SHOULDER
Common causes of shoulder pain, or reduced mobility, treated at Bridger Orthopedic include:
Shoulder problems can affect people at any age and activity level, from athletes and manual workers to retirees. Common shoulder conditions include instability (such as shoulder dislocations and labral tears), rotator cuff pathology (including impingement, tendinitis, and rotator cuff tears), and degenerative disease such as shoulder arthritis. These issues can cause pain, weakness, limited range of motion, and difficulty with everyday activities like lifting, reaching, or sleeping comfortably.
Our orthopedic shoulder specialists offer a full spectrum of non-surgical (conservative) treatments tailored to each patient. These options may include activity modification, targeted physical therapy and strengthening programs, anti-inflammatory medications, and image-guided injections to reduce inflammation and pain. For many patients, a structured rehabilitation plan focusing on restoring motion, improving shoulder stability, and strengthening the rotator cuff and scapular muscles can successfully relieve symptoms and avoid surgery.
When non-operative care is not enough, we provide advanced surgical treatment for shoulder conditions. Our orthopedic surgeons perform minimally invasive arthroscopic procedures for shoulder instability and rotator cuff repair, as well as open stabilizations when indicated. For patients with advanced arthritis or irreparable damage, we offer total shoulder arthroplasty (shoulder replacement), including anatomic and reverse shoulder replacements. Each surgical plan is customized to the patient’s condition and goals, with a strong emphasis on postoperative rehabilitation to restore function, reduce pain, and help you safely return to work, sports, and daily activities.
In the low back, nerves join to form the sciatic nerve, which runs down into the leg and controls the leg muscles. Sciatica is a condition that may cause radiating pain, numbness, tingling, and/or muscle weakness in the leg but originates from nerve root impingement in the lower back. Nerve impingement is most often caused by a herniated disk or spinal stenosis.
Stenosis refers to a narrowing of the spinal canal, usually in the lower back (lumbar) region. This narrowing is often a result of the normal degenerative aging process. It occurs as the disks of cartilage that separate the spine's vertebrae lose water and the space between the vertebrae become smaller, causing friction between the bones. The loss of water in the disks makes them less flexible and unable to act as shock absorbers in the spine. Daily wear and tear on the spine becomes more significant without these shock absorbers.
As the disks degenerate, vertebrae may shift, causing the spinal canal to narrow. In some cases, the nerves that travel through the spinal column to the legs become squeezed. This can cause back and leg pain, and even leg weakness. Arthritis and falls also contribute to the narrowing of the spinal canal, compressing the nerves and nerve roots and causing pain and discomfort.
Degenerative disk disease is a general term applied to back pain that has lasted for more than three months. It is caused by degenerative changes in the intervertebral disks in the spine and can occur anywhere in the spine: low back (lumbar), mid-back (thoracic), or neck (cervical).
Under the age of 30, these disks are normally soft, and they act as cushions for the vertebrae. With age, the material in these lumbar disks becomes less flexible and the disks begin to erode, losing some of their height. As their thickness decreases, their ability to act as a cushion lessens. The less dense cushion now alters the position of the vertebrae and the ligaments that connect them. In some cases, the loss of density can even cause the vertebra to shift their positions. As the vertebrae shift and affect the other bones, the nerves can get caught or pinched and muscle spasms can occur.
Degenerative disk disease is primarily a result of the normal aging process, but it may also occur as a result of trauma, infection, or direct injury to the disk. Heredity and physical fitness may also play a part in the process.
The spinal vertebrae are separated by flexible disks of shock absorbing cartilage. These disks are made of a supple outer layer with a soft jelly-like core (nucleus). If a disk is compressed, so that part of it intrudes into the spinal canal but the outer layer has not been ruptured, it may be referred to as a "bulging" disk. This condition may or may not be painful and is extremely common.
Herniated disks are often referred to as "slipped" or "ruptured" disks. When a disk herniates, the tissue located in the center (nucleus) of the disk is forced outward. Although the disk does not actually "slip," strong pressure on the disk may force a fragment of the nucleus to rupture the outer layer of the disk.
If the disk fragment does not interfere with the spinal nerves, the injury is usually not painful. If the disk fragment moves into the spinal canal and presses against one or more of the spinal nerves, it can cause nerve impingement and pain.
If the injured disk is in the low back, it may produce pain, numbness, or weakness in the lower back, leg, or foot. If the injured disk is in the neck, it may produce pain, numbness, or weakness in the shoulder, arm, or hand.
Radiculopathy refers to a condition in which the spinal nerve roots are irritated or compressed. Many people refer to it as having a "pinched nerve." Lumbar nerve impingement indicates that the nerve roots in the lower spine are involved, while cervical radiculopathy is associated with nerve roots in the neck. Nerve impingement is most often caused by a herniated disk or spinal stenosis.
An epidural is a potent steroid injection that helps decrease the inflammation of compressed spinal nerves to relieve pain in the back, neck, arms or legs. Cortisone is injected directly into the spinal canal for pain relief from conditions such as herniated disks, spinal stenosis, or radiculopathy. Some patients may need only one injection, but it usually takes two or three injections, given two weeks apart, to provide significant pain relief.
