Shoulder Treatment Overview

Dr. Siegrist’s standard approach for patient’s with shoulder pain:

Initial consultation:
- Your history, examination, XRay; identify the problem
- Educating you about the problem, how you can correct it
  - Exercises–on your own, or at Physical Therapy
  - Medications–OTC or prescription
  - Cortisone shot–if the pain is keeping you up at night or away from work
Follow up visit, 3-4 weeks later:
- Are you better? If so, continue the exercises! Follow-up as needed.
- If not:
  - Go to PT if home exercises didn’t help
  - or, Order MRI to plan for surgery, if appropriate
If pain returns in the future
- Reassess the problem
- What worked in the past? What didn’t?
- Plan for surgery, if appropriate.

Surgery: If pain/weakness limits your function despite treatment so far

Distal Clavicle Excision (Removing 1/2″ of the end of the collarbone)
- If the problem is arthritis at the AC joint
Arthroscopic surgery to remove the bone-spur/bursitis:
- If no rotator cuff tear on the MRI
- If you’re not on blood-thinners and don’t have bad heart disease
- If your shoulder is not-too-large
- Shoulder Arthroscopy Slideshow from NIH
- What to Expect: Shoulder Arthroscopy
- Postop Instructions: Shoulder Arthroscopy
- 2-6 weeks after Shoulder Arthroscopy
- 6+ weeks after Shoulder Arthroscopy
“Open” surgery to remove the bone spur (and repair a torn rotator cuff)
- If the MRI shows your cuff is torn (Dr. Siegrist does not repair cuff tears arthroscopically)
- If you’re on blood-thinners, or have significant other medical problems (“Open” surgery takes about half as much time as a “scope”).
- If your shoulder is too large for the ‘scope instruments.
- What to Expect: Rotator Cuff Surgery
- Postop Instructions: Rotator Cuff Surgery
- 2-6 weeks after Rotator Cuff Surgery
- 6+ Weeks after Rotator Cuff Surgery
Exercises after Shoulder Surgery