Prayagraj: Shoulder pain and stiffness should not be ignored as a normal part of ageing, as early diagnosis and advanced treatment can help patients regain mobility and resume daily activities, said noted orthopaedic surgeon Dr KD Tripathi on World Arthritis Day on Sunday.Tripathi said shoulder problems were earlier often broadly diagnosed as “periarthritis shoulder”, particularly among elderly patients who reported difficulty in combing their hair, wearing a sari, reaching overhead or sleeping on the affected side. Since X-rays generally showed no significant abnormality, treatment was often limited to hot fomentation, exercises and painkillers.“Many patients improved, but several continued to suffer and eventually accepted the pain as a consequence of age,” he said.He said advances in imaging had significantly improved diagnosis of shoulder disorders. While X-rays primarily show bones, ultrasound and MRI provide a better assessment of the rotator cuff tendons, cartilage and joint lining. This helps doctors distinguish between frozen shoulder, rotator cuff tears, calcium deposits and arthritis and choose treatment accordingly.Shoulder arthroscopy has also expanded treatment options. The minimally invasive procedure can be used to repair certain tendon tears, release a stiff joint capsule and remove calcium deposits, generally allowing quicker recovery.For some elderly patients with longstanding rotator cuff tears and severe joint damage, reverse shoulder replacement has emerged as an important option.Tripathi said 3D planning based on CT scans had further improved the accuracy of shoulder replacement surgery by allowing surgeons to plan implant size, position and alignment before the procedure.He stressed that most painful shoulders do not require surgery. Medicines, selected injections and regular physiotherapy can help a large number of patients.He advised specialist evaluation if pain persists beyond four to six weeks, causes night-time discomfort, restricts overhead movement, follows a fall or is accompanied by progressive stiffness, particularly among people with diabetes.
