Shoulder surgeon answers - common questions about shoulder complaints
Author Dr. Bálint Major | 2018.10.20.
Dr Bálint Major, orthopaedic traumatologist and shoulder specialist, answers the most frequently asked questions about shoulder complaints.
I have shoulder complaints:
Should I try to treat myself at home or should I show my shoulder to a shoulder surgeon?
Some shoulder conditions are, to put it mildly, a race against time, as over time lesions can develop that can prevent full recovery. For these reasons, it is also advisable to consult a shoulder surgeon.
Where should I go for my shoulder complaints, to a shoulder surgeon straight away, or should I start with a general musculoskeletal examination (orthopaedics, rheumatology, possibly surgery)?
Of course, shoulder surgeons are not the only ones who understand shoulder conditions, but given that many of them work almost exclusively in this area, they are perhaps the most experienced in diagnosing shoulder conditions and setting up and implementing the optimal treatment plan.
If I see a shoulder surgeon, will he recommend surgery?
Of course not. One of my colleagues suggested that instead of shoulder surgery, it would be better to call it shoulder surgery, because many shoulder conditions can be treated without surgery. A specialist in shoulder diseases can judge whether there is a chance of conservative treatment and, if so, usually start with that. However, there are some conditions for which experience and the literature suggest that conservative treatment is unlikely to be successful, in which case we will offer and consider the option of surgery.
What imaging tests may be needed for the investigation?
The imaging tests required are determined by the examining doctor. He or she can decide which imaging tests make sense for your condition (X-ray, CT, arthro-CT, MRI, arthro-MRI, ultrasound, isotope scan, etc.) Diagnostic imaging usually starts with a non-MRI scan. X-ray is considered a basic test and is requested by almost everyone.
If I want to do some of the imaging tests myself, where do I go?
The quality of an imaging examination depends largely on the person performing the examination, the settings used, or the quality of the imaging equipment. So it makes a difference where a particular examination is performed. Patients can save time and sometimes money by seeking the advice of a shoulder surgeon in advance (what? where?).
The shoulder surgeon recommended steroid injections. Should I be afraid?
Almost everyone is aware of the many potential side effects of steroids. However, in the right cases, used in the right way, it is one of, if not the most effective conservative treatment for shoulder conditions. With the topical injection form, the chances of potential side effects are much lower than with tablet or infusion applications, as the injection mainly acts at the site of administration, with only a relatively small amount entering the bloodstream and reaching other parts of the body. In addition, it is not a series of injections, usually one or two infiltrations in total.
What are the most common side effects after steroid injections?
Adverse effects are rare and include flushing of the face (mainly in women), feeling of tension, increased blood pressure (in hypertensive patients), increased blood sugar levels (in diabetic patients). The vast majority of these adverse effects are temporary and disappear within a few days.
So if I have diabetes, can I not have steroid injections?
In diabetes, steroids should be used with caution. If the patient has a blood glucose meter or if the patient's GP is available to the patient if a temporary change in diabetes medication is needed because of the higher blood glucose levels observed, the injection can usually be given.
Can I give an injection with a blood thinner?
This depends on the strength and type of medicine. Be sure to mention to your doctor if you are taking a blood thinning medicine, the possibility of giving an injection will be considered by your doctor. It is not advisable to give a shoulder injection while taking Syncumar, Marfarin, Warfarin, in which case the doctor will recommend a switch to “abdominal blood thinner injection” before the shoulder injection, and will also ask the patient's GP for help.
If surgery is performed, is it under anaesthesia?
Shoulder surgery is performed under either general anaesthesia, “neck anaesthesia” (regional anaesthesia) or a combination of both. The choice of anaesthesia is made by the anaesthetist on the basis of his or her own experience and experience.
How long is the rehabilitation after the operation?
This depends on the type of intervention and will be advised by your doctor. However, it is important to know that, compared to other joints, the shoulder joint has a major role to play in rehabilitation. With a little exaggeration, a correctly performed operation is worthless if the subsequent physiotherapy is not carried out professionally, e.g. too quickly or is neglected. For these reasons, rehabilitation options will be discussed in detail with your doctor to ensure a successful surgery.
I have heard that the results of shoulder replacements are not so good. Is this true?
No. Shoulder prostheses and their implantation techniques have evolved considerably in recent years and decades. There are many types of prosthesis to choose from to suit the patient and his or her condition. When correctly implanted in the right way for the situation, shoulder prostheses can provide excellent results for the patient.
