With our active lives here on the Central Coast, it's not surprising so many of us suffer from troublesome shoulder pain. According to the American Academy of Orthopaedic Surgeons, about four million people in the United States seek medical care each year for shoulder sprain, strain, dislocation, or other problems.

Shoulder injuries can be caused by activities that involve excessive overhead motion. In some cases, a shoulder problem can develop slowly in athletes through repetitive, intensive training routines. In addition, everyday activities like washing walls, hanging curtains, and gardening can cause shoulder injuries due to excessive overhead arm motion.

Like many active people, you may have a tendency to ignore the pain, and "play through" your shoulder injury which only aggravates the condition, and possibly causes more problems. You may also underestimate the extent of the injury because steady pain, weakness in the arm, or limited mobility has become almost second nature to you.

Treating Shoulder Pain, Shoulder Injuries, and Shoulder Arthritis in SLO
No joint has greater range of motion than the shoulder. But this flexibility also poses potential problems, because it makes the shoulder prone to dislocation and instability. The upper arm bone sits in a saucer-shaped part of the shoulder. A circle of ligaments, tendons, muscles, and cartilage form a capsule around the joint to keep it in place.

Most shoulder problems fall into two main categories. First are the familiar problems such as fracture and dislocation of the shoulder, broken collarbone, or arthritis of the shoulder. Then there are the much more common but less familiar problems that involve the muscles, ligaments, and tendons rather than bones, such as instability, impingement, rotator cuff tear, and frozen shoulder.

If you are experiencing pain in your shoulder ask yourself these questions:

• Is the shoulder stiff? Can you rotate your arm in all the normal positions?
• Does it feel like your shoulder could pop out or slide out of the socket?
• Do you lack the strength in your shoulder to carry out your daily activities?

If you answer "yes" to any one of these questions, contact Dr. Thomas Ferro at the Bone & Joint Center at 805-481-3685 in Arroyo Grande for help in determining the severity of the problem and an effective course of treatment.

When you come in to see Dr. Ferro, the first thing you'll discover is he's committed to helping you return to the most active life you can lead on the Central Coast. His approach is to become your partner in a treatment plan you design together. He'll listen to you, help you learn about your condition and work with you to determine the right choices for your lifestyle.

Teaming with Dr. Ferro is the best way to determine the cause of your shoulder problem and how to treat it. He'll evaluate your medical history, assess your range of movement and level of shoulder pain or stiffness, and he may take X-rays or MRIs. Together you may decide that a regimen of mild analgesics and gentle exercises is all that is necessary to get you back to your busy life in San Luis Obispo County. Alternatively, you may determine minimally-invasive, arthroscopic shoulder surgery, followed by physical therapy provides a better opportunity for a rapid return to your activities. Or you may learn about the advantages of today's modern total shoulder replacement procedures with Dr. Ferro and choose that option.

With his advanced credentials, and emphasis on an open, two-way relationship, no matter what path you choose you'll be glad you chose to work with Dr. Ferro.

Managing Shoulder Arthritis on the Central Coast
Although most people think of the shoulder as a single joint, there are really two joints. One is the ball and socket joint that allows the arm to be placed in an incredibly wide range of positions during every day activities. The other is located where the collarbone meets the tip of the shoulder bone. Both joints may be affected by arthritis.

The surfaces of these joints are covered with cartilage, a tissue that allows joints to glide in a smooth and frictionless way. Arthritis of the shoulder is a condition in which the cartilage on either of these joints deteriorates.

Early arthritis of the shoulder can be managed with mild analgesics and gentle exercises. In the case of rheumatoid arthritis, specific medications selected by a rheumatologist may offer substantial relief.

As the arthritis becomes more advanced, the joint surfaces become rough, and areas of bone may be exposed. Motion of the arthritic joint causes the surfaces to grate rather than glide. Progressive joint destruction makes the shoulder stiff, painful, and unable to carry out its normal functions.

To provide you with effective treatment, Dr. Ferro will determine which joint is affected and what type of arthritis you have: osteoarthritis or "wear-and-tear" arthritis a degenerative condition that destroys the smooth cartilage, rheumatoid arthritis a systemic inflammatory condition of the joint lining, or posttraumatic arthritis a form of osteoarthritis that develops after an injury such as a fracture or dislocation of the shoulder. Arthritis can also develop after a rotator cuff tear.

As with most arthritic conditions, Dr Ferro's initial treatment of arthritis of the shoulder will typically be conservative including some or all of the following:

• Rest and/or a change in activities to avoid provoking pain; you may need to modify the way you move your arm to do things
• Nonsteroidal anti-inflammatory medications such as aspirin or ibuprofen to reduce inflammation
• Ice shoulder for 20 to 30 minutes two or three times a day to reduce inflammation and ease pain
• A disease-modifying drug such as methotrexate or recommend a series of corticosteroid injections rheumatoid arthritis
• Dietary supplements such as glucosamine and chondroitin sulfate

If conservative treatment does not resolve the problem, there are surgical options. Surgical treatment of arthritis of the shoulder is generally very effective in reducing pain and restoring motion.

Arthritis of the ball and socket joint can be treated by replacing the head of the upper arm bone or, in some cases, replacing the entire shoulder joint with a prosthesis.

The most common surgical procedure used to treat arthritis of the collarbone and shoulder bone joint is a procedure where Dr. Ferro removes a small piece of bone from the end of the collarbone leaving a space that later fills with scar tissue.

Call us at 805-481-3685 in Arroyo Grande for an appointment today.