues after at least six months of treatment.

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While many elbow and shoulder conditions and injuries typically heal with nonsurgical treatments, your doctor might recommend arthroscopic surgery if your pain does not get better after several months of conservative treatments.

Arthroscopy is a minimally invasive procedure that allows orthopaedic surgeons to see, diagnose, and treat problems inside a joint. The procedure requires only small incisions and is guided by a miniature viewing instrument or scope. Typically performed as outpatient surgery, arthroscopy causes less pain and requires a shorter length of time for recovery than open joint surgery.

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Reverse shoulder replacement is performed for those with certain complex shoulder conditions, such as a complete rotator cuff tear, severe arthritis with rotator cuff damage, or prior failed shoulder surgery. The procedure replaces a damaged shoulder joint with an artificial one to allow pain-free movement and function.

In contrast to total shoulder replacement, the components of the artificial joint are placed in reversed positions to allow the deltoid muscle at the shoulder to raise the arm. Like traditional total shoulder replacement, physical therapy following the procedure helps to ensure the best outcomes.

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There are several types of surgeries that can be performed for rotator cuff tears. The type of surgery you have depends on the size, shape, and location of your tear.

Partial rotator cuff tears may only require debridement, a surgical procedure in which the tendon is trimmed. A complete tear involves suturing the tendon together. Additionally, tendons can be reattached to the bone. Many of these surgeries can be done on an outpatient basis using arthroscopy.

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Because the arm is not a weight-bearing extremity, arthritis of the shoulder is not as common as in the hip and knee. However, severe shoulder arthritis can cause crippling pain and disability. If you get to this point, your doctor may recommend shoulder replacement surgery.

Total shoulder replacement, or shoulder arthroplasty, is performed for those who have osteoarthritis but no rotator cuff damage. Your joint replacement surgeon will remove damaged bone and cartilage from the joint and replace them with metal and plastic implants. The goal is to relieve pain and restore shoulder mobility.

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