Selected Podcast
Shoulder Pain: Common Causes and Treatments
Common causes and treatments for shoulder pain.
Featuring:
Peter Hogg, MD
Peter G. Hogg, MD, is a board-certified orthopedic surgeon practicing with Franciscan Physician Network. Dr. Hogg provides total orthopedic care, including treatments for shoulder, elbow, hand, wrist, hip, knee, foot and ankle disorders. He earned his medical degree from the Indiana University School of Medicine and completed his orthopedic residency training at William Beaumont Hospital in Royal Oak, Michigan. Transcription:
Scott Webb: Sometimes shoulder pain is caused by injuries like a rotator cuff injury. And sometimes it's just, well, arthritis. Joining me today is Dr. Peter Hogg. He's a board-certified orthopedic surgeon with the Franciscan Physician Network. And today, we're going to talk about the causes and treatment options for shoulder pain.
This is the Franciscan Health Doc Pod. I'm Scott Webb. Doctor, thanks so much for your time today. We're going to talk about shoulder pain, the causes, things you can do to help folks, we'll even get into rotator cuff later on in the podcast. As we get rolling here, what are the most common causes of shoulder pain?
Dr. Peter Hogg: The most common causes of shoulder pain are still kind of anything that would cause pain in any joint, sprains, strains, overuse, doing something that you probably shouldn't have done, can cause tendonitis, bursitis. You can have something called impingement in the shoulder where your humerus bone can kind of impact on your shoulder blade, raising your arm up. And then, you can get tears in tendons. You can have arthritis. Those are really the most common causes.
Scott Webb: Yeah, it does seem like some of these things we do to ourselves, you know, injury, overuse and then, of course, the dreaded arthritis, which at almost 54 years of age, I can certainly feel that pain. I certainly understand. And staying with arthritis, how do you diagnose arthritis in the shoulder and how is it treated?
Dr. Peter Hogg: So arthritis is diagnosed with x-ray. So at our office or anywhere you get an x-ray, that can make the diagnosis for arthritis. And then, treatment, most people kind of know the basics of treatment of arthritis, because like you said, most people have some type of arthritis pain somewhere. So common things are just avoiding things to make it hurt, trying to modify the way you do things. So it doesn't aggravate it or irritate it. You know, keeping joints moving is usually good for it to a degree, but you can overdo it and do too much and cause it to hurt more. The common over-the-counter medicines, Tylenol, ibuprofen, Aleve are good treatment options, ice and heat can help. And then after that, you can get into more invasive stuff. Sometimes just home exercise on your own or going to formal physical therapy can sometimes help. We do injections, most commonly the corticosteroid to kind of calm down some of the inflammation and pain. And then, the last resort for arthritis is surgery, which what we have now is joint replacement surgery, where we replace your joint with an artificial metal-on-plastic implant to get rid of that pain you're having from the arthritis.
Scott Webb: Yeah. So you've taken us through the range there. Obviously, most of us are familiar with the OTCs and some exercise, possibly some injections. So let's talk about shoulder replacement surgery. I've seen some folks who had the surgery and it seems like kind of a big, right? And so maybe you can take us through that. What's involved with shoulder replacement surgery? You know, how long do those shoulders last, are they good for a lifetime and so on?
Dr. Peter Hogg: Yeah. So, I mean, any joint replacement, it is a big deal. But at the same time, it's a very common procedure that we do a lot of. So if you get to the point where you need it, we try to make it not be a big deal. So the surgery itself, it usually takes about an hour to an hour and a half, and most people are able to go home the same day of the surgery. It involves cutting into your shoulder and then getting to the shoulder joint and then basically taking out the ball and the socket. And the shoulder replacement, the only thing we actually take out is the top of the humerus bone, the ball, and then putting in implant that, like I said, is kind of a metal-on-plastic recreation of your shoulder joint and then closing back up. And generally, that gets rid of your pain and works well.
Scott Webb: Yeah. And I'm wondering, I think I've heard this, or maybe I'm just wishful thinking, is there such a thing as a sort of a partial shoulder replacement or is it all or nothing?
Dr. Peter Hogg: Most of the time, it's a total shoulder replacement. A partial shoulder replacement would be just replacing the ball. And that was more common in the past. And it's still done occasionally, but the shoulder replacements have gotten better over time to where most of the time you're going to get a total shoulder replacement.
Scott Webb: Yeah. Let's talk about sort of the ages, right? So like maybe what's the youngest patient you've ever had, maybe the oldest patient? And is there a range sort of that sweet spot? Is it generally folks over 50 or is it sort of anywhere on the spectrum?
Dr. Peter Hogg: Yeah. There's no specific age limit. Ideally, what you're talking about is doing a shoulder replacement or any joint replacement on somebody, that one surgery will last them the rest of their life. So you asked on average how long it would last, and there's a lot of factors that go into that, like your activity level and how much you use it. But on average, I'd say about 15 years for shoulder replacement. So you're looking at a good age to do a shoulder replacement on somebody who's 60 or 65 years old. But there's a lot of other factors to consider obviously, such as, you know, your pain, your limitations, your lifestyle, your overall health and, you know, other treatment and options and whether they work or not. So I've had patients as young as 30 something that I've done a shoulder replacement on, which isn't ideal from an age standpoint. But if you're to the point where you can't do anything with that arm, it can be an option. And conversely, I've done shoulder replacement on, I think the oldest was 95. She was in fairly good health and, you know, was pretty miserable and didn't want to live like that with the shoulder pain anymore.
Scott Webb: Maybe it always comes back to quality of life, right? So we all tend to sort of maybe suffer in silence a little bit, maybe some suffer less in silence and just sort of make us all suffer because of their suffering. But in general, we all maybe experience arthritis. We may suffer. Maybe we try to put something like this off as long as we can, so we only have to do it once. I think most of us have a pretty good sense, especially as sports fans, what the rotator cuff is. But from an expert, what is it exactly?
Dr. Peter Hogg: The rotator cuff is a group of muscles around the shoulder. They come from the shoulder blade and the muscles are on the shoulder blade and they come over and attach to the top of the ball. So they kind of go across the ball and socket joint and attach to the top of the ball and they are what help kind of keep the ball centered in the socket and help you raise and rotate your arm. The shoulder joint's kind of unique in the sense that the socket is very shallow. So the ball isn't just held in there by the geometry of the socket, kind of like the hip. You can imagine a real deep socket. The deep socket just holds onto the ball. In the shoulder, that's not the case. If you didn't have soft tissues around hold the ball in the socket, it wouldn't be stable in there. So the rotator cuff is one of the main things that helps hold that ball kind of centered in the sock and helps you raise and rotate your arm without your ball popping out the socket.
Scott Webb: Yeah. And I think, again, most of us sports fans, especially baseball fans, we hear about rotator cuff surgery seems fairly common. But is that also a common injury that folks tend to injure their rotator cuffs just doing different things around the house, whether it's cutting the grass or getting up on the roof or however they might do it. Do you find that that's a common injury just for regular folks?
Dr. Peter Hogg: Yeah, it is a very common injury. The same reason that that socket is shallow gives you so much motion in the shoulder that it makes it susceptible to injury and to tears. And also, your rotator cuff takes a lot of wear and tear just over time. Even if you're not an athlete or doing heavy labor, it just takes a lot of wear and tear over the time. And as you get older, the tendon gets weaker and is more susceptible to injury. So it is a very common thing with injury and also it's pretty easily torn without injury.
Scott Webb: All right. So as you say, it's a fairly common thing and I'm sure that, again, maybe you try the OTCs, we work around this as much as possible, is surgery the last resort again for rotator cuff injuries?
Dr. Peter Hogg: Yeah. Usually, surgeries are the last resort. It depends on a lot of things such as, you know, your age, your activity level, overall health, again symptoms, kind of your treatment goals. And then, also it depends on tear size and kind of factors about the rotator cuff. So a lot of times, you can get by without surgery with rotator cuff tears or tendonitis. And then, sometimes surgery is recommended and then, occasionally, you can have a big or bad enough rotator cuff tear that you can't fix it. And then, the only surgical option would be a shoulder replacement at that point.
Scott Webb: Yeah. You know, and this has been really educational and fun today, doc. You know, when it comes to surgery, I find it always interesting when I speak with surgeons, they'll often say like you have today that, you know, surgery's kind of the last resort, even though I am a surgeon and I like doing surgery. Maybe you could just reassure folks as we wrap up here, that there's lots of other things to try before they get to surgery. But if they get to surgery, if it's really that bad and it really is the thing that they need to get back to living their lives the way they want to, that they're in good hands with you and your partners at Franciscan.
Dr. Peter Hogg: Yeah, absolutely. I think that most people don't end up needing surgery for most joint pain that they have. And so, you know, just doing the common sense things at home and trying to get things feeling better on your own. And then, obviously, if you need to see somebody, we're here for you and we can take you as far as we need to go. And if that does end up being surgery, we do it all the time and try to make the experience as seamless and as easy as possible. And it's never fun, it's never ideal to have surgery, but we do our best to serve you and make the experience as good as possible and the outcome as excellent and optimal as we can.
Scott Webb: Yeah. You definitely do. Well, doctor, thanks so much for your time today and you stay well.
Dr. Peter Hogg: Absolutely. Thank you.
Scott Webb: And for more information, visit franciscanhealth.org and search shoulder care. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.
Scott Webb: Sometimes shoulder pain is caused by injuries like a rotator cuff injury. And sometimes it's just, well, arthritis. Joining me today is Dr. Peter Hogg. He's a board-certified orthopedic surgeon with the Franciscan Physician Network. And today, we're going to talk about the causes and treatment options for shoulder pain.
This is the Franciscan Health Doc Pod. I'm Scott Webb. Doctor, thanks so much for your time today. We're going to talk about shoulder pain, the causes, things you can do to help folks, we'll even get into rotator cuff later on in the podcast. As we get rolling here, what are the most common causes of shoulder pain?
Dr. Peter Hogg: The most common causes of shoulder pain are still kind of anything that would cause pain in any joint, sprains, strains, overuse, doing something that you probably shouldn't have done, can cause tendonitis, bursitis. You can have something called impingement in the shoulder where your humerus bone can kind of impact on your shoulder blade, raising your arm up. And then, you can get tears in tendons. You can have arthritis. Those are really the most common causes.
Scott Webb: Yeah, it does seem like some of these things we do to ourselves, you know, injury, overuse and then, of course, the dreaded arthritis, which at almost 54 years of age, I can certainly feel that pain. I certainly understand. And staying with arthritis, how do you diagnose arthritis in the shoulder and how is it treated?
Dr. Peter Hogg: So arthritis is diagnosed with x-ray. So at our office or anywhere you get an x-ray, that can make the diagnosis for arthritis. And then, treatment, most people kind of know the basics of treatment of arthritis, because like you said, most people have some type of arthritis pain somewhere. So common things are just avoiding things to make it hurt, trying to modify the way you do things. So it doesn't aggravate it or irritate it. You know, keeping joints moving is usually good for it to a degree, but you can overdo it and do too much and cause it to hurt more. The common over-the-counter medicines, Tylenol, ibuprofen, Aleve are good treatment options, ice and heat can help. And then after that, you can get into more invasive stuff. Sometimes just home exercise on your own or going to formal physical therapy can sometimes help. We do injections, most commonly the corticosteroid to kind of calm down some of the inflammation and pain. And then, the last resort for arthritis is surgery, which what we have now is joint replacement surgery, where we replace your joint with an artificial metal-on-plastic implant to get rid of that pain you're having from the arthritis.
Scott Webb: Yeah. So you've taken us through the range there. Obviously, most of us are familiar with the OTCs and some exercise, possibly some injections. So let's talk about shoulder replacement surgery. I've seen some folks who had the surgery and it seems like kind of a big, right? And so maybe you can take us through that. What's involved with shoulder replacement surgery? You know, how long do those shoulders last, are they good for a lifetime and so on?
Dr. Peter Hogg: Yeah. So, I mean, any joint replacement, it is a big deal. But at the same time, it's a very common procedure that we do a lot of. So if you get to the point where you need it, we try to make it not be a big deal. So the surgery itself, it usually takes about an hour to an hour and a half, and most people are able to go home the same day of the surgery. It involves cutting into your shoulder and then getting to the shoulder joint and then basically taking out the ball and the socket. And the shoulder replacement, the only thing we actually take out is the top of the humerus bone, the ball, and then putting in implant that, like I said, is kind of a metal-on-plastic recreation of your shoulder joint and then closing back up. And generally, that gets rid of your pain and works well.
Scott Webb: Yeah. And I'm wondering, I think I've heard this, or maybe I'm just wishful thinking, is there such a thing as a sort of a partial shoulder replacement or is it all or nothing?
Dr. Peter Hogg: Most of the time, it's a total shoulder replacement. A partial shoulder replacement would be just replacing the ball. And that was more common in the past. And it's still done occasionally, but the shoulder replacements have gotten better over time to where most of the time you're going to get a total shoulder replacement.
Scott Webb: Yeah. Let's talk about sort of the ages, right? So like maybe what's the youngest patient you've ever had, maybe the oldest patient? And is there a range sort of that sweet spot? Is it generally folks over 50 or is it sort of anywhere on the spectrum?
Dr. Peter Hogg: Yeah. There's no specific age limit. Ideally, what you're talking about is doing a shoulder replacement or any joint replacement on somebody, that one surgery will last them the rest of their life. So you asked on average how long it would last, and there's a lot of factors that go into that, like your activity level and how much you use it. But on average, I'd say about 15 years for shoulder replacement. So you're looking at a good age to do a shoulder replacement on somebody who's 60 or 65 years old. But there's a lot of other factors to consider obviously, such as, you know, your pain, your limitations, your lifestyle, your overall health and, you know, other treatment and options and whether they work or not. So I've had patients as young as 30 something that I've done a shoulder replacement on, which isn't ideal from an age standpoint. But if you're to the point where you can't do anything with that arm, it can be an option. And conversely, I've done shoulder replacement on, I think the oldest was 95. She was in fairly good health and, you know, was pretty miserable and didn't want to live like that with the shoulder pain anymore.
Scott Webb: Maybe it always comes back to quality of life, right? So we all tend to sort of maybe suffer in silence a little bit, maybe some suffer less in silence and just sort of make us all suffer because of their suffering. But in general, we all maybe experience arthritis. We may suffer. Maybe we try to put something like this off as long as we can, so we only have to do it once. I think most of us have a pretty good sense, especially as sports fans, what the rotator cuff is. But from an expert, what is it exactly?
Dr. Peter Hogg: The rotator cuff is a group of muscles around the shoulder. They come from the shoulder blade and the muscles are on the shoulder blade and they come over and attach to the top of the ball. So they kind of go across the ball and socket joint and attach to the top of the ball and they are what help kind of keep the ball centered in the socket and help you raise and rotate your arm. The shoulder joint's kind of unique in the sense that the socket is very shallow. So the ball isn't just held in there by the geometry of the socket, kind of like the hip. You can imagine a real deep socket. The deep socket just holds onto the ball. In the shoulder, that's not the case. If you didn't have soft tissues around hold the ball in the socket, it wouldn't be stable in there. So the rotator cuff is one of the main things that helps hold that ball kind of centered in the sock and helps you raise and rotate your arm without your ball popping out the socket.
Scott Webb: Yeah. And I think, again, most of us sports fans, especially baseball fans, we hear about rotator cuff surgery seems fairly common. But is that also a common injury that folks tend to injure their rotator cuffs just doing different things around the house, whether it's cutting the grass or getting up on the roof or however they might do it. Do you find that that's a common injury just for regular folks?
Dr. Peter Hogg: Yeah, it is a very common injury. The same reason that that socket is shallow gives you so much motion in the shoulder that it makes it susceptible to injury and to tears. And also, your rotator cuff takes a lot of wear and tear just over time. Even if you're not an athlete or doing heavy labor, it just takes a lot of wear and tear over the time. And as you get older, the tendon gets weaker and is more susceptible to injury. So it is a very common thing with injury and also it's pretty easily torn without injury.
Scott Webb: All right. So as you say, it's a fairly common thing and I'm sure that, again, maybe you try the OTCs, we work around this as much as possible, is surgery the last resort again for rotator cuff injuries?
Dr. Peter Hogg: Yeah. Usually, surgeries are the last resort. It depends on a lot of things such as, you know, your age, your activity level, overall health, again symptoms, kind of your treatment goals. And then, also it depends on tear size and kind of factors about the rotator cuff. So a lot of times, you can get by without surgery with rotator cuff tears or tendonitis. And then, sometimes surgery is recommended and then, occasionally, you can have a big or bad enough rotator cuff tear that you can't fix it. And then, the only surgical option would be a shoulder replacement at that point.
Scott Webb: Yeah. You know, and this has been really educational and fun today, doc. You know, when it comes to surgery, I find it always interesting when I speak with surgeons, they'll often say like you have today that, you know, surgery's kind of the last resort, even though I am a surgeon and I like doing surgery. Maybe you could just reassure folks as we wrap up here, that there's lots of other things to try before they get to surgery. But if they get to surgery, if it's really that bad and it really is the thing that they need to get back to living their lives the way they want to, that they're in good hands with you and your partners at Franciscan.
Dr. Peter Hogg: Yeah, absolutely. I think that most people don't end up needing surgery for most joint pain that they have. And so, you know, just doing the common sense things at home and trying to get things feeling better on your own. And then, obviously, if you need to see somebody, we're here for you and we can take you as far as we need to go. And if that does end up being surgery, we do it all the time and try to make the experience as seamless and as easy as possible. And it's never fun, it's never ideal to have surgery, but we do our best to serve you and make the experience as good as possible and the outcome as excellent and optimal as we can.
Scott Webb: Yeah. You definitely do. Well, doctor, thanks so much for your time today and you stay well.
Dr. Peter Hogg: Absolutely. Thank you.
Scott Webb: And for more information, visit franciscanhealth.org and search shoulder care. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.