The Chiltern HospitalLondon Road, Great Missenden, Buckinghamshire, HP16 0EN Directions
Inpatients: 24 hours
Day patients: 8am - 9pm
Due to COVID restrictions no visitors are currently allowed
Yes - 218 spaces
Struggling with a shoulder or elbow problem? We can help
Our fast access to advanced imaging equipment and diagnostic technology allows our team to begin your rehabilitation without delay. With a focus on exceptional care and a comfortable patient journey from start to finish, our shoulder and elbow specialists & supporting teams deliver world class treatment including tailored physiotherapy plans and cutting edge surgical procedures.
During your time with us you will enjoy a consultant-led care experience within the clean and comfortable environment of The Chiltern Hospital.
Often, a patient will book an appointment due to long term, persistent discomfort in the shoulder or elbow area, which can include pain and stiffness from the neck to the hands. It may be that pain is regularly waking you from sleep or that you are finding you do not have the full range of motion in your shoulder that you used to. Indeed you may have suffered an injury in day to day life, perhaps playing sports or as a result of an accident, which has caused a fracture, dislocation, break or other trauma.
A common cause of shoulder pain is shoulder impingement, which is when the rotator cuff tendons rub or catch on the bone at the top of the shoulder. As with many conditions in the area, mild cases can be treated with exercise, rest and painkillers, while more severe cases can require steroid injections and occasionally rotator cuff repair surgery, such as an arthroscopic decompression procedure.
5% of the population will at some point experience a persistent stiffness, known as frozen shoulder, which can also significantly inhibit movement. Once again, this condition can often be managed through physiotherapy exercises and painkillers, but in severe cases may require a procedure like arthroscopic frozen shoulder release.
Pain in the elbow is known as tennis elbow and is a common reason for seeing a shoulder and elbow specialist. Golfer’s elbow, a less common condition, refers to pain on the inside of the elbow. Both golfers and tennis elbow are helped by rest and physiotherapy exercises, though there is a surgical procedure available known as golfers and tennis elbow release. Although it is rare, issues with the elbow can also be related to arthritis.
Another cause of pain specifically in the front of the elbow may be distal bicep tendinopathy, which is usually a result of significant weight training, causing a degeneration of tendons surrounding the bicep. Pain related to this condition is often exacerbated by moving or twisting the forearm. If necessary this can be treated with an injection of platelet rich plasma (PRP) or surgery.
Pain, numbness and tingling in the forearm and the fourth and fifth fingers can be a sign of ulnar nerve entrapment, which may require elbow or wrist surgery. A consultant may also use splints to immobilize the elbow as part of the treatment plan, alongside physiotherapy.
Sports injuries and other major traumas, such as dislocated shoulders and breaks, may require a variety of treatments. For example a dislocated shoulder can require surgical procedures, including arthroscopic stabilisation, if tendons have been damaged or stability has been lost.
Shoulder replacement surgery as a result of arthritis is less common than hip and knee replacement, though it is considered as safe and effective. During this procedure, the ball and socket joint where the scapula and humerus meet is replaced. The joint then continues to rely on the rotator cuff muscles and tendons for functionality. Reverse shoulder replacement surgery is a different procedure which reverses the ball and socket joint so that the deltoid muscle is used for strength and function.
At your initial consultation, your consultant will lead a conversation about your medical history and ask for any relevant information about your symptoms, such as injuries, triggers, or possible long term factors. As well as describing your symptoms, your consultant will ask you to carry out simple movements as part of a physical examination to help them understand your condition. From this, your consultant will determine the next diagnostic steps, which will be one or several of the scans and tests available onsite at The Chiltern Hospital.
X-rays, which are used to investigate a myriad of conditions including frozen shoulder, are available the same day as your appointment. Our other state of the art diagnostic equipment includes imaging technology such as MRI and CT scanners which can identify structural issues and arthritis. Any test you require will be booked in for an appointment within two weeks.
Another way to diagnose shoulder and elbow conditions is to provide a steroid or anaesthetic injection to relieve pain, which, if successful, points to a certain diagnosis.
When the results of your diagnostic tests are ready you will be invited in to speak to your consultant about a treatment plan.
Treatment for the shoulder and elbow will often centre around physiotherapy exercises which build strength and functionality in affected areas. Often, a mixture of physiotherapy and painkillers can be enough to guide a patient to a sufficiently pain free and mobile future. Beyond this, your consultant will consider steroid injections and surgical procedures to yield successful long term results. Nevertheless, virtually every condition will require a considered physiotherapy plan, both pre and post surgery, and your consultant will work closely with the physical therapy team at The Chiltern Hospital to produce a tailored programme for you.
Should your consultant decide that a surgical procedure is required, they will talk you through this in detail and answer any questions that you have. If you are choosing to pay for your own treatment, we will offer you a fixed quote price, which will be sent to you in writing. If you are using medical insurance, be sure to contact your provider to obtain an authorisation code for treatment.
All surgery you receive will be carried out in the first class facilities of The Chiltern Hospital. Three of our state of the art operating theatres are specialised laminar flow theatres, which significantly reduce the chance of infection by generating a continuous flow of air. You will be seen by a physical therapist on ward after your procedure and continue to work with them for six to eight outpatient sessions during your rehabilitation and recovery.