Shoulder pain that won’t go away
Chronic shoulder pain is a common presentation to physicians. Multiple treatment modalities and specialists often have proposed extensive regimens of pharmacologic therapy without lasting results. Arthritis pain medications have disappointed over the years as arthritis developed anyway. Pain pills are temporary measures that are fraught with dependence and tolerance over long term usage. Therapy can help, but what if the pain persists? There are a variety of disorders in the shoulder that can remain injured, fail to heal, or shoulder joint structure has been altered as the result of surgery with Pain and joint function problems lasting after surgery. This can impact not only ordinary daily activities, job function, and exercise and sports performance. Shoulder pathology from the rotator cuff, glenoid labrum, gleno-humeral joint, acromio-clavicular joint, bursa, mu sculo-tendinous injuries, support muscles, trigger points, fractures, dislocations, avascular necrosis and joint degenerative arthritis all may be part of shoulder pain that won’t go away.
What remedies may realistically be then employed?
Regenerative medicine has taken hold in mainstream medicine. Healing the body by localized repair mechanisms has been done with surgical techniques of micro fracture. Attempting to allow the bone marrow to heal injured cartilage and bone in the joint is a stem cell therapy utilizing bone marrow cells to repair. This repair may be functional, yet often resulting tissue is fibrous tissue rather hyaline cartilage or desired bone.
Surgical repair techniques using biological scaffolds also are regenerative medicine techniques. Advanced Stem cell therapies incorporating mesenchymal autologous (your own cells) have been tried with both bone marrow and adipose cells to create a healing response. Platelet-Rich-Plasma (PRP) a concentrated source of your own blood platelets has been used intra-operatively to aid in post-surgical recovery and healing, as well as a standalone therapy in acute and chronic shoulder pain.
Future directions for biological therapy include gene therapy implanted in cells to direct a targeted response.
Biologic regenerative therapies such as PRP and Stem Cell Therapy may be viable alternatives to shoulder surgery, including shoulder joint replacement surgery, when shoulder pain won’t go away.