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INFORMATION FOR PATIENTS

Shoulder and elbow problems can be hugely debilitating.

The shoulder is actually part of a much larger system of interacting parts. The bony structures provide basic stability. The muscles not only play a role to induce movement but, in the case of the shoulder, also fulfill an important supportive and stabilizing function. Together with the capsule and connective tissue these elements can move the arm in all kinds of different directions in a stable manner. The back, neck and thorax also play an important role in the proper functioning of the arm and shoulder (kinetic chain). In order to ensure that the shoulder and arm can move properly, there are a number of joints which all have to function and interact properly. Any disruption to the mutual balance (disruption of the kinetic chain) can cause a variety of problems.

Shoulder problems often cause intense pain and prevent movement. Usually the patient experiences pain at night and when raising his or her arm. This pain can radiate to the neck, the upper arm, the elbow or the hand and can also cause a tingling sensation in the fingers. These complaints sometimes resemble symptoms which can be caused by neck problems.

Patients often feel the pain caused by shoulder problems somewhere other than where the actual problem is (often in the upper arm). All these factors often make it difficult to diagnose shoulder complaints.

The elbow is a hinge joint which, in the arm (hand, elbow, shoulder) chain, enables us, for example, to raise our hand to our mouth. Apart from this hinge movement, the lower arm can also rotate to allow us to turn the palms of our hands upwards or downwards. This is possible because the radius and the ulna can turn independently from each other. This rotational movement is a combination of movements of the wrist and elbow joints.

Elbow complaints can have a variety of causes, for example a tennis elbow, golfer's elbow, fractures or arthritis. Loose elements in the joint can lead to locking complaints of the elbow. Such elbow complaints can also be a consequence of a disrupted kinetic chain.

An important category of people with elbow problems are patients with rheumatoid arthritis.