Understanding Common Shoulder Conditions
This guide explains the shoulder conditions Dr Julyan sees most often, in plain language. It is for general information and is not a substitute for a consultation. Importantly, most shoulder problems improve with non-surgical treatment — so seeing a shoulder surgeon does not mean you will need an operation.
1Rotator cuff problems (impingement and tears)
What it is
The rotator cuff is a group of tendons that move and steady the shoulder. It can become pinched and inflamed (impingement), or partly or fully torn — from wear over time or after an injury.
Common symptoms: pain on the outer shoulder and upper arm, worse with reaching overhead or lying on that side at night, and sometimes weakness lifting the arm.
Treatment: many people improve with physiotherapy, activity changes, anti-inflammatory medicine or an injection. Repair surgery may be considered for certain tears, or when symptoms persist despite non-surgical care.
2Frozen shoulder (adhesive capsulitis)
What it is
The lining of the shoulder joint becomes inflamed and tight, causing pain and progressive stiffness. It often settles on its own but can take many months.
Common symptoms: a painful, gradually stiffening shoulder that is hard to move in all directions. It is more common in people with diabetes.
Treatment: usually non-surgical — physiotherapy, pain control and sometimes an injection. A procedure is only occasionally needed for a shoulder that stays very stiff.
3Shoulder osteoarthritis
What it is
The smooth cartilage on the ball-and-socket joint wears down, so the bones rub, causing pain and stiffness.
Common symptoms: deep aching pain, stiffness and grinding, worse with use and often at night in more advanced cases.
Treatment: begins with activity changes, medication, physiotherapy and injections. When arthritis is advanced and quality of life is affected, a shoulder replacement may be discussed. Dr Julyan uses CT-based planning to prepare for joint-replacement surgery.
4Shoulder instability and dislocation
What it is
The shoulder is the body’s most mobile joint, which makes it prone to slipping partly (subluxation) or fully (dislocation) out of place, often after an injury or in people with naturally loose joints.
Common symptoms: a feeling the shoulder may ‘give way’, apprehension with certain movements, or repeated dislocations.
Treatment: physiotherapy to strengthen the shoulder helps many people. Surgery to repair or tighten the structures may be considered after repeated dislocations or certain injuries.
5Calcific tendinitis
What it is
Calcium deposits form in a rotator cuff tendon, which can cause sudden, severe shoulder pain.
Treatment: the great majority of cases settle with non-surgical care — pain relief, physiotherapy, and sometimes a guided injection or needling of the deposit. Surgery is rarely needed.
6AC joint problems
What it is
The acromioclavicular (AC) joint sits at the top of the shoulder where the collarbone meets the shoulder blade. It can be injured (a ‘separated shoulder’) or wear with arthritis.
Common symptoms: pain at the top of the shoulder, tender to press, worse reaching across the body.
Treatment: usually non-surgical. Surgery is occasionally needed for severe injuries or persistent symptoms.
This leaflet gives general information for patients of Dr Anton Julyan and is written for a South African context. It does not replace the specific advice Dr Julyan, the anaesthetist or the nursing staff give you — their instructions always take precedence. Every patient, condition and recovery is different, and individual results vary. This is not a substitute for professional medical advice. In an emergency, phone 10177 (ambulance) or 112 from a mobile, or go to your nearest hospital casualty/emergency unit. © Dr Anton Julyan Orthopaedic Surgeon Inc. Draft for clinical review.