Shoulder Pain

Dr. James - Orthopaedic Surgeon in Singapore

Written by Dr James Tan

Contents

    Shoulder pain is a common condition that affects a large number of people from time to time. Shoulder pain is any pain you feel in or around the shoulder joint. Depending on different situations and factors, the causes of shoulder pain are different for different individuals. Determining the cause of shoulder pain can help a shoulder specialist Singapore to recommend effective shoulder pain treatment options.

    Causes Of Shoulder Pain

    Shoulder pain can be caused by an acute injury, repetitive movements, trauma, or chronic conditions. These causes can include:

    • Rotator cuff injuries
    • Torn cartilage
    • Swollen tendons
    • Swollen bursa
    • Frozen shoulder
    • Pinched nerve in the cervical spine
    • Dislocated shoulder
    • Spinal cord injury

    Diagnosis

    For any kind of shoulder pain treatment in Singapore, the first step is to confirm the diagnosis. A qualified shoulder pain specialist in Singapore can diagnose the underlying cause and suggest treatment accordingly. The shoulder specialist can evaluate your physical condition, ask questions about the pain and injury, and carry out a physical exam. He may order additional tests such as electromyography and other nerve conduction tests to rule out any neurological disorders involving pinched nerves from slipped or herniated discs in the spine. An MRI is recommended if the doctor suspects any problems related to soft tissues, muscles, and tendons.

    To learn the difference between an x-ray MRI, and a CT scan, check out this article.

    Types of Shoulder Pain

    As part of the diagnosis, a Singapore shoulder specialist will determine the type of shoulder pain before he can recommend an effective treatment plan.

    Acute Shoulder Pain

    This refers to the sudden onset of pain, usually associated with an injury. It can result in sharp, shooting pains that restrict the range of motion of the arm. Pain increases with movement and may be accompanied by swelling and inflammation.

    Chronic Shoulder Pain

    This usually manifests slowly and gradually over time with a dull and mild ache. The pain can cause low shoulder mobility over time. Although patients may feel a mild ache when resting, they may experience pain flare-ups from time to time.

    shoulder pain anatomy
    Shoulder pain - Image Credit: Musculoskeletal Australia

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    Did You Know...

    Shoulder mobility decreases as you get older?

    Due to age, our shoulder mobility decreases due to

    Natural degenerative changes

    Loss of muscle mass & strength

    Joint stiffness

    Poor posture

    How Good is Your Mobility?

    Try the Mobility Test

    Bend your leg and hold onto your foot with your opposite arm in the air.

    Bend over and touch the ground.

    Slowly return to the upright position.

    Drop your knee to the ground, lightly tap it and stand back up.

    Find Shoulder Pain Treatment in Singapore

    If you or your loved ones are suffering from shoulder pain, either from degenerative joint diseases, accidents, trauma, or overuse of the shoulder joint, consider choosing our specialised shoulder pain treatment in Singapore! Our shoulder specialists at Ray of Health will carry out an evaluation and diagnose your condition followed by creating a customised treatment plan to help you recover. We also specialise in wrist injury treatment and sports injury treatment for your injuries.

    Reach out to our shoulder specialist in Singapore by calling +65 6235 8781 or chat with us on WhatsApp at +65 8028 4572. You can also talk to us by clicking the button below.

    Locations

    Camden Medical

    1 Orchard Boulevard, #09-06

    Singapore 248649

    Mount Alvernia Hospital

    820 Thomson Road

    Medical Centre D #05-60

    Singapore 574623

    Book an Appointment

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    Shoulder Pain Treatment With Dr James Tan

    Dr James Tan, our shoulder specialist at Ray of Health, deals with various orthopaedic conditions of the body. He advises his patients to consult him in case of any pain or injury at the earliest so that the condition can be assessed and diagnosed properly.

    1. Registration: Firstly, register with Dr James' team and book an appointment here.
    2. First appointment: At the first appointment, Dr James Tan will carry out a thorough physical exam for your shoulder pain, evaluate your medical history.
    3. Diagnosis: Typically, additional diagnostic tests are required to access the causes of the problems accurately. This usually comes in the form of MRI or X-ray scans.
    4. Personalised Treatment Plan: Dr James will then create a personalised treatment plan based on your specific condition and needs, which could include undergoing surgery, and recommend the necessary treatment modalities to you.
    5. Follow-up sessions: Dr James will schedule additional follow-up sessions to monitor the recovery process until you fully recover.

    Disclaimer: Treatment plans may differ for different patients. Please contact Dr James for more information.

    dr james tan

    Medisave & Insurance Shield Plan Approved

    If you are a Singaporean or a Permanent Resident of Singapore, some of our orthopaedic procedures can be claimed under Medisave. The claimable amount will vary based on the procedure's complexity.

    For other situations, please consult our friendly clinic staff regarding the use of your Integrated Shield Plan insurance.

    The Way Forward: Shoulder Pain Treatment

    The way forward towards treating shoulder pain is to get an accurate diagnosis from a qualified shoulder specialist, who can then recommend the most suitable treatment regimen according to the patient’s unique case.

    Shoulder pain treatment in Singapore comprises a wide range of modalities including self-care practices, physical therapy, medication, and sometimes surgery. Here is a detailed look at all these options.

    Non-Surgical/Conservative Treatments

    Your orthopaedic shoulder specialist will most likely advise you to follow the conservative approach initially. These non-surgical treatment options can include the following:

    Activity Modification and Rest

    Probably the first step in neck and shoulder treatment is to modify your lifestyle and avoid activities that aggravate the pain. Resting and giving enough time for the shoulder to heal is crucial to ensure a desirable effect in managing the pain. Moreover, cold and heat applications, especially during the first 48 hours of pain onset, can help reduce swelling and pain. Cold compresses help reduce inflammation while hot compresses can help relax tense muscles and stiffness. Frozen shoulder treatment at home also comprises resting and avoiding activities that may aggravate the condition further.

    Medications

    Oral medications that include anti-inflammatory drugs are usually the first line of treatment for mild to moderate pain.

    Anti-inflammatory medicines like acetaminophen, ibuprofen, and naproxen may be prescribed to reduce swelling and consequently relieve pain. In cases of severe pain, the shoulder pain doctor may prescribe stronger painkillers and oral steroids. It is important to take the medicine dosage as advised by the doctor as taking too less or too much can result in adverse side effects.

    Injections

    Another conservative mode of shoulder joint pain treatment is through injections.

    • These injections may be diagnostic as they help to determine the actual cause of the pain. Diagnostic injections may include injecting a numbing drug like Lidocaine directly into the suspected joint or tendon.
    • If the patient feels immediate relief from pain or a significant reduction in pain following the injection, it means that that suspected area is the actual cause of the problem.
    • If the patient does not feel any improvement in pain, it is an indication for the doctor to carry out other tests to determine the actual source of the problem.
    • Injections can also be therapeutic, as they work well in reducing inflammation and pain, especially in conditions such as rotator cuff tears, osteoarthritis, bursitis, and frozen shoulder. Cortisone Injections can also be injected directly into the shoulder joint area, bursa, or inflamed tendon as an effective frozen shoulder treatment Singapore option.
    • Trigger point injections are also an effective way to reduce pain.

    Sometimes, the doctor may use an ultrasound to help guide him in administering the injection directly into the affected tendon. An acromioclavicular (AC) injection helps in managing pain associated with arthritis and inflammation in the AC joint.

    Plasma-Rich Platelets (PRP) or Stem Cell Therapy

    Another mode of chronic shoulder pain treatment is through PRP or stem cell therapy. Both these therapies involve taking specific kinds of cells or plasma from the patient’s body, concentrating them, and then injecting them back into the patient’s affected shoulder to provide symptomatic relief.

    Physical Therapy

    Physical therapy is an important component of conservative shoulder blade pain treatment as it allows the shoulder to regain its strength in addition to reducing inflammation and pain.

    Through physical therapy exercises, the therapist can help reduce inflammation and pain in the shoulder area, strengthen the surrounding muscles, and improve shoulder joint flexibility to not only treat the current condition but also help prevent re-injury. A frozen shoulder specialist in Singapore can often recommend physical therapy as an effective treatment option for frozen shoulders.

    Braces and Support

    Another conservative treatment measure for treating shoulder pain is to use braces or slings to support the shoulder and arm.

    These braces can help immobilise the shoulder, which aids in faster recovery. Some braces provide strict movement restriction of the arm while others help protect the AC joint against further injury and quicken the healing process.

    Surgical Treatments

    If the doctor feels that conservative measures will not be effective or if the patient has been following conservative measures for a considerable amount of time and still there is no improvement in the pain, he may suggest surgical treatments.

    Different types of shoulder conditions call for different types of surgical techniques which are discussed below.

    Open Repair

    During an open repair surgery, a traditional incision, that is several centimetres long, is made to gain a better view of the area and gain access to the affected tendon, muscle, or bone spurs. A shoulder specialist surgeon may carry out this surgery if the tendon tear is large or when extensive reconstruction is required.

    Arthroscopic Repair

    Over the years, many different technologies have been introduced in the field of medicine and surgery that have improved the way surgeries used to take place. One such type of surgery is an arthroscopy where very small incisions are made in the shoulder area.

    A small camera is inserted into one of the incisions with a live camera feed, which guides the surgeon in carrying out the procedure. Very small and thin surgical instruments are then inserted through the other small incisions. Arthroscopy involves making just these tiny incisions instead of large ones as are done in traditional surgeries.

    Mini-Open Repair

    A mini-open repair surgery involves using tiny incisions and an arthroscope to treat the damage in the shoulder joint. If a tendon is also involved in the injury, the tendon is repaired through the mini-open incision. Visit our tendon injury page to learn more.

    The different types of surgeries performed in Singapore include the following:

    Rotator Cuff Repair

    Rotator cuff repair is one of the most common surgeries on the shoulder. The damaged or torn tendons are reattached or stitched together through either of the three surgical techniques.

    Capsular Release

    Frozen shoulder treatment involves a surgical procedure called the Capsular release. Frozen shoulder or adhesive capsulitis is a common condition that many people face. The condition occurs when the capsule of connective tissues surrounding the shoulder tightens, causing stiffness, restriction of movement, and pain in the shoulder.

    During the capsular release, three small incisions are made in the shoulder. An arthroscope is inserted into one of the incisions and surgical instruments are inserted through the others. Guided by the camera, the surgeon cuts the tight capsular tissue around the joint to relax it. The incisions are closed with sutures at the end.

    Shoulder Joint Replacement

    A shoulder joint replacement surgery is carried out when the joint is damaged through osteoarthritis, fractures, rotator cuff injuries, rheumatoid arthritis, osteonecrosis, and other inflammatory disorders.

    The surgery called arthroplasty removes damaged areas of the joints and replaces them with artificial components such as plastic or metallic implants. This procedure depends on the severity of the injuries.

    Arthroscopic SLAP Repair

    Arthroscopic surgery is carried out to repair a SLAP tear in which the surgeon identifies the damaged tissue of the labrum and removes it. Then he drills a small hole into the bone of the shoulder joint near the damaged tissue and inserts a strong anchor into the hole.

    The surgeon may place additional anchors if the need is to secure the torn labrum with the bone and attach them through sutures.

    Acromioplasty and Subacromial Decompression

    This surgery is part of shoulder impingement treatment when the tendons that support the rotator cuff muscles become torn or damaged. During this arthroscopic surgery, the damaged bone and tissue is removed from under the acromion. Any damaged tendons are also repaired during the procedure after which the incisions are closed.

    Ligament Repair or Bankart Repair

    Dislocated shoulder treatment comprises a ligament repair or Bankart repair surgery. When a shoulder is dislocated, it damages the ligaments in the shoulder joint, causing instability and pain. During a ligament repair surgery, any ligaments that are torn or damaged are repaired or reconstructed.

    This surgery helps treat pain and instability and helps prevent future dislocations. This surgery is also referred to as Bankart repair surgery.

    For more information on shoulder dislocation, visit our shoulder dislocation treatment page now.

    Bursectomy

    For people suffering from bursitis, a condition where the bursa in the shoulder becomes inflamed causing pain and stiffness, surgery may be advised. A bursa rests between the bone and soft tissues of the shoulder joint. It can become damaged because of an injury or trauma, causing pain and inflammation.

    During a bursectomy surgery, the inflamed bursa is removed through an arthroscopy procedure.

    Fracture Repair

    If the pain is caused by fractures due to any kind of injury, fall, or accident, a fracture repair surgery will be carried out. During the surgery, broken bones are fixated using plates, pins, and screws. This kind of surgery is usually carried out under general anaesthesia.

    AC Joint Repair

    When the AC joint in the shoulder gets damaged, an acromioclavicular joint repair and reconstruction surgery may be carried out. In case of an acute injury, arthroscopic surgery is carried out to repair the torn ligaments.

    However, if the condition has become chronic, an open procedure will be carried out to repair and reconstruct the damaged ligaments.

    Biceps Tendon Surgery

    When the biceps tendons become damaged due to injury or overuse, a Biceps Tenodesis surgery may be carried out.

    During the procedure, the torn biceps tendons are detached from the labrum. In some cases, the biceps tendons are relocated to the upper arm bone, the humerus.

    Rehabilitation

    Whether a patient goes through non-surgical or surgical treatment options, post-treatment rehabilitation is crucial to ensure recovery and prevent future problems. Rehabilitation involves the following steps:

      • Physical Therapy: Physical therapy and exercises help improve strength, restore function, and prevent future injuries associated with the shoulder.

      • Gradual Increase in Activity: This is an important step where the patient must increase activity gradually, giving enough time for the injury to heal.

      • Pain Management: During the recovery process, it is also important to manage pain either through medications or other alternative methods to help the patient recover properly.

    Alternative Treatments

    In addition to conservative and surgical treatment options, certain alternative methods are helpful. These include:

      • Acupuncture — can help in reducing pain and improving shoulder movement.

      • Chiropractic Care — can help release tension in the shoulder muscles

      • Massage Therapy — helpful in relaxing the muscles and reducing shoulder pain

      • Yoga and Pilates — can help in improving posture, flexibility, and strength of the shoulder over time to manage pain.

    Shoulder Pain Treatment With Dr James Tan

    Dr James Tan, our shoulder pain specialist at Ray of Health, Singapore deals with various orthopaedic conditions of the body. He advises his patients to consult him in case of any pain or injury at the earliest so that the condition can be assessed and diagnosed properly.

    At the first appointment, Dr James Tan will carry out a thorough physical exam for your shoulder pain, evaluate your medical history, and order any additional diagnostic tests if required. He will then create a personalised treatment plan based on your specific condition and needs, and recommend the necessary treatment plan for you. Contact him today for more information about chronic shoulder pain treatment or any other orthopaedic condition.

    Frequently-Asked Questions

    Shoulder pain can cause significant difficulty in one’s life and daily activities. In case of minor shoulder sprains, home remedies can help aid healing and result in fast recovery. These home remedies include applying ice on the affected area, restricting the movement of the affected arm, using an arm sling, and giving the shoulder joint as much rest as possible.

    Disclaimer

    The information provided on this page is for educational purposes only and is not intended as a substitute for professional medical advice or treatment. Always consult your healthcare provider or specialist doctor regarding any medical condition that you might be facing and act on the doctor’s recommendations.

    References:

    1. "Overview: Shoulder pain", National Library of Medicine, National Center for Biotechnology Information, 2020, https://www.ncbi.nlm.nih.gov/books/NBK554693/
    2. "Shoulder pain: Learn More – Shoulder pain: What helps?", National Library of Medicine, National Center for Biotechnology Information, 2020, https://www.ncbi.nlm.nih.gov/books/NBK554692/
    3. "Shoulder pain", National Library of Medicine, https://medlineplus.gov/ency/article/003171.htm

    About The Author

    dr james tan

    Dr James Tan Chung Hui

    Dr James Tan is a skilled orthopaedic surgeon at Quantum Orthopaedics located at Camden Medical and Mount Alvernia Hospital, known for providing specialised medical services. Dr Tan has more than 10 years of experience in sports surgery and exercise medicine in Singapore. Apart from partnering with the industry to introduce various treatment techniques, Dr Tan has treated athletes from the Singapore National Teams and professional footballers from the Singapore Premier League and the Young Lions.

    Dr Tan specialises in treating sports injuries of the knee, shoulder and elbow joints, as well as cartilage and meniscus surgery. He is a member of the elite Asian Shoulder and Elbow Group and a founding member of the Singapore Shoulder and Elbow Surgery Society.

    Medical Education and Affiliations
    MBBS - National University of Singapore (NUS), Faculty of Medicine
    Member of the Royal College of Surgeons of Edinburgh (MRCS)
    MMed - Master of Medicine in Orthopaedic Surgery (NUS)
    Fellow of Royal College of Surgeons (Edinburgh)
    Adjunct Assistant Professor | NUS, LKC
    Senior Consultant Orthopaedic Surgery, Sports and Exercise Medicine
    Head of Department | Orthopaedic Surgery and Sports Medicine Centre
    Awards
    Principal Investigator of Tissue Engineering
    National Medical Research Council grants
    Collaboration with Scientists at NTU, TUM, A*Star, Osteopore & Trendlines Medical Singapore

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    Accreditations

    1. Mount Elizabeth Orchard
    2. Mount Elizabeth Novena
    3. Farrer Park Hospital
    4. Mount Alvernia Hospital
    5. Aptus Surgery Centre
    6. Novaptus Surgery Centre

    Insurances

    1. Great Eastern
    2. Prudential
    3. HSBC Life

    Corporate

    1. MHC
    2. Fullerton
    3. Adept
    4. Alliance