💪
🏥 Gotokuji Orthopedic Clinic / Patient Guide

4 Common Shoulder Disorders

Calcific tendinitis · Proximal humerus fracture · Shoulder dislocation · Shoulder osteoarthritis

Shoulder pain looks alike on the outside but the underlying causes are very different. Four of the most important are calcific tendinitis, proximal humerus fracture, shoulder dislocation, and shoulder osteoarthritis.
Each one has a distinct treatment path, and an incorrect first call can leave lasting limitations.
We use bedside ultrasound to identify the cause quickly and treat on the spot when appropriate.

1
Calcific Tendinitis

Calcium hydroxyapatite deposits form in the rotator cuff and trigger sudden, intense inflammation

2
Proximal Humerus Fracture

A fall onto an outstretched hand breaks the upper part of the humerus — common in older adults

3
Shoulder Dislocation

Forceful contact in sports or trauma pops the joint out of place; recurrence is high in young people

4
Shoulder Osteoarthritis

Cartilage wears down with age, producing progressive pain and loss of motion

👵 Middle-aged & older 🤸 Falls 🏉 Contact sports 🦴 Osteoporosis 🧗 Prior dislocation in youth
🔥
Sudden severe pain out of nowhere (calcific)
🌙
Pain that keeps you awake at night
🤕
Swelling and inability to move after a fall
↩️
Sense of the arm "popping out" / repeated dislocations
🪟
Gradual loss of range — combing hair and dressing become hard (OA)
💊
Oral Medication
NSAIDs and acetaminophen control pain and inflammation. NSAIDs must not be used if you have a peptic ulcer or have ever had an asthma attack triggered by a painkiller (aspirin-induced asthma)
💉
Joint Injection
Corticosteroid or hyaluronic acid delivered to the joint. Injections are not given if there is infection at or around the site, are spaced at least 2 weeks apart, and are kept to a limited number
📡
Ultrasound-Guided Calcium Removal
Aspiration of the calcium deposit can produce dramatic relief
🧘
Rehabilitation
Range-of-motion and rotator cuff strengthening reduce recurrence
🩹
Reduction & Immobilization
Dislocations need prompt reduction — avoid leaving them >3 weeks
🔬
Surgery / Shoulder Replacement
Plates, intramedullary nails, or shoulder arthroplasty when indicated. We do not perform surgery here, so we refer you to a partner hospital
🌱

Most cases improve with conservative care if diagnosed correctly first

Calcific tendinitis can resolve on its own within 1–2 weeks. About 80% of proximal humerus fractures can be managed without surgery. Dislocations left untreated for over 3 weeks often need surgery, and first-time dislocations in young patients should be evaluated with MRI to plan recurrence prevention.

🔧

Anatomic vs. Reverse Total Shoulder Replacement.
If the rotator cuff is healthy, an anatomic prosthesis is used. If the cuff is severely torn, a reverse design uses the deltoid muscle instead — in Japan, generally for patients aged 70 and older. The right implant depends on age and rotator cuff status.

💡 4 Things to Remember

  • Sudden out-of-nowhere severe pain → suspect calcific tendinitis
  • Pain after a fall → rule out fracture before anything else
  • Dislocations are time-sensitive — never let them go past 3 weeks
  • The first decision shapes the outcome — see an orthopedic specialist with ultrasound capability early