Shoulder Pain Harley Street. Mike Squirrell Physiotherapy at 25 Wimpole Street W1G 8GL are here to help diagnose and treat your shoulder pain and lower neck pain at our physiotherapy clinic within the Harley Street medical area, Westminster W1.
Maybe you're suffering from a dislocated shoulder or separated shoulder? In either case you are probably experiencing pain, which you shouldn't have to. Contact Mike Squirrell Physiotherapy at our clinic on Harley Street for a consultation and we will get you back to fitness in no time.
Shoulder Pain Harley Street
Shoulder problems, including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. It is easily subject to injury because the ball of the upper arm is larger than the shoulder socket that holds it. To remain stable, the shoulder must be anchored by its muscles, tendons, and ligaments. Some shoulder problems arise from the disruption of these soft tissues as a result of injury or from overuse or underuse of the shoulder. Other problems arise from a degenerative process in which tissues break down and no longer function well.
Shoulder pain may be localized or may be referred to areas around the shoulder or down the arm. Disease within the body (such as gallbladder, liver, or heart disease, or disease of the cervical spine of the neck) also may generate pain that travels along nerves to the shoulder. Conversely, pain felt in the region of the shoulder blade or scapula nearly always has its origin in the neck.
Diagnosing Shoulder Pain
* Medical history (the patient tells the doctor about an injury or other condition that might be causing the pain).
* Physical examination to feel for injury and discover the limits of movement, location of pain, and extent of joint instability. However, a systematic review of relevant research found that the accuracy of the physical examination is low.
Diagnostic tests
Tests to confirm the diagnosis of certain conditions. Some of these tests include:
- X ray
- Arthrogram--Diagnostic record that can be seen on an x ray after injection of a contrast fluid into the shoulder joint to outline structures such as the rotator cuff. In disease or injury, this contrast fluid may either leak into an area where it does not belong, indicating a tear or opening, or be blocked from entering an area where there normally is an opening.
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MRI (magnetic resonance imaging)--A non-invasive procedure in which a machine produces a series of cross-sectional images of the shoulder.
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Other diagnostic tests, such as injection of an anesthetic into and around the shoulder joint
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Shoulder Dislocation
The shoulder joint is the most frequently dislocated major joint of the body. In a typical case of a dislocated shoulder, a strong force that pulls the shoulder outward (abduction) or extreme rotation of the joint pops the ball of the humerus out of the shoulder socket. Dislocation commonly occurs when there is a backward pull on the arm that either catches the muscles unprepared to resist or overwhelms the muscles. When a shoulder dislocates frequently, the condition is referred to as shoulder instability. A partial dislocation where the upper arm bone is partially in and partially out of the socket is called a subluxation. In the medical community, dislocation is commonly referred to as luxation.
Signs and diagnosis
The shoulder can dislocate either forward, backward, or downward. Not only does the arm appear out of position when the shoulder dislocates, but the dislocation also produces pain. Muscle spasms may increase the intensity of pain. Swelling, numbness, weakness, and bruising are likely to develop. Problems seen with a dislocated shoulder are tearing of the ligaments or tendons reinforcing the joint capsule and, less commonly, nerve damage. Doctors usually diagnose a dislocation by a physical examination, and x rays may be taken to confirm the diagnosis and to rule out a related fracture.
How to treat a Shoulder Dislocation
Doctors treat a dislocation by putting the head of the humerus back into the joint socket (glenoid fossa) of the scapula — a procedure called manipulation and reduction (M&R). This is usually followed up with an x ray to make sure the reduction didn't fracture the surrounding bones. The arm is then immobilized in a sling or a device called a shoulder immobilizer for several days. Usually the doctor recommends resting the shoulder and applying ice three or four times a day. After pain and swelling have been controlled, the patient enters a rehabilitation program that includes exercises to restore the range of motion of the shoulder and strengthen the muscles to prevent future dislocations. These exercises may progress from simple motion to the use of weights.
After treatment and recovery, a previously dislocated shoulder may remain more susceptible to reinjury, especially in young, active individuals. Ligaments are stretched and may tear due to dislocation. Torn ligaments and other problems resulting from dislocation can increase the chance of repeated dislocation. A shoulder that dislocates severely or often, injuring surrounding tissues or nerves, usually requires surgery to repair the damaged parts of the shoulder.
Sometimes the doctor performs surgery through a tiny incision into which a small scope (arthroscope) is inserted to observe the inside of the joint. After this procedure, called arthroscopic surgery, the shoulder is generally restrained by a sling for 3 to 6 weeks and full recovery, including physical therapy takes several months. Arthroscopic techniques involving the shoulder are relatively new and many surgeons prefer to repair a recurrent dislocating shoulder by the time-tested open surgery under direct vision. There are usually fewer repeat dislocations and improved movement following open surgery, but it may take a little longer to regain motion. Return to top of Shoulder Pain
Shoulder Separation Harley Street
What is shoulder separation?
A shoulder separation occurs where the collarbone (clavicle) meets the shoulder blade (scapula). When ligaments that hold the AC (acromioclavicular) joint together are partially or completely torn, the outer end of the clavicle may slip out of place, preventing it from properly meeting the scapula. Most often the injury is caused by a blow to the shoulder or by falling on an outstretched hand. After injury it is hard to do a 180 degrees rotation.
Signs and diagnosis
Shoulder pain or tenderness and, occasionally, a bump in the middle of the top of the shoulder (over the AC joint) are signs that a separation may have occurred. Sometimes the severity of a separation can be detected by taking x rays while the patient holds a light weight that pulls on the muscles, making a separation more pronounced.
Treating Shoulder Separation at our Harley Street Clinic
A shoulder separation is usually treated conservatively by rest and wearing a sling. Soon after injury, an ice bag may be applied to relieve pain and swelling. After a period of rest, a therapist helps the patient perform exercises that put the shoulder through its range of motion. Most shoulder separations heal within 2 or 3 months without further intervention. However, if ligaments are severely torn, surgical repair may be required to hold the clavicle in place. A doctor may wait to see if conservative treatment works before deciding whether surgery is required
Courtesy of Wikipedia/Shoulder Pain
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All health insurance including BUPA, AXA/PPP cover our treatments. X/Ray, MRI and GP/Specialist referral can be arranged immediately if required.