Shoulder pain is a common problem that affects millions of people worldwide. It can render the entire arm dysfunctional, making even simple daily activities, like combing your hair or getting dressed, difficult. Immediate treatment and management are essential, as the pain and reduced shoulder mobility can worsen over time if left unaddressed.
When conservative treatment fails, surgical intervention is recommended. The latest minimally invasive techniques, involving small incisions and advanced digital technology (specialized software and navigators), allow for customized procedures tailored to the unique anatomy of each patient. These can result in faster and more permanent relief from shoulder pain.
Causes and Diagnosis
Shoulder pain is caused by conditions and injuries affecting the shoulder joint (bones, cartilage, tendons, muscles, nerves). Diagnosis is based on medical history and physical examination, often supplemented with imaging tests such as X-rays, MRI, or CT scans.
Conservative Treatment
Initially, symptoms can often be managed conservatively with:
- Rest, sometimes using a brace to partially immobilize the shoulder
- Cold compresses (and occasionally heat therapy)
- Painkillers and anti-inflammatory medications
- Intra-articular or periarticular injections with hyaluronic acid or corticosteroids
- In certain conditions, biological therapies such as PRP (Platelet-Rich Plasma) or stem cell treatments
- Physiotherapy and muscle strengthening exercises
Shoulder Arthroscopy
When conservative treatment fails, shoulder arthroscopy is a minimally invasive method that allows both diagnosis and treatment without the need for hospitalization. Its effectiveness may be enhanced when combined with biological therapies (PRP or stem cell injections).
During arthroscopy, the orthopedic surgeon inserts an arthroscope—a tiny, high-definition camera—into the shoulder through a small incision (3–5 mm). The internal structures of the joint are displayed in color and magnified on a monitor.
This enables the surgeon to:
- Thoroughly examine the inside of the joint and accurately detect even very small or hard-to-reach lesions
- Immediately repair these injuries using very fine instruments
The incisions are minimal compared to traditional open surgery, causing less damage to surrounding muscles and tissues, which results in fewer complications and reduced postoperative pain. Any marks that do remain usually fade within a few months.
In most cases, shoulder arthroscopy lasts about an hour, with the patient being mobilized immediately afterward and discharged the same day.
Which Shoulder Conditions Are Treated with Arthroscopy?
Shoulder arthroscopy is mainly used to treat:
- Early-stage arthritis
- Calcific tendinitis
- Instability – recurrent shoulder dislocations
- Tendon tears
- Impingement syndromes
- Adhesive capsulitis – frozen shoulder
Shoulder Arthroplasty (Joint Replacement)
For advanced arthritis where conservative treatments are no longer effective, shoulder arthroplasty is recommended. This involves replacing the damaged joint surfaces with highly durable and biocompatible implants. In Europe and the US, the most modern form for severe damage or fractures is reverse shoulder arthroplasty, as it offers solutions even for the most complex cases.
How Reverse Shoulder Arthroplasty Works
In reverse shoulder arthroplasty, the normal anatomy of the shoulder is reversed. The surgeon repositions the joint surfaces to enhance the mechanical advantage of the surrounding muscles. This creates a stable joint capable of functioning even when tendons are severely damaged.
Before surgery, a CT scan of the shoulder is performed to create a 3D model of the patient’s actual anatomy. Using specialized software, the orthopedic surgeon plans the procedure in detail. During surgery, 3D-printed, patient-specific guides are used to ensure precise implant placement.
Minimally invasive techniques are employed to preserve critical muscles and tendons, reducing trauma and allowing for:
- Faster tissue healing
- Minimal postoperative pain
- Less blood loss
- Shorter hospital stays
- Faster rehabilitation compared to traditional open techniques
The patient can usually stand up and mobilize the arm as soon as the anesthesia wears off and may return home within one day—depending, of course, on their general health and medical history.