Maxfacts

Shoulder

The treatment of shoulder issues lies largely in the areas of physiotherapy and, rarely, orthopaedic or upper limb surgery. Treatment of postoperative problems affecting the shoulder include:

• Physiotherapy to mobilise, reduce discomfort and improve function. Neck dissections of all types interfere to a greater or lesser extent with the spinal accessory nerve. This nerve provides part of the motor innervation to the trapezius muscle and the sternomastoid muscle both of which have an important role in shoulder stabilisation and mobility (trapezius by far the greater).
• Analgesia. Pain may be caused by muscle spasm or impingement of the muscles, tendons and bone of the shoulder as a result of trapezius muscle dysfunction. A range of suitable analgesics is available for pain relief.
• Counterirritation or similar techniques may help altered sensation.
• Genuine impingement or mechanical dysfunction may require upper limb surgical input. This is exceptionally rare.