Shoulder problems should not be ignored. MIS with smaller incision is an effective solution.

The muscles and joints of the shoulder allow it to move through a remarkable range of motion, making it one of the most mobile parts in the human body. Shoulder function is a compromise between mobility and stability. One of its main functions is helping movement of arms to the desired actions. The warning signs and symptoms that might indicate shoulder problems include shoulder pain, cannot make a complete hand crossed at the back, cannot reach the back and severe back pain that disturbs daily life and activities such as regular sport.  If these symptoms are presented, medical attention in shoulder care must be sought as soon as possible in order to get an accurate diagnosis and receive effective and timely treatment. With the advancements of minimally invasive surgery, shoulder injuries can be efficiently treated with satisfactory results due to smaller incisions, less pain and fewer post-surgical complications, resulting in a faster recovery and a quick return to daily life.

Taking care of shoulder problems

Shoulder problems with the manifestation of shoulder pain, swelling and inflammation of joints, muscles, tendons and ligaments surrounding the shoulder are mainly caused by:

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• Pulled shoulder 
• A direct blow to the shoulder
• Falling on an outstretched arm
• Abnormal twisting or bending of the shoulder
• A sudden arm movement led to muscle and joint tear and dislocation.

Treatment

Given treatment entirely depends on the location and severity of conditions:

• Inflammation of surrounding muscles: Treatments include stopping using shoulders temporarily with cold compression, taking nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxant medicines with shoulder rehabilitation. 
• Bone or joint dislocation: Using arm sling to restrict shoulder movement is needed. If the condition is persistent manifested with chronic pain, undiagnosed torn tendons are suspected. Medical attention must be immediately given in order to diagnose and plan for surgical treatment. Minimally invasive surgery (MIS) for rotator cuff tear caused by injuries or accidents results in less pain due to smaller incision, fewer post-operative complications with faster recovery and shorter hospital stay. This surgical technique, compared to open surgery, enables the athletes to get a quick return to daily sport activities.

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Age-related osteoarthritis and bone spurs

Due to the advanced age that affects bone density and its functions, bone disease is a common problem in the elderly. Joint damage associated with osteoarthritis is the main cause of bone spurs, one of the most frequently found conditions in the elderly. 

Bone spurs (osteophytes) are bony projections (bony lumps) that develop along bone edges. Bone spurs most often form next to joints (where two or more bones meet). Since osteoarthritis breaks down the cartilage cushioning the ends of the bones, the body attempts to repair the loss by using calcium to create bone spurs near the damaged area. As a result, bony lumps are formed leading to irregular shape of bones at the affected parts such as feet, elbow, spine, hip, knee and shoulder. 

Motion in the shoulder may be impaired by bone spurs rubbing against tendons and muscles in the shoulder’s rotator cuff. This can lead to nerve compression, tendinitis (an inflammation or irritation of a tendon) and a tear in the rotator cuff, expressed with severe shoulder pain. 

Combined effects of untreated shoulder inflammation and physical damages caused by overuse or shoulder injuries from sports e.g. badminton, weightlifting, boxing and tennis substantially increase the severity of bone spurs. Nevertheless, not only the elderly, but it can also strike younger people in working age. If the abnormal bony lumps are found in any part of the body, immediate medical attention should be provided by orthopedic specialists. 

Treatment

Bone spurs with severe nerve compression often need surgical treatment. Minimally Invasive Surgery (MIS) is considered as an effective option. Compared to open surgery which is a conventional approach, MIS can be performed via smaller incision, in the range of 0.5 – 1 cm. Instead of having an open cut, smaller incision results in less blood loss, fewer complications such as lower infection rates and reduced damages to surrounding tissues and nerves as well as less pain leading to a faster recovery and quick return to daily life and activities. 

The indication of surgical treatments in patients with shoulder bone spurs is an absence of response after receiving non-surgical treatment e.g. pain killer medicine, nonsteroidal anti-inflammatory drugs and muscle relaxant pills combined with physical rehabilitation at least 3-6 months consecutively. 

Minimally Invasive Surgery is an increasingly used technique to improve patient’s quality of life and enhance the ability to be self-dependent in the elderly.

If abnormal signs and symptoms of shoulder are presented, these should not be ignored. Medical assistance must be provided by expert orthopedic doctors. Customized treatment plan will be given to individual patients based on personal conditions and underlying diseases. Prevention of shoulder injuries during exercise remains important. A shoulder warm-up before and after workouts is essential for keeping shoulders, related muscles and tendons healthy with optimal flexibility. To strengthen scapula (shoulder blade) and shoulder joints, exercise of scapular muscles is highly advised. Nonetheless, if shoulder problems are unavoidable, early diagnosis and appropriate treatment help to restore shoulder functions with improved quality of life.