The trend in orthopedics is for a specialist to exhaust all non-surgical treatment options in advance of surgery. That’s because the more invasive (surgical) the treatment option, the more tissue is disrupted and there is more potential for more complications than with physical therapy or a injection.
So if you are impatient, wanting a quick fix to your problem, keep in mind that the best specialists in orthopedics, and sports medicine will first look at if there are non-surgical options for you to try first before surgery.
With sports medicine problems involving strain, sprain or overuse syndrome — non-surgical treatment options like anti-inflammatory medication, injections into a joint space or specialized therapy, can many times provide relief of symptoms without the need for surgery.
Fortunately, most common shoulder problems can be managed successfully without surgery.
Diagnosing a Shoulder Problem
Our orthopaedic specialists may order x-rays to help diagnose your condition. While relatively rare, arthritis is best seen with plain x-rays. The orthopaedic specialist may order an MRI to see if there is a problem that requires surgery.
About Nonsurgical Care
The specialist may recommend a series of exercises to strengthen the muscles around the shoulder. A skilled physical therapist can help educate you in this program and make sure the exercises are done properly. This can restore stability and balance to the shoulder and provide relief from pain and instability.
Non-steroidal anti-inflammatory medicines (i.e. ibuprofen) can help with the pain and inflammation. Steroid injections can be very effective at rapidly reducing inflammation and pain, making the rehab process easier.
Stem Cell Therapy
Mesenchymal Stem Cells (MSCs) are remarkable cells located in many tissues of your body. One of the most important characteristics of MSCs is that they are unspecialized cells with the ability to mature and differentiate into multiple types of tissue including bone, tendon, ligament, cartilage, muscle and meniscus. In addition, these stem cells can self-renew, producing more stem cells. They can even prevent other cells from dying due to lack of oxygen and they can produce anti-inflammatory proteins.
When stem cells are injected into an arthritic joint or injured tendon, they attach to the areas of damaged tissue. The MSCs are able to sense the microenvironment of the injury and determine what kind of cells to grow and what molecules are needed to enhance tissue healing. The stimulated MSCs begin to grow new cells and also act as your body’s own natural drug store producing and releasing the right combination of growth factors and proteins to stimulate healing and new growth of cartilage, tendon and other injured tissues.
Platelet Rich Plasma (PRP) Therapy
Plasma is the clear portion of the blood in which all the other blood components such as platelets, red blood cells and white blood cells travel. Platelets are part of the blood that circulate around the body ready to help stop the bleeding should you have a cut, broken bone or injury that bleeds internally. Besides containing clotting factors, the platelets release growth factors and proteins that help start the healing process. PRP contains a concentrated amount of platelets that release potent quantities of these growth factors and proteins to stimulate a robust healing response.
Many famous athletes — PGA’s Tiger Woods, NBA’s Kobe Bryant and Steph Curry, MLB’s Alex Rodriguez, tennis star Rafael Nadal, and several others — have received PRP for various problems such as sprained knees and chronic tendon injuries. This treatment technique is relatively new in the field of sports medicine, but has been gaining popularity quickly.
Treatments you can administer at home
Non-Steroidal Anti-Inflammatory medication, or NSAID's, such as ibuprofen (Advil, Nuprin and Motrin IB) help reduce swelling and inflammation and can be quite helpful. The ibuprofen also helps mask the pain of a shoulder injury. Use NSAID's cautiously, however, as taking them regularly over a long period of time can cause ulcers or other gastro-intestinal problems.