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When Does a Shoulder Ache Become A Shoulder Problem?

Did you know that shoulder injuries typically occur prior to the progressive aches and pains that follow the injury? The shoulder joint is the most complex joint of the upper body, designed for mobility and physical interaction.

For example, think about opening a jar: although the hand and wrist provides the twisting motion, the shoulder joint provides the greatest amount of strength and stability. In fact, the shoulder’s multidirectional flexibility relies on the ‘rotator cuff muscles’ – four muscles (supraspinatus, infraspinatus, subscapularis, teres minor) inserting around the shoulder joint that help move it, as well as providing stability. However, this architectural complexity creates an inherent risk for shoulder instability and injury, and is a common source of pain

Shoulder Aches and Pains

Most people are unaware of their shoulder problem for a long time. This is why: There are several muscles connected to the shoulder joint. When there is a deficit in one of the muscles, the other muscles have the ability to compensate. Therefore, shoulder injuries do not become apparent as problems until there are multiple deficits causing significant aches and pains.

Another important point to mention is that acute pain felt in the shoulder region may not indicate that there is a primary shoulder problem at all. There are several adjacent musculoskeletal regions (e.g. the neck) that can be painful but appear to be originating from the shoulder. In addition, there some body organs that, when inflamed, can “refer pain” to the shoulder- such as the heart, gallbladder, liver, and lungs. Therefore, a thorough clinical assessment must be made to differentiate whether it is a true shoulder problem, a problem with a nearby musculoskeletal region, or a problem with other internal organs.

The Common Presentation of Shoulder Problems:

  • Non-specific aches and pains in the shoulder area that occurs spontaneously, oftentimes unaware of source or trigger of pain.
  • Loss of range of motion usually in one or two directions (often goes unnoticed)- difficulty with regular activities (reaching for an object, pulling, lifting, holding, etc).
  • Noticeable weakness with activities, inability to lay on the shoulder, swelling, stiffness and difficulty with dressing (e.g. clasping brassiere).
  • If untreated, progresses to multi-directional loss of range of motion and muscle atrophy.
  • Shoulder discomfort with daily activities:
    • Reaching overhead – i.e. opening kitchen cabinet, grabbing an item on a shelf above your head
    • Repetitive motion- i.e.driving, combing hair, brushing teeth,
    • Sustained activities- i.e. pulling, lifting or carrying an item
    • Opening door
    • reaching for seatbelt or an item from the back seat of your car
  • Grinding or cracking sound with shoulder movement
  • Pain or discomfort when laying on the shoulder
  • Difficulty with upper body dressing (ie. clasping brazire)
  • Shoulder discomfort with daily activities, ie driving, carrying grocery, shopping

6 Common Musculoskeletal Shoulder Problems:

  1. Shoulder Arthritis (Glenohumeral Joint Disorder)
  2. Rotator Cuff Syndrome
  3. Frozen Shoulder (Adhesive Capsulitis)
  4. Shoulder Instability
  5. Shoulder Acromioclavicular (AC) Joint Pain

Treatment Options:

Conventional Treatment includes:

  • Ice
  • Anti-inflammatories (oral, topicals, steroid injections)
  • Physical Therapy
  • Surgical Interventions

How Shoulder Problems are Evaluated and Alternative Therapeutic Treatments offered at the Blum Center:

  • Comprehensive Physical Diagnostic Evaluatio
  • Musculoskeletal Ultrasound Diagnostic and Therapeutic Treatment
  • Comprehensive Physical Therapy Program based on diagnostic evaluation
  • Platelet Rich Plasma (PRP)– used to repair the damaged degenerative cartilage, tendons and ligaments
  • Bone Marrow Derived Stem Cells– recommended for more progressive and severe joint issues
  • Prolotherapy– for loose and unstable shoulder ligaments and tendons
    Prolotherapy is routinely the preferred treatment option for chronic shoulder pain/injury. Prolotherapy can be used successfully for treating most chronic injuries of the shoulder including rotator cuff injuries and tears, arthritis, sprains, and AC separation. Prolotherapy is 85-90% successful in stimulating healing of the injured shoulder. Prolotherapy, the injection of a growth promoting solution in injured ligaments and tendons of the shoulder is an effective treatment that decreases pain, increases functional capacity and promotes healing better and in less time than standard treatment with physiotherapy.Remember, shoulder injuries typically occur prior to the progressive aches and pains that follow the injury. The shoulder joint is comprised of a complex system of muscles, tendons, bones, and ligaments that act in a dynamic and flexible way to provide structural support and mobility. Therefore, if you suspect that you’re having progressive shoulder aches or pains, it is highly recommended to seek medical evaluation and treatment if necessary. If so, please call us to make an appointment!

Meet Dr. Aligene: Dr. Kathy Aligene is a Double Boarded Physiatrist and Interventional Pain Management Specialist, and an innovative physician in the field of Integrative Pain and Regenerative Medicine.  Her expertise in these complementing areas of medicine has led her to successfully treat patients with musculoskeletal, joint, spine, pelvic and nerve related problems without depending on chronic use of pain medication. Dr. Aligene treats men and women of all ages and activity levels to support their functional goals and promote an active and healthy lifestyle. Book an appointment with Dr.Aligene by calling 914-652-7800.

  • References
    1. https://www.myvmc.com/symptoms/pain-2/
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Is There a Way to Prevent and Delay Knee Arthritis?

Chronic Inflammation in the bones and the joints (osteoarthritis, OA, or commonly referred to as arthritis) is one of those hushed terms that we tend to associate with aging or obesity. Yet, as the U.S. population ages, surviving well past “old age,” and remaining physically active, more and more people will suffer from OA. Due to chronic pain and limited range of motion, OA places a significant functional limitation on the individual and can negatively impact mental health and well-being.

How do people develop OA?

Knee osteoarthritis, the most prevalent type of OA, is a main cause of disability, and affects men and women equally. Over a person’s lifetime, bones and joints are subjected to normal wear and tear. Our bodies will naturally repair itself through an inflammatory and healing process. As we age, inflammation in bones and joints can become unchecked, made worse by poor diet and other system-wide triggers of inflammation like digestive issues (imbalanced gut microbiome) and chronic stress. (You can learn more about that in Dr. Blum’s book, Healing Arthritis).   In weight-bearing joints, such as the knee, in addition to systemic inflammation, the direct and repetitive physical impact with abnormal loading forces and stress to the joint, further contributes to increased inflammation and slowing of the healing process.

How you can prevent or delay knee arthritis 

Luckily, knee OA  is more preventable than is commonly assumed. The early stages of joint degeneration often does not cause pain, and early detection is key to making sure your arthritis doesn’t progress to irreversible damage. So, what are some of the warning signs to look out for?

Signs that might indicate you have knee OA:

  • Decreased range of motion or pain on initiating movement (sitting to standing, getting up out of bed, squatting)
  • Difficulty walking up/down stairs
  • Knee swelling (with exercise or activity)

How can we solve the Knee OA problem?

Here are ways you can help make sure you don’t get OA, and how you can prevent it from getting worse:

  • Have a Physiatrist (Physical Medicine & Rehabilitation Specialist) evaluate the physical factors that might be adding wear and tear to your joints:
    • Biomechanics — addressing underlying or potential biomechanical problems leading to abnormal forces or stress on your knee joint.
    • Ergonomics — activities or position that lead to knee ache, pain or stiffness.
    • Footwear — wearing well-fitted and appropriate footwear that supports the entire foot
    • Physical and Joint Health — maintaining joint stability with muscle strengthening, range of motion and balance exercises. The key to maintaining active exercise routine is to use proper positioning techniques that are personalized to you. Using proper techniques during any activity, decrease your risk of abnormal joint stress.  
  • Work with a Functional Medicine Practitioner, such as ours at Blum Center for Health, to treat underlying medical conditions that may cause chronic inflammation, like improving your gut microbiome.
  • Work with a Nutritionist to learn how to eat an anti-inflammatory diet.

How is Blum Center of Health helping to change the course of Knee OA?

We are thrilled, that in addition to our functional medicine and nutrition team, we are now able to offer Regenerative Medicine — a state-of-the-art treatment focused on directly impacting the damage in, and around, the joint.

Treatment Options:

  • Platelet Rich Plasma (PRP)– used to repair the damaged degenerative cartilage, tendons and ligaments.
  • Bone Marrow Derived Stem Cells– recommended for more progressive and severe knee OA
  • Prolotherapy– for loose and unstable knee ligament and tendon

Remember, knee osteoarthritis (OA) is a medical condition that is increasing in prevalence in the US, as the population ages and survives longer. OA is a chronic condition in the soft tissue of joints that causes significant disability due to pain and limited range of motion. OA can be delayed, or even prevented with proper medical management and innovative/integrative medical interventions. If you or someone you love shows signs of OA, please call us to make an appointment!

Meet Dr. Aligene: Dr. Kathy Aligene is Board Certified Physiatrist, Interventional Pain Management Specialist and an innovative physician in the field of Integrative Pain and Regenerative Medicine.  Her expertise in these complementing areas of medicine has led her to successfully treat patients with musculoskeletal, joint, spine, pelvic and nerve related problems without depending on chronic use of pain medication. Dr. Aligene treats men and women of all ages and activity levels to support their functional goals and promote an active and healthy lifestyle. Book an appointment with Dr.Aligene by calling 914-652-7800.