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When Shoulder Pain Won't Go Away: Exploring Your Treatment Options · Meaningful Medicine with Novant Health

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  Nolan Alexander (Host): Meaningful Medicine is a Novant Health podcast
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  bringing you access to leading doctors who answer questions they wish you would ask.
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  From routine care to rare conditions, our physicians offer tips to navigate medical
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  decisions and build a healthier future.
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  Today, we'll talk about shoulder surgery, what causes shoulder pain, when to
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  seek care, and what today's treatments and surgeries can really do to help
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  you get back to the life you love.
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  I'm your host, Nolan Alexander.
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  And with me is Dr.
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  Steven Potter, an orthopedic surgeon from Novant Health.
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  Dr.
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  Potter, thanks for joining us, and how are you today?
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  Steven Potter, MD: Doing well, Nolan.
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  Thank you for having me.
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  Host: It's certainly my pleasure.
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  So, let's jump on into it.
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  I'm curious, what are the most common shoulder injuries that you see?
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  Steven Potter, MD: Rotator cuff injuries are one of the most common I see.
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  And then, we'll see some labral injuries, either whether it's a
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  dislocation or just overuse type injury.
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  Host: So, I can be a backyard warrior on the weekend, right?
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  Hanging out with my kids, and I've kind of bumped myself a few times.
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  And it's always the question, when should someone consider scheduling an appointment
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  versus taking over-the-counter treatments?
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  Steven Potter, MD: I think it's certainly reasonable to start most
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  of the time unless you've had some specific incident where you know
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  the shoulder just didn't feel right instantaneously after a particular motion.
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  But for the most part, start with over-the-counter medications,
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  maybe rest for a week or so.
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  But if you're not seeing much improvement at that point, it's
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  worth coming in to have it looked at.
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  Host: Okay.
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  So, you said about a week or so of trying to manage it on your own and
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  then come in for an appointment?
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  Steven Potter, MD: I would say that's pretty routine.
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  Or if you notice that you have some major functional deficit, can't lift
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  it at all or anything along that line.
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  Host: So when I make a visit, what does that first visit look like?
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  And can you outline some of the non-surgical treatment
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  options that you provide?
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  Steven Potter, MD: Sure.
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  The first visit oftentimes is just figuring out how the injury
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  happened, what you're feeling, what specifically the symptoms are for you.
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  Oftentimes, we'll get an X-ray of the shoulder to get an idea
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  if there's any kind of, you know, long-term abnormality like arthritis
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  or anything that's kind of playing into the pathology in the shoulder.
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  And then, it's just a matter of figuring out what mechanism may have
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  caused it, and then starting oftentimes with non-operative or conservative
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  management, as we often call it, with things such as anti-inflammatories,
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  maybe a prescription strength versus just over-the-counter, often a home exercise
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  program, and activity modification.
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  Sometimes physical therapy if people prefer that over home exercise.
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  Host: So, there's a progression leading up to surgery.
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  It's not coming in for one visit and, "Hey, we're going
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  to book you a month out."
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  Steven Potter, MD: Very rarely.
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  That would be an odd incidence.
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  That would be more like a fracture-type situation versus something like a
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  rotator cuff or a labral injury.
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  Host: So, what's new in shoulder surgery?
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  I understand there's some more minimally invasive options around today.
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  Steven Potter, MD: So, you're seeing much more commonly shoulder pathology
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  dealt with using arthroscopic surgery.
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  Historically, they've done some open procedures, but that's becoming less
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  and less common as the visualization with the arthroscope is getting
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  better for us to look through, better quality images, better equipment,
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  better utensils, like our implants, our tools that we use are much more
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  amenable to the arthroscopic surgery.
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  So, rotator cuff repairs, labral issues, even treating some other
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  type of inflammatory conditions can be dealt with through the scope.
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  Host: So, it sounds like technology's playing a pretty big role in this.
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  Steven Potter, MD: Yes.
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  It's been a very beneficial advance for us.
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  Host: When does someone need a shoulder replacement?
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  And is that as intimidating as it sounds to me?
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  Steven Potter, MD: Shoulder replacement, we like to leave that
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  for our, you know, last-ditch effort.
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  Usually, it's end-stage arthritis.
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  Somebody's kind of gone through all the non-operative treatment, whether it's
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  injections or activity modification therapy, they just have essentially
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  bone-on-bone wear and tear in the shoulder, and really it's a loss
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  of motion, a loss of function, and severe pain that leads to the option
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  to go with a shoulder replacement.
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  And yes, initially it can be very intimidating.
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  But the new technology, again, with the quality of the implants, the size of
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  the implants improving, it's become a much more tolerable surgery, to include
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  the aftercare with physical therapy.
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  Host: I'm sure recovery is a very frequent subject that's brought up in your office.
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  So, what is realistic for patients setting recovery expectations?
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  Steven Potter, MD: I usually, for most of the procedures that we do, typically
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  tell people around the three-month mark getting back to doing sort of your
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  normal routine, oftentimes getting back into the more aggressive activities.
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  Overhead throwing type activities typically take a little bit
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  longer, somewhere close to the five or six-month mark.
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  But initially, you're in a sling for four to six weeks, really doing
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  therapy starting a week or two after surgery, trying to get that motion
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  and strength back as soon as possible.
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  Host: All right.
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  So, I got some time before my 50-mile-an-hour fastball
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  can get back to the plate.
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  Steven Potter, MD: That's right.
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  Host: Is there anything before or after surgery that a patient can
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  do to speed up their recovery?
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  Steven Potter, MD: Honestly, generalized health is sort of the best way to do it.
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  Eat a healthy diet, stay active, just take care of yourself really
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  overall, and that's the fastest way to get your body to recover.
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  Host: So for someone who's joining us in this conversation, they're
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  listening and they've lived with shoulder pain for quite some time,
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  what advice do you have for them?
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  Steven Potter, MD: If it's been a long time and you've been trying to do it
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  with over-the-counter medications or activity modification, then come on in
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  and we'll take a look at it and see if we can figure out some other options and
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  modalities to get you back to doing the things you want to do, whether that's
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  non-operative or eventually operative.
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  Host: Dr.
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  Potter, you've given us so many great answers today.
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  Is there anything else that you feel is important related to this topic?
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  Steven Potter, MD: Really just stay active.
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  Stay active.
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  Take care of yourself.
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  Continue to eat well, sleep well, and don't let yourself
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  just sit around and do nothing.
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  Host: There we go.
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  I'm going to go hit the weights right after this.
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  Dr.
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  Potter, thank you so much for your time today
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  Steven Potter, MD: Thank you.
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  Host: That was Dr.
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  Steven Potter.
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  To find a physician, visit novanthealth.org.
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  For more health and wellness information from our experts,
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  visit healthyheadlines.org.