Angie's LIST Guide to
Shoulder and arm orthopedics
Shoulder and arm problems
You'll need to visit this type of orthopedic doctor if you have a particular disease or condition that affects your shoulder or arm and lies outside general physician's realm of expertise. Some of the most common conditions that involve shoulder and arm orthopedics include bursitis of the elbow, tennis elbow, shoulder impingement, rotator cuff tendonitis, frozen shoulder, arthritis, cubital tunnel syndrome, tendonitis of the biceps, brachial plexus birth palsy, compartment syndrome, instability, fracture and tendon inflammation.
In some of these cases, your regular doctor might have previously diagnosed your condition or it may not have healed with treatment. A new perspective might help your medical care team find a diagnosis that they can implement successfully. Underlying causes like cancerous or benign tumors, inflammation, tenderness, infection and nerve damage can make it uncomfortable or impossible for you to complete simple, everyday tasks. Getting a thorough diagnosis can help you begin to seek the treatment for each problem, whether it's acute or chronic.
Depending on your insurance plan, you may need a referral from your primary care physician before you can set up an appointment with an orthopedic shoulder and arm specialist. Upon your initial appointment, you'll have a complete physical and evaluation, which includes motion exercises and measurements as well as pain-level exercises. Explain what type of concerns you have: Are you experiencing pain, discomfort or numbness? Have you experienced an injury or accident recently? You'll need all of these questions answered thoroughly in order to make sure that you get the right care and that the right insurance is billed, particularly if the issue is work-related or involves an auto accident.
In addition to a physical exam, your doctor may request further diagnostic testing that includes CAT scans, MRI testing, X-rays and a physical therapy evaluation. Blood tests or results from prior laboratory testing may be necessary to make an accurate diagnosis and proceed with treatment. Treatment may involve exercise therapy, medication, physical rehabilitation and, in some cases, surgery. Your orthopedic doctor or surgeon may have to consult with your primary doctor to determine the best course of action depending on your current and past medical history.
Because this field of orthopedics specializes in a variety of conditions, your doctor will come up with a treatment plan that will provide both pain relief and restored mobility. Some conditions may require surgery, such as joint replacement, thermal capsular shrinkage, shoulder surgery, shoulder arthroscopy, rotator cuff surgery through an open repair or all arthroscopic repair as well as a mini-open repair. Surgery is often a last resort, taken only after other treatments do not provide relief.
Your doctor may recommend physical therapy exercises and routines. Aquatic therapy can help relieve pressure on your joints and help soothe the surrounding tendons and muscles. If pain management is an issue, nutritional supplements—including chondroitin sulfate, glucosamine and vitamin D—may be used alone or in conjunction with statins and NSAIDS to help manage light to moderate discomfort and pain issues. Fractures, tears and instability may require steroid injections or slings to help keep joints in place and reduce friction and further physical damage and pain.
Finding an orthopedist
Orthopedic surgeons and doctors often have up to 14 or more years of formal education that include study from an accredited university, medical school, orthopedic residency and specialized education and hands-on training at a major medical center.
If you know that you'll need the services of an orthopedic doctor, contact your health insurance company to make sure that this medical specialty is covered. Read through the listing of orthopedic doctors in the provider directory available from your health insurance company and check with the American Academy of Orthopaedic Surgeons. Carefully research the orthopedic doctors you are considering. Verify their qualifications, education, continuing education, accepted insurance plans and affiliated hospitals by consulting Angie's List, where you can also see member reviews and rankings.
When you meet with you potential doctors, ask questions about their experience with the particular procedures you might undergo. Ask about recovery time. Note the conditions of the doctor's office. Is the staff friendly and accommodating? Do you have any difficulty in scheduling an appointment? You'll want to make sure you have a great rapport with your orthopedic doctor and the staff.