Shoulder Problems in the Elderly

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We ask a lot of our shoulders. Indeed, we rely on them both for performing everyday tasks as well as sports activities requiring lateral and overhead reach. When you think of it, that’s a lot for your shoulder to bear!

As the most mobile joint in the body with the ability to perform the greatest range of motion, the shoulder’s susceptibility to injury directly correlates to the high expectations placed upon it.

For the elderly, shoulder disorders are a sometimes underestimated cause of pain and disability, affecting approximately 20% of the aged community. Within this population segment, more women are affected (25%) than men (17%). Besides the disability caused by shoulder pain, many elderly individuals do not seek medical treatment, further resulting in generally poor health and depression.

senior woman gardening

Following are examples of shoulder issues that can arise specifically among the elderly population.  This is not an exhaustive list, but offers some basic information.

  • Rotator Cuff Tendinitis.  The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and keeping it stable.  Rotator cuff tendinitis refers to irritation of these tendons and inflammation of the bursa (a normally smooth layer) lining these tendons.  This condition is indicated by pain while reaching upward, such as loading dishes into a cupboard or brushing your hair, as well as somewhat decreased range of motion.  Rotator cuff tendinitis can typically be treated with non-surgical care, such as ice, anti-inflammatory drugs and physical therapy to increase and fully restore range of motion.

rotator_cuff_diagram

  • Rotator Cuff Tear. A rotator cuff tear occurs when one of the tendons of the rotator cuff is torn from overuse or injury. A sudden rotator cuff tear may happen from a fall on your arm while it is stretched out, or after a sudden, jerking motion when you try to lift something heavy. A chronic tear of the rotator cuff tendon occurs slowly over time and is more likely to occur in those with chronic tendinitis. The pain with a sudden tear after a fall or injury is usually intense. Weakness of the shoulder and arm is often present, along with a snapping sensation of movement. Symptoms of a chronic rotator cuff tear include a gradual worsening of pain, weakness, and stiffness or loss of motion. Most people with rotator cuff tendon tears have pain at night. During the day, the pain is more tolerable and hurts with certain movements. Patients may be unable to hold their arm directly out in front of their body, parallel to the ground. Rest and exercise may help someone with a partial rotator cuff tear who does not normally place a lot of demand on the shoulder. If initial non-surgical treatment and physical therapy is not successful, surgery may be recommended. Most of the time, arthroscopic surgery can be used. Some large tears require open surgery to repair the torn tendon.
  • Osteoarthritis. This is an age-related “wear and tear” type of arthritis that usually occurs in people 50 years of age and older. With this condition, the cartilage that cushions the bones of the shoulder softens and wears away causing the bones to rub against one another. Over time, the shoulder joint slowly becomes stiff and painful. Unfortunately, there is no way to prevent the development of osteoarthritis. Often, as pain worsens and non-surgical measures become ineffective, your doctor may recommend surgery such as a total shoulder replacement. Osteoarthritis is a common reason people have shoulder replacement surgery.

What is total shoulder replacement and why should I consider it?

Total shoulder replacement is a surgical procedure during which the damaged parts of the shoulder are removed and replaced with artificial parts called prostheses. The typical total shoulder replacement involves replacing the arthritic joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket. The primary goal of total shoulder replacement surgery is to alleviate pain with secondary goals of improving motion, strength and function. Your surgeon may recommend shoulder replacement to you if you have:

  • Severe shoulder pain that interferes with everyday activities, such as reaching into a cabinet, dressing, toileting, and washing.
  • Moderate to severe pain while resting. This pain may be severe enough to prevent a good night’s sleep.
  • Loss of motion and/or weakness in the shoulder.
  • Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, or physical therapy.

The decision to have shoulder replacement should be made only after careful consideration and discussions with your surgeon and your family. Shoulder replacement surgery is highly technical. It should be performed by a surgical team with experience in this procedure.

Recently, Dr. James Shaffer, Board certified orthopedic surgeon, provided a lunch and learn seminar at the Highlands at Wyomissing describing typical shoulder issues and their care. Learn more by viewing the video now.

If you are experiencing shoulder issues affecting your daily activities, make an appointment to see Dr. Shaffer today!

To your wellness,
AJRC

Comments

  1. B. Carter on July 24, 2014 at 1:39 pm said:

    Good info. Thanks.

  2. Good article and helpful information. Thank you for sharing this to us. Thank you so much.

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