Rotator cuff/ SLAP tear/ Cervical Strain

ROTATOR CUFF/ SLAP TEAR/ CERVICAL STRAIN
Rotator cuff/ SLAP tear/ Cervical Strain are common medical conditions that affect the shoulder joint and neck area. The shoulder joint is like a ball and socket and is composed of three main bones:

• The upper arm bone
• Shoulder blade
• Collar bone

The Rotator cuff is a group of muscles and tendons that compose the shoulder joint that keeps and hold the upper arm bone firmly within the shallow socket of the shoulder. Repeated overhead motions cause injuries and tear to the soft cartilage of the shoulder causing pain. Rotator cuff injuries are common in people who repeatedly perform overhead motions like painting or tennis playing.

A SLAP tear is caused when the ring of cartilage and fibrous tissues outside the socket that holds the upper arm bone is injured. SLAP stand for superior labrum anterior and posterior and a Slap injury occurs in the top area or in the front or back of the cartilage joint. A SLAP tear occurs due to a trauma or repeated shoulder stretch motions.

Cervical strain occurs when a muscle or tendon is stretched or torn in the neck and shoulder plates causing pain and stiffness in the area. Cervical strain occurs from an accident, fall or sports injury. It is often confused with trigger points in the Trapezius muscle, which are taut bands/ thickened areas of muscle which cause referred pain.

Common symptoms associated with these conditions include pain and stiffness limiting the range of motion and arm weakness. The patient will feel a dull ache all over the shoulder plates and neck and find it difficult to raise the hands above the head. Besides, trauma and sport injury, degeneration of bones with age can also causes these conditions.

Conventional treatment methods include surgical methods like arthroscopic rotator cuff/SLAP tear repair, open repair of rotator cuff, tendon transfer and reverse shoulder replacement.

ALTERNATIVE TREATMENT METHODS AT BETH YEHUDAH ARTHRITIS CENTER, PULLAD AND DAYSTAR CLINIC, ALAPPUZHA FOR ROTATOR CUFF/ SHOULDER-

1) Platelet Rich Plasma in Partial tears of Rotator cuff/ Cervical strain/ minor SLAP tears : Plasma rich platelet prolotherapy is the recent trend in treating various joint conditions and is designed to stimulate repair of chronically inflamed synovium, partially torn ligaments in the affected joint and to reduce swelling and pain caused by the condition. PRP therapy is directly administered at the site of the partial Rotator cuff tear/ Cervical strain/ minor SLAP tear. This treatment may help a patient who does not want surgery and helps to overcome the disease condition with minimally invasive injection techniques. The treatment method stimulates the natural immune repair mechanisms of the body and delivers the building block essential to build and repair damaged tissues.

How does PRP work? Blood components are of four major types - plasma, platelets, white blood cells and red blood cells. Platelets assist in clotting and are also the “first-responders” of the body post injury; helping repair an injured region and in building up of new tissue and thereby promoting the healing process. Once platelets contact collagen in damaged tissues, the platelets release various biological growth factors (Table 1 as given below) to promote healing in soft tissues locally. Activated platelets commonly release the following growth factors:

Table 1: Various biological growth factors released by PRP when activated

PRP injection delivers a high concentration of autologous (patient’s own) platelets to the site of the partial Rotator cuff tear/ cervical strain/ minor SLAP tear. Platelets present in the blood are the first responders to an injured area and helps build up new soft tissues. Introducing high concentration of platelets directly into the site using PRP injection stimulates the healing process and faster recovery from the joint condition.

Patient Benefits of PRP Prolotherapy:

• Minimally invasive treatment method
• Almost painless injection technique using very thin needles under local anesthesia
• For those who wish to avoid if not delay Surgery for partial Rotator cuff tear/ Cervical strain/ minor SLAP tear.
• Significantly reduces the symptoms associated with partial Rotator cuff tear/ Cervical strain/ minor SLAP tear.
• Reduced risk of adverse events
• Repairs and tightens ligaments improving joint stability.
• Safe and effective treatment method
• Faster healing and recovery
• PRP Prolotherapy results in safe, significant, effective, progressive improvement of shoulder pain, function and reduction of stiffness.
• The throbbing pain is stopped by stimulating the healing mechanism at the source of the ligament.

2) Prolotherapy for Shoulder: Prolotherapy is a natural and cost effective alternative method to surgery. Prolotherapy is an almost painless injection technique under local anesthesia where very thin needles are used to inject high concentrations of dextrose solution (sugar similar to glucose) in to the region of partial tear of rotator cuff. Prolotherapy works by increasing the glucose concentration in the fluid outside the cells. This results in movement of fluid from inside the cells through the cell membrane to the outside of the cells thereby shrinking the cells and causing temporary cell damage (hyperosmolar damage). As the cells are temporarily damaged, they release many biosignals to the body which results in stimulation of the immune system of the body to accelerate the inflammatory process locally resulting in increased local blood circulation, fibroblast (fibrous cell) proliferation, ligament/ tendon regeneration, tightening and repair. This treatment method has the ability to strengthen the existing intact, but weakened, ligamentous and tendinous structures in the joint as well as partial tears of the rotator cuff. Along with the treatment technique, it is important to perform series of movement and muscle strengthening exercises to strengthen the already weakened muscles due to the compromised joint condition.

Patient Benefits of Prolotherapy:

• Minimally invasive treatment method
• Almost painless injection technique using very thin needles under local anesthesia
• Avoid if not delay Shoulder Surgery
• May significantly reduce the symptoms associated with partial Rotator cuff tear/ Cervical strain/ minor SLAP tear.
• Reduced risk of adverse events
• Repairs and tightens ligaments improving joint stability and ease of walking
• Safe and effective treatment method
• Faster healing and recovery
• Prolotherapy usually results in safe, significant, effective, progressive improvement of shoulder pain.

At Beth Yehuwdah Arthritis Centre, Pullad and Daystar Clinic, Alappuzha, we have facilities to treat you and help you to recover from the above mentined medical conditions affecting the shoulders. To know more about partial Rotator cuff tear/ Cervical strain/ minor SLAP tear treatment and costs, book an appointment now.