Shoulder pain can arise for a number of reasons. Discomfort in the shoulder joint can often be explained by muscle spasms. But conditions such as osteoarthritis, injury or inflammation can also cause pain in the intricately constructed shoulder joint. Besides the muscles, the tendons, ligaments and bones can also be affected. Statistics show that the incidence of acute and chronic shoulder pain has risen considerably.

Ligament injuries and tears are most often caused by one of two things – degeneration or trauma – or by both together.

Degeneration – with age, ligaments lose their elasticity and become weak, which often leads to various micro-injuries. These accumulate over time until the ligament tears.

Trauma – a ligament tear can have several causes. Certain situations lead to shoulder problems, for example a fall or a blow after which you cannot raise your arm. If you fall on your elbow, an outstretched arm and so on, the shoulder ligaments can tear.

Painkillers only help for a short time. They cannot repair anatomical damage, so you should see an orthopaedic surgeon for a detailed examination of the shoulder.

Shoulder surgery

The quickest diagnostic method is ultrasound. An experienced specialist can assess shoulder injuries, but only magnetic resonance imaging (MRI) or computed tomography (CT) can provide a complete analysis of the problem. The sooner you see a doctor, the lower the risk of possible complications.

Whether shoulder surgery is needed, and how urgently, depends on an accurate diagnosis by a shoulder specialist and on how the condition develops. In Switzerland, shoulder operations are performed using minimally invasive (arthroscopic) and open surgical methods.

  • In open surgery, the doctor makes an incision in the skin that gives a clear view of the operating site.
  • For arthroscopic procedures, a minimal incision of 0.5–1 cm is sufficient, through which the surgeon inserts special thin tubes a few millimetres in diameter into the joint. Using these, the doctor can introduce a camera and other small surgical instruments into the joint and guide them along the tendons, bones and cartilage surfaces.

The advantage of arthroscopic surgery is that it removes the need for large incisions in the skin, soft tissues and other structures to obtain a good view of the operating field.

Recovery and rehabilitation

To protect the repaired ligament from tearing, the shoulder must be kept still, so the arm is supported in a sling for about 4–6 weeks (depending on the extent of the operation). Pain may last for up to 3–4 months.

After 4–6 weeks, physiotherapy should begin under the supervision of a specialist.

Once these six weeks have passed, the patient can resume light activities (such as driving a car), and after two and a half months can return to office work.

However, full recovery after shoulder replacement usually takes about six months, and returning to excellent shape and to your previous lifestyle takes 6 to 12 months.