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Shoulder & Elbow Problems

The Shoulder & Elbow Unit at Highgate Private Hospital operates with a multi-disciplinary collaborative approach to diagnose and treat injuries and conditions affecting all areas of the elbow and shoulder. You’ll have access to world-class Consultant Orthopaedic Surgeons, Sports & Exercise Medicine Specialists, Chartered Physiotherapists and onsite diagnostic imaging including MRI and CT, with radiology expertise from specialist MSK Radiologists.

Highgate Private Hospital is equipped with two state-of-the-art theatres built with laminar flow systems to specifically accommodate Orthopaedic procedures. Our theatre staff are highly skilled in MSK & Orthopaedic operations, and we also have an Orthopaedic Lead Nurse and all nurses are trained to assist with your recovery following Orthopaedic surgery.

Services & Treatments

At the Highgate Shoulder & Elbow Unit, we can treat a wide range of conditions and injuries of the elbow and shoulder. Whether you are suffering from a common condition to something more complex, we work with London’s leading Consultants and Specialists to offer you first-class care.

Shoulder Pain

Shoulder Pain and Surgery treatment at Highgate Private Hospital

Three bones make up your shoulder: the collar bone (clavicle), the shoulder blade (scapula) and the upper arm bone (humerus), which are controlled by several associated muscles and ligaments. Shoulder pain can be caused by injury or impairment to any of these bones, ligaments, muscles and tendons. There are also four major tendons, called the rotator cuff tendons. The shoulder joint (or glenohumeral joint) allows for a wide range of movement as it is a ball-and-socket, making it exceptionally mobile

 

 

There are many causes of shoulder pain. It is often brought on by sudden, high-stress movements in sports, or repetitive movements. Rowing is an example of a sport that can cause shoulder pain. Shoulder tendons may also tear, having worn down due to ageing and poor circulation in the tendons.

There are many reasons why you might be experiencing shoulder pain, including:

  • Adhesive capsulitis, also known as frozen shoulder is when a flexible tissue that surrounds the shoulder joint (called a capsule) becomes inflamed and restricts the range of movement in your shoulder.
  • Rotator cuffs can suffer from tears. Tendonitis and bursitis occur when the inflammation of tendons or the fluid-filled bursa sacs happens between the tendons and bones, due to repetitive overuse.
  • Although the shoulder joint is very moveable, shoulder instability can occur when the ball part of the shoulder joint does not move correctly in the socket. This can range from slipping to a full dislocation.
  • The acromioclavicular joint is at the top of the shoulder and the ligaments can suffer from tearing or stretching.
  • Osteoarthritis is a degenerative disease that can affect the shoulder joints.
  • Broken or fractured bones can occur if an injury breaks or fractures the humerus or collarbone.

Shoulder Procedures

Shoulder arthroscopy

Arthroscopy, also known as keyhole surgery, allows your surgeon to look inside your shoulder through a small cut using a miniature camera. This means that they can quickly diagnose problems and often treat them at the same time. Because this is a minimally invasive form of surgery, your recovery time is much quicker and you should experience less pain.

Rotator cuff repair

Your rotator cuff is made up of four muscles and tendons and connects your shoulder blade and your arm. If your rotator cuff is torn or impinged then your shoulder may feel less mobile, or even painful.

Treatment

Painkillers, anti-inflammatories, steroid injections or local anaesthetic injections can help you manage the pain, and physiotherapy can help. But if the tear is large, you may need rotator cuff surgery to able to use your shoulder normally again.

During your operation, which will use some form of anaesthetic and usually takes 45 to 60 minutes, your surgeon will release any impingement, usually by keyhole surgery. This involves shaving off some bone and removing thickened tissue. Further repairs to the rotator cuff might require open surgery, where your rotator cuff is reattached to the bone using stitches.

Brachial plexus surgery

The brachial plexus is a set of nerves that send signals from your spine to your shoulders, arms and hands. These nerves control the feeling and movement of your upper limbs. If you damage your brachial plexus, for example during sport or an accident, you may experience reduced muscle control, pain and weakness in the muscle, loss of sensation and even paralysis.

Treatment

Our expert consultants will use the latest imaging techniques, such as MRI and CT scanning or electrodiagnostic testing, to make a swift and accurate diagnosis. In most cases, you’ll be able to recover from your injury with physical rehabilitation therapy. But in more severe cases, particularly if you have sustained an avulsion (where the nerve is pulled from the spine) or a rupture (where the nerve has been stretched or torn), you may require surgery.

Depending on your injury, our surgeons may recommend one of the following operations:

  • Neuroma excision – to remove the swollen nerve
  • Neurolysis – to remove the scar tissue surrounding the nerve
  • Neurotisation – to relocate less important nerves to the damaged nerve
  • Nerve graft – to replace the damaged nerve with part of a healthier nerve

Elbow Procedures

The elbow joint is formed by the humerus, radius and ulna. The joint allows for rotation, flexion and extension of the forearm while the muscles surrounding the elbow control movement in our wrist and fingers. Elbow pain is generally a result of overuse, injury or age.

What should I do if I am experiencing pain in my elbow?

If you feel pain or discomfort in your elbow, your doctor may recommend an elbow arthroscopy, which will allow them to inspect, diagnose and treat your condition.

You may be given medication or offered physiotherapy, but if these options do not prove to be successful, you may need to undergo surgery. Many different conditions can be treated via an elbow arthroscopy, including osteoarthritis, rheumatoid arthritis and tennis elbow. Arthroscopy may also be performed to remove cartilage or bone fragments or to release scar tissue.

Elbow arthroscopy

Before the start of the arthroscopy, most patients will be given a general anaesthetic and so will be asleep during the procedure. You will be turned on your side for the operation to reduce bleeding. The surgeon will make small incisions in the elbow joint, into which a camera (arthroscope) and small operating instruments will be inserted. The arthroscope will guide the surgeons through the procedure by taking images of the area, which will be displayed on a monitor.

The nature of your procedure will depend entirely on your condition, which will be determined from an initial consultation.

Release of stiff elbow

Elbow stiffness often occurs after a fall or an injury to the elbow and is sometimes due to osteoarthritis. Common causes of elbow pain include sporting injuries like sprains, tennis elbow or golfer’s elbow, fluid building up over the elbow joint (bursitis) or trapped nerves. If you find it difficult to straighten your arm more than halfway or experience pain and discomfort when clenching your fist, your consultant may recommend surgery to release elbow stiffness.

Ulnar nerve release surgery

Your ulnar nerve goes around the back of the inner elbow, then through a tight tunnel between your forearm muscles. Increased pressure on this nerve can result in numbness in your little finger and ring finger.

Treatment

If you have mild symptoms that mostly happen during the night, a splint may help to hold your elbow straight while you are in bed. But if you’re experiencing discomfort then your consultant may recommend ulnar nerve release surgery to prevent further damage to the nerve. The surgery may improve any numbness in your hand as long as you have the operation in good time.

During your operation, which takes around 30 to 45 minutes and will use one of a variety of anaesthetic techniques, your surgeon will cut any tight tissue that is compressing the nerve over the back, inner side, of your elbow. They may need to remove some bone or shift a nerve to lie in front of the elbow.

Peripheral nerve block (upper limb)

Upper limb peripheral nerve block - anaesthetic injection in arm

An upper limb peripheral nerve block is an anaesthetic injection in your arm, close to the major nerves. It is often used to relieve pain during and after an operation by numbing the nerve. The block can be administered while you are conscious, sedated, or with a general anaesthetic. Sometimes you may have a peripheral nerve block instead of a general anaesthetic during upper limb procedures.

The injection can be given in various places, such as your forearm, wrist, elbow, or near to your collarbone or armpit. Our specialist anaesthetists will locate the best site for your injection using an ultrasound scanner and a nerve stimulator.

References:

EIDO Healthcare Limited – The operation and treatment information on this website is produced using information from EIDO Healthcare Ltd and is licensed by Aspen Healthcare. 

The information should not replace advice that your relevant health professional would give you.

Shoulder & Elbow Problems Consultants

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