Monday 13 May 2013

Common Queries on Shoulder and Elbow Problems


Dr.Senthilvelan
Consultant Orthopaedic Surgeon
Apollo Hospitals, Chennai
MBBS, MRCS, FRCS (Orth), FEBOT (France)
Specialist in  Shoulder and Elbow.,Foot Ankle,
Apollo Hospitals Ayanambakkam, Chennai, India.
Apollo Clinic, Annanagar.
For appointments Contact 082205009176/velansenthil78@yahoo.com





I have listed some some common Queries on: Shoulder, Elbow and Wrist Problems that patients commonly ask me, so that it can benefit others.The answers apply to each individual so if you have any specific queries contact me on velansenthil78@yahoo.com

S V: I developed a chronic painful shoulder from the day when somebody twisted my shoulder. Along with it my elbow and wrist also started paining . What can be the reason? My other shoulder also has started paining. Both the shoulders cant are not like before, why so? What is the cure?

Shoulder pain after twisting injury could be because of damage to the lining of Shoulder joint socket(SLAP tear) or Tendon injury(rotator cuff tear). To accurately identify the issue you need to consult Specialist shoulder surgeon.You may require further investigations like Xray/USG of shoulder to confirm the diagnosis. Once confirmed it can be addressed by Key hole surgery (Arthroscopy) to relieve symptoms.For further information on SLAP tears kindly look at www.nexusortho.net


T S: My father's hand pains when he raises his hand up straight. I'll be highly obliged if you give me the suggestion regarding the treatment for it.

The clinical history suggests that your father he could have rotator cuff (tendons around shoulder) tear. He should be seen by specialist Shoulder surgeon and he may require further investigations like USG/Xrays to confirm the diagnosis. If rotator cuff tear is confirmed this can be addressed by Key Hole surgery (Arthroscopy) to repair the tendons. If you need further information on rotator cuff tears kindly look at www.nexusortho.net

A S: I'm 22 and have pain in the root of my right hand thumb near the wrist since last 6 months. Mostly when pressurised, the pain becomes unbearable. Doctors have confirmed that it isn't dislocated. Kindly suggest me a way out other than a surgery.

The pain in the region of wrist you are described is commonly due to what is called Dequervains synovitis. The tendons around the wrist reaching the thumb become inflamed and can cause significant pain. You need to consult a specialist Wrist surgeon for further assessment. If the diagnosis is confirmed most often it can be managed conservatively with Wrist splints or injections. Only if doesn’t resolve then surgery is indicated.

N D: In Mid fifties a friend has develop some sort of pain in the entire arm specially the biceps of both arms. They have no strength, for example, while sleeping both the arms start paining as they cannot sustain the weight of the body, while holding the newspaper abone they start paining in less than 30 secs. He cannot dust with a dusting cloth, cannot scrub clothes with a brush as immediately the hands confirm get tired and it  starts paining right from shoulder down to the elbow.

The clinical history of your friend suggest he could have rotator cuff (tendons around shoulder) tear. This could happen bilaterally. He should be seen by specialist Shoulder surgeon and he may require further investigations like USG/Xrays to confirm the diagnosis. If rotator cuff tear is confirmed this can be addressed by Key Hole surgery (Arthroscopy) to repair the tendons. If you need further information on rotator cuff tears kindly look at www.nexusortho.net
           
S M I usually have pain in my shoulders & back of my neck whenever I sit on my desk for a long time & a portion of my shoulder has turned numb. I can't feel anything there when touched. What can be the reason?

Painful shoulder along with neck pain is usually due to problem in your neck. This could be due to trapped nerve secondary to disc prolapse. If you have developed numbness that is constant seek early appointment with Orthopaedic Surgeon. You will require thorough clinical assessment and MRI scan to further assess the cause of the problem.

D T: Is any elbow joint replacement surgery available?
Yes. I carry out Elbow joint replacements for patients who have arthritis of elbow. This relieves pain and restores elbow range of movements. For more details visit www.nexusortho.net

A R what is frozen shoulder?????
Frozen shoulder is condition in which the covering of shoulder undergoes contracture.It happens more in diabetics but can also happen in non diabetics.
The volume of shoulder is reduced and this results in reduced movement and can cause pain.
Treatment is firstly physiotherapy and if this doesnot help Keyhole surgery(arthroscopic) release can be done in resistant cases. For more information look at www.nexusortho.net

G S sir i m feeling pain in the upper part of my right shoulder. It started when i played cricket after many years of gap. When i take rest it isnt felt but when i start playing again it does.

Shoulder pain after sporting injuries usually represent tear in lining of socket of shoulder.This is called SLAP(superior labral anteroposterior tears). The pain typically happens only when you r getting into throwing action or lifting things. These can be addressed by Arthroscopic(Key hole) repair . The diagnosis should be first confirmed by an MRI scan with contrast . Once diagnosis is confirmed SLAP repair can be done. This has to  be carried out by specialist Shoulder surgeon experianced in these . For further information pls look at www.nexusortho.net

JS Please give some signs & symptoms of Tennis Elbow? Please explain medications also for the same?
In regards to Tennis elbow, patients experience pan in outside aspect of elbow . This happens especially with repeated activities of wrist . Pressing on outside aspect of elbow reproduces the symptoms. Initial treatment involves Tennis elbow splints, anti inflammatories. But persistant symptoms can be treated with new modality of Stem cell injections.This involves taking blood from patient (15 ml) centrifuging it and separating the stem cells and injecting into the outside aspect of elbow. Studies have shown favourable results of Stem cell injections in Resistant tennis elbow.

A  C: Sir my mom has a stiff wrist. What should she do?
Wrist pain and stiffness are most commonly due to Wrist arthritis in the elderly. We need to identlfy the cause of stiffness . Xrays of wrist can identify what stage of arthritis is present. If diagnosis is confirmed number of minimally invasive options like Key hole surgery(arthroscopy) of wrist are available now in Apollo which were only available in the west.This surgery involves 2  small scars on front of wrist , and debridement of wrist joint cn be done.  Sometimes if arthritis is advanced  then Wrist replacement can be done to relieve pain and stiffness.This is done only in selected centres and should be done by specialist Wrist surgeon experianced in such procedures



Sunday 5 May 2013

How to deal with Shoulder Arthritis

Article in Deccan Chronicle by
 Dr Senthil Velan Consultant Shoulder Elbow Surgeon





The Link for the article is
http://www.dc-epaper.com/PUBLICATIONS/DC/DCC/2013/05/05/ArticleHtmls/The-shoulder-has-its-reasons-05052013110019.shtml?Mode=1

For queries and appointments contact nexusortho@gmail.com/9566222533