I Have Shoulder Pain: Who Should I See?

Shoulder, Shoulder Arthritis, Shoulder Pain, Shoulder Surgeon, Shoulder Surgery

I Have Shoulder Pain: Who Should I See?

Studies estimate that about 15% of people experience shoulder pain at any given time. Are you one of those people?

If you are, you may be confused about where to go. You might feel tempted to start research online, or watch online videos to try and figure out why you are hurting. You may consider seeing your primary care doctor or a trusted physical therapist or chiropractor.

Many of these options are acceptable starting points. However, if you want to improve your chances of receiving a very clear answer about why your shoulder is hurting, it is best to start with an orthopedic shoulder specialist.

An orthopedic shoulder specialist also improves your chances of getting back to life without shoulder pain!

First, it is essential to understand the role of a shoulder specialist. It is true that a shoulder specialist, such as Dr. Johnny T. Nelson, MD, is a highly trained in skilled shoulder surgeon. However, seeing a shoulder surgeon does not always mean you will receive an operation!

Fellowship-trained shoulder specialists spend more time and effort studying the shoulder, including anatomy, diseases, and surgical and nonsurgical treatments than anyone else. No other field of medical providers has such in-depth knowledge of the shoulder or its problems. Because of this, an orthopedic shoulder specialist like Dr. Nelson is much more likely to make the correct diagnosis right away. Not only does he have the most training and expertise, but also has more tools at his disposal, including physical examination, ultrasound scanning, and the ability to order and interpret tests such as x-rays and MRI scans.

Once your shoulder specialist makes the correct diagnosis, then he will discuss with you different treatment options. These treatment options include everything from continued watchful waiting or “observation,” physical therapy, oral medications and anti-inflammatories, chiropractic care, home exercises, injections such as steroids or platelet rich plasma, or surgery. Often, orthopedic shoulder specialists will send you to a top performing physical therapist or chiropractor because they know you and the shoulder problem that you are having will respond well.

In conclusion, to get the “biggest bang for your buck,” start with an orthopedic shoulder specialist such as Dr. Johnny T. Nelson, MD. Dr. Nelson is North Carolina’s shoulder expert and includes ultrasound in the diagnosis of most shoulder problems. If you have shoulder pain, call 919-872-5296 today to schedule your visit!

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Why Is It Important for a Shoulder Specialist to Use Ultrasound?

Injections, Platelet Rich Plasma, Rotator Cuff, Shoulder, Shoulder Arthritis, Shoulder Pain, Shoulder Surgeon, Shoulder Surgery, Sports Injuries, Ultrasound

Why Is It Important for a Shoulder Specialist to Use Ultrasound?

If you are reading this, it is likely that you or someone you know has shoulder pain. It is possible that you tried treatments to improve your shoulder pain without success and are considering a visit with an orthopedic shoulder specialist.

This is certainly a good place to start.

An orthopedic shoulder specialist is expert in the evaluation, diagnosis, and treatment of all shoulder problems including rotator cuff tears, bursitis, instability, and biceps problems. An orthopedic specialist can order and read x-rays, CT scans, MRI studies and has more in-depth knowledge of the shoulder and shoulder problems than any other healthcare provider, including primary care physicians, physical therapists, chiropractors, and nonsurgical sports medicine doctors. Not only can an orthopedic shoulder specialist evaluate your shoulder, but they also provide treatment. It is also important to know that a visit with an orthopedic shoulder specialist does not always mean you will have surgery.

But there are many options out there! It is important that you see a shoulder specialist that uses ultrasound as part of evaluation and treatment of shoulder pain.

If you live in North Carolina, you are in luck! Dr. Johnny T. Nelson, MD is one of those shoulder specialists!

At The Bone and Joint Surgery Clinic, Dr. Johnny Nelson has state-of-the-art ultrasound equipment that allows a high-resolution scan of the rotator cuff and other structures in the shoulder. Along with a physical exam, x-rays, and a short discussion, Dr. Nelson can give you important information about the cause of your shoulder pain.

Doctors that do not use ultrasound are not able to see or evaluate the rotator cuff at the time of evaluation. This often requires an MRI study, which insurance companies will often deny, are expensive, require complicated scheduling, and multiple other visits to obtain. As a result, patients with big rotator cuff tears may possibly be treated with physical therapy, injections, or observation when they should be undergoing rotator cuff repair.

Dr. Johnny T. Nelson is also able to use ultrasound to perform targeted injections that are not possible without ultrasound. These include biceps injections and suprascapular nerve injections, which can be very helpful and more effective than “traditional” blind injections performed without ultrasound.

Do you have shoulder pain? Are you worried that you have a rotator cuff tear? Call 919-872-5296 today to schedule a visit with Dr. Johnny T. Nelson, MD, Raleigh North Carolina shoulder specialist.

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What is the Difference Between Standard and Reverse Shoulder Replacement?

Shoulder Arthritis, Shoulder Replacement, Shoulder Surgery

I have heard of shoulder replacement, but what is the difference between reverse and standard shoulder replacement?

The easiest way to understand this is to look at the normal arrangement of the human shoulder. It is basically a ball and socket joint, with the upper part of the arm bone as the ball, and the shoulder blade as the socket.

A standard shoulder replacement, also known as an “anatomic” shoulder replacement, simply re-creates this normal arrangement of the human shoulder. The ball at the top of the arm bone is refinished or replaced with a shiny metallic surface, and the socket in the shoulder blade is replaced by a special type of advanced plastic.

A “reverse” replacement simply “reverses” this arrangement. At the top of the arm bone, a special type of advanced plastic cup is placed, usually at the top of a stem that sits inside the arm bone. On the shoulder blade side, a shiny metallic ball is implanted into the shoulder blade, usually held in place by screws.

But why do some patients get reverse replacements and other patients get standard replacements?

There are 2 main reasons to use a reverse replacement.

The first reason is due to rotator cuff problems. Some patients with bad arthritis also have very large and long-term rotator cuff tears, and some may have complete absence of the rotator cuff altogether. The reverse replacement changes the arrangement of the shoulder joint and allows the patient to overcome this lack of rotator cuff and use the “meaty” muscle on the outside of the shoulder to lift and move their arm.

The second reason is due to the severity of the arthritis. Very advanced and long-term arthritis can cause wear and tear of the socket part of the joint that is so bad that doing a standard replacement places the patient at risk of complications such as instability and implant loosening. If this is the case, a reverse replacement may be the best option to avoid the risks of these complications.

If you are struggling with shoulder arthritis pain or rotator cuff problems, a visit with Dr. Johnny T. Nelson will shed some light on your unique situation. Using a combination of your history, physical examination, and review of available imaging, a treatment plan will be created that is right for you.

Call 919-872-5296 today to make your appointment!

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“Aren’t I Too Old For Shoulder Replacement?”

Shoulder, Shoulder Arthritis, Shoulder Pain, Shoulder Replacement, Shoulder Surgery

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“Aren’t I too old for a shoulder replacement?”

This is a common way of thinking amongst older patients who struggle with chronic shoulder pain due to to things like arthritis and long-term rotator cuff tears.

But while it is very common, this way of thinking is actually based on several misconceptions about shoulder replacement surgery and the impact it can have on one’s quality of life.

In fact, shoulder replacement surgeons such as Dr. Johnny Nelson believe that the overall benefits of shoulder replacement surgery are higher in older patients compared to younger patients.

Some of this is because any joint replacement, including shoulder replacements, have a limited life span. Even if perfectly placed, shoulder replacement implants over time experience the same wearing tear that our normal joints experience over our life times. Because of this, shoulder surgeons are less likely to recommend shoulder replacement on very young patients, even if the arthritis and pain is very severe. Younger patients are more likely to wear out their shoulder replacements and require a second procedure.

Older patients are much less likely to have this problem. This is because the needs and activities of older patients are very different from those of younger patients. Older patients are much more likely to use their shoulders for simple, less strenuous activities: hygiene, dressing, cooking, etc. They are less likely to need their shoulders for heavy lifting, pushing, pulling and repetitive overhead motions. Therefore they are actually much better candidates for shoulder replacement surgery than younger patients because they are less likely to have complications with their implants.

Another reason why older patients are better candidates for shoulder replacement surgery is that the pain relieving benefits of shoulder replacement can be life-changing for them. While younger patients with chronic shoulder pain certainly could benefit from shoulder replacement, they are less likely to lose their independence and rely on friends, family, and other loved ones for help. Many older patients who struggle with chronic shoulder pain find it very difficult to stay independent, take care of themselves and maintain their living environments. Those who do not receive proper treatment for their shoulder pain may find themselves increasingly dependent on others, even having to sell their homes and move into assisted living facilities or in with family. Many older patients who undergo shoulder replacement surgery are able to maintain or even improve their level of independence and quality of life due to the improved ability to use their once painful arm.

Are you struggling with chronic shoulder pain that is interfering your independence and quality of life? Schedule a visit with Dr. Johnny Nelson to see if shoulder replacement surgery could be a life-changing option for you!

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