doctor explaining rotator cuff injury to patient

‘Shouldering’ The Pain May Just Come Naturally

Treating shoulder pain may be simply a matter of doing what comes naturally. So, says noted orthopedic surgeon Alejandro Badia MD, a specialist in treating diseases of the upper limbs and a leader in orthobiologics – the harnessing of a patient’s own natural defenses to mitigate joint inflammation, relieve chronic musculoskeletal pain and repair orthopedic injuries.

Dr. Badia has been using a bovine-collagen bioinductive implant – about the size of a postage stamp – to effectively treat rotator cuff disease.

“Clinical experience indicates that this implant promotes new tendon growth in the shoulder joint and can either halt progression of rotator cuff disease or prevent re-tearing of a tendon that has been surgically repaired,” says Dr. Badia, founder and chief medical officer of the Badia Hand to Shoulder Center and OrthoNOW®.

Underscoring Dr. Badia’s comments are recent orthopedic studies that demonstrate the importance of the implant and other natural healing approaches in resolving shoulder pain and its causes.

Authors of a study published February 2019 in The Journal of Bone & Joint Surgery, for example, theorize that autologous – a patient’s own — stem cells taken from the calf muscle could be used to prompt healing of rotator cuff repairs and prevent accumulation of fat deposits in the joint. These deposits often complicate recovery and weaken the rotator cuff muscles and tendons – what keep the arm bone tethered to the rounded socket in the shoulder blade and allow for the shoulder’s circular motion.

Dr. Badia uses autologous platelet-rich plasma (PRP) to introduce natural growth factors found in platelets. These growth factors can accelerate healing of minor lesions before they can become major problems.

Shoulder ailments and impairment are a leading cause of musculoskeletal pain and can significantly impact quality of life. As many as 50 million to 100 million people — one of every three to six adults — in the United States experience a shoulder disorder at some time in their lives.

Causes of shoulder pain are multiple, the most common being joint wear-and-tear as a result of overuse or age; tendon inflammation due to bursitis or tendinitis in the rotator cuff; osteoarthritis; shoulder joint instability; injury, including dislocation of a shoulder joint; and a thickening of the shoulder capsule (adhesive capsulitis), leading to an impairment called “frozen shoulder.”

Data presented at the 2017 annual meeting of the Association of Academic Physiatrists even suggest the propensity to develop rotator cuff tears is an inheritable trait.

“Shoulder pain can affect all aspects of a person’s daily activities, including the ability to sleep at night,” says Dr. Badia. “Mounting evidence supports early intervention to address the underlying cause of the pain in order to prevent the disorder from worsening and reaching a point where it becomes unmanageable and difficult to treat.”

“Unfortunately, too many patients fear their shoulder problem will require surgery and avoid getting it checked. They also think surgery will only make their lives worse. But those assumptions are simply not true,” says Dr. Badia.

Most specialists rely first on more conservative measures to address shoulder issues, including exercises for rotator cuff and scapular muscles, manual shoulder therapy, modification of daily activities and medications, such as non-steroidal anti-inflammatories, analgesics, and corticosteroid injections.

For shoulder impingement syndrome, which causes an inflammation and irritation of the rotator cuff muscles, nonsurgical treatment might also include various forms of electrotherapy — transcutaneous electrical nerve stimulation, for example — to increase blood circulation and control pain.

Should surgery be necessary, advanced techniques in tendon repair, joint resurfacing, total shoulder-joint replacement, half-joint replacement (hemiarthroplasty) and even “reverse” shoulder arthroplasty, have increased effectiveness of treatments and made them less painful with quicker recovery times, Dr. Badia says.

In fact, Dr. Badia is able to perform all shoulder surgeries, including complex shoulder replacements and difficult fractures, on an outpatient basis because of his work with an experienced surgical and anesthesia team, the low risk of infection and recent introduction of an advanced anesthetic, Exparel, an injectable nerve blocker, which can be used during surgery and postoperatively to provide significant pain relief.

Of course, the best treatment is prevention. Dr. Badia offers these tips for keeping shoulder joints healthy:

  • Stay active; keep in shape.
  • Exercise properly. Warm up before workouts or engagement in sports.
  • Use proper techniques when lifting heavy objects.
  • Don’t strain shoulder joints by over-reaching.
  • At work, avoid awkward positions, working too long with arms above the head, or mechanical contact stress, which occurs, for example, when wrists rest on a hard surface while typing.

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