How to treat a diseased shoulder joint

Pain in the right shoulder can occur for various reasons: inflammation of the tendons, arthritis of various origins, arthrosis, pain “backache” with osteochondrosis of the cervical spine, etc.

The nature of the lesion of the shoulder of the right hand, its course, symptoms and treatment are the same as in the case of pathology of the left joint. But since most people are right-handed, for the same reasons, the right shoulder joint is more often affected – after all, it experiences maximum stress during physical exertion, while working with hands, when practicing some sports (for example, tennis).

The severity of complaints of a patient with joint damage can be different: from minor, transient pains to a painful pain syndrome, which is accompanied by loss of joint function. The severity of the condition depends on the disease, the degree of its development, the adequacy of the treatment (or lack thereof). For example, with arthrosis at the initial stage, the symptoms are little expressed, joint function suffers slightly, and with infectious arthritis there is acute pain, fever and swelling of the shoulder.

The prognosis for pain in the right shoulder most depends on the timeliness of treatment: the sooner therapy is started, the more likely it is to maintain range of motion in the arm or to achieve full recovery. In the general case, pain in the right shoulder can be successfully cured, but the process of therapy, its complexity and results – all this depends on the particular disease.

If you have pain in the shoulder, you should immediately consult a doctor (orthopedic traumatologist, arthrologist or first therapist), who will find out the cause and prescribe the optimal treatment.

Important! By anatomy, the shoulder is a hand from the shoulder joint to the elbow; pain in this area is noted with a number of diseases of the internal organs: with cholecystitis, pancreatitis, angina pectoris. In this article I proceed from a more “popular” concept that the shoulder is the shoulder joint.

Further in the article: the main reasons why pain occurs in the right shoulder (possible pathologies), diagnosis and treatment methods.

The main causes of pain in the right shoulder

The eight most likely reasons why your right shoulder arm joint may hurt:

Tendonitis is an inflammation of the tendons in the shoulder joint that occurs due to an unbalanced, excessive exercise.

Arthritis is an inflammation of the joint for various reasons (infections, allergies, immune diseases, etc.).

Arthritis (inflammation) of the shoulder joint

Periarthritis of the shoulder-gland – inflammation of the periarticular tissues (capsules, ligaments, muscles).

Arthrosis is a progressive destruction of the cartilage, which leads to damage to the articular surfaces.

Arthrosis of the shoulder joint

Bursitis is an inflammation of the joint bag.

With osteochondrosis of the cervical spine, the pain can “give” to the shoulder.

Rarer causes: metastases of the tumor to the joint (metastases – that is, secondary foci of the tumor that arose due to the transfer of the “cause of the tumor” from the primary focus of the disease), chondrosarcoma (cancer of the articular cartilage), tuberculosis of the joint (their destruction).

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Possible pathologies

It is possible to assume which particular illness caused the pain in the right shoulder for some typical symptoms:

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It occurs more often in people of young and middle age, physically active, including those involved in sports. There is a connection between strong and (or) long-term shoulder loads and the occurrence of pain. The pain itself is dull, at rest it may be absent, but it occurs with movements in the shoulder.

Arthritis is characterized by an acute onset and severe signs of inflammation in the joint: it feels hot to the touch, hurts at rest and especially with movements, swells, the skin above it is red, movements in the shoulder are limited.

It develops for the same reasons as arthritis, has similar symptoms.

Usually occurs in people of middle and old age, developing after injuries, hypothermia, excessive loads. The pains are quite sharp, associated with movement in the arm. There are no external signs (the shape of the joint does not change).

In the shoulder joint, arthrosis occurs mainly in elderly people whose professional activity was associated with stresses on the right hand (tennis players in the past, people with hard physical labor; perhaps teachers, writers, secretaries – who write or type a lot of time, especially if the hand is in an uncomfortable position).

The disease progresses gradually: first, the shoulder hurts at the end of the day, over time, the joint gradually deforms. Characteristically increasing limitation of joint function.

The occurrence of pain is clearly associated with a previous injury or a sudden sharp and heavy load.

For pain in the shoulder due to osteochondrosis, this disease is also manifested by other symptoms: pain in the neck, back, crunch in the neck with movements of the head.

Cancer metastases or chondrosarcomas (articular cartilage cancer)

They appear against the background of cancer symptoms of any localization (cancer of the lungs, thyroid gland, liver, bones of the arm can metastasize to the shoulder). Often the diagnosis is already known.

With chondrosarcoma, the tumor is primarily located in the shoulder. The pains are very strong, painful, the function of the joint is quickly lost.

It is relatively rare. Gradually increasing pains are typical: at first dull, at night; then constant and pronounced. Often there is a prolonged increase in temperature within 37,5 degrees, sweating, weight loss against a background of good appetite.


The doctor should determine exactly the reason why the shoulder on the right hurts. An experienced specialist, based on complaints and examination, will be able to suggest a diagnosis, and radiography helps to confirm it. Additionally, computed tomography, ultrasound of the joint, a blood test (general, biochemical analyzes) are performed.


Treatment of pain in the shoulder joint of the right hand is carried out depending on the identified cause:

  • with tendonitis and arthrosis – limit the load;
  • with bursitis and arthritis of infectious origin, antibiotics are used;
  • with osteochondrosis, it is necessary to treat the underlying disease, and the shoulder joint has nothing to do with it;
  • with joint tuberculosis, anti-TB drugs are prescribed;
  • with metastases and chondrosarcoma, antitumor therapy (radiation, chemotherapy) or surgical treatment.

In all cases, painkillers are actively used: for cases not related to cancer, the use of non-steroidal anti-inflammatory drugs (nimesulide, diclofenac, etc.) is sufficient. In acute pain, they can be injected for some time, and then switched to tablets.

The duration of treatment also depends on the cause of the problem:

  • most forms of arthritis, bursitis, tendonitis respond well to treatment and end in recovery or prolonged remission;
  • arthrosis and osteochondrosis are incurable, but pain can be stopped by constant or course taking anti-inflammatory drugs, physiotherapy, special exercises that develop the joint;
  • with tuberculosis, treatment is long, but after a full course of therapy, recovery is possible;
  • in cancer, the prognosis depends on the time of establishing the correct diagnosis.


A positive result in the fight against pain in the shoulder of the right hand depends most of all on timely diagnosis and the adequacy of treatment. Therefore, do not try to find out the cause on your own, and do not take painkillers for more than 2-3 days without a doctor’s prescription – this can lead to “blurring” of symptoms and difficulties in diagnosis.

All about joints

Shoulder joint inflammation or arthritis is a serious disease in which a sick person gradually develops degeneration and degeneration of the articular cartilage. In this condition, the affected shoulder gradually loses its function.

Consider in more detail the symptoms of inflammation of the shoulder joint and the most effective methods of treating this ailment.

Causes of Shoulder Inflammation

Most often, arthritis of the shoulder joint is observed in people with an age of forty-five to sixty-five years. In this case, the following factors provoke such a disease:

1. Strong hypothermia.

2. Excessive physical exertion on the shoulder joint (especially weight lifting).

3. Earlier injuries of the shoulder joint, which gave a complication in the form of inflammation.

4. Complication after acute viral illness (influenza, acute respiratory viral infections, etc.).

5. Allergic reaction.

6. Infection in the open shoulder wound.

7. An insufficiently active lifestyle that led to hypokinesia.

8. Deterioration of articular tissues.

9. Ingestion of harmful fungi or bacteria that lowered immunity. In this state, substances that must fight dangerous microbes will be worse “working”, so a person will become more susceptible to various diseases, including arthritis.

10. Professional exercise in which a person constantly exerts strain on the shoulder joint and injures him.

11. The lack of nutrients in the body.

12. Various pathologies of the nervous system can also cause inflammation of the shoulder joint. Moreover, disorders in the central nervous system can cause exacerbation of gastrointestinal diseases, disruptions in the hormonal system, and also worsen the functioning of the male and female reproductive systems.

13. Tuberculosis, which is not treated, can cause significant harm to the musculoskeletal system of a person.

14. Frequent intake of alcohol-containing drinks.

15. An insect bite on the shoulder, and the ingress of poison directly into the joint capsule.

16. Various failures in the human endocrine system.

19. Genetic predisposition of the patient to the development of arthritis.

20. The period of menopause in women can also affect the development of inflammation in the joints.

Symptoms, signs and forms of inflammation of the shoulder joint

Inflammation of the shoulder joint has the following symptoms:

1. At first, the person will feel a slight pain in the shoulder area. Over time, the pain will become clearly localized and acute. The pain will also intensify after physical exertion on the hands.

The nature of the pain: aching, shooting, stitching, burning. In addition, sometimes the pain spreads not only to the shoulder, but also to the neck, the area of ​​the shoulder blades and gives to the back.

2. The appearance of severe swelling of the joint.

3. Perhaps a slight reddening of the affected shoulder area.

4. An increase in body temperature.

5. Weakness and aches in the body.

7. Imbalance in shoulder movement.

8. A feeling of stagnation in the shoulder.

9. The appearance of a characteristic crunch in the shoulder.

10. Difficulty in raising a hand. At the same time, stiffness in the joint will increase every day and will be especially pronounced in the morning.

11. Aching pain can occur at night, preventing a person from falling asleep. In addition, such a symptom will be quite difficult to remove with conventional analgesics.

12. Deterioration of the general well-being of the patient.

When the first signs of arthritis appear, doctors recommend immediately diagnosing and choosing treatment. This is the only way to protect yourself from the development of dangerous complications and the transition of inflammation into a chronic form.

In addition to the main symptoms, arthritis can manifest itself in different ways and depending on the stage of the disease. Three degrees of neglect of arthritis are distinguished:

1. The first stage is accompanied by aching pain in the joint that occurs after physical exertion and completely disappears at rest. There may also be weakness in the arm and shoulder.

2. The second stage is characterized by the appearance of a more severe pain syndrome and a crunch in the hand. The movements are preserved.

3. The third stage is accompanied by very sharp pains and impaired shoulder function. It is difficult for a person in this state to move his hand. The cartilage of his shoulder deforms irreparably.

Depending on the cause of arthritis, two types of it are distinguished: acute and chronic.

An acute form of inflammation usually develops due to infection. It has pronounced symptoms and the rapid development of deterioration.

A chronic form of arthritis can occur due to trauma or metabolic disorders. In this state of a person, outbreaks of pain will torment from time to time.

The chronic form of inflammation is considered to be the most dangerous, since it can cause deformation of the cartilage and atrophy of the joint, especially if the person does not start treatment on time.

The general course of arthritis largely depends on its variety.

There are four separate subspecies of arthritis:

1. Rheumatoid arthritis. As a rule, it has a chronic course and develops in people with a genetic predisposition to joint inflammation.

With this form of arthritis, the patient is strongly affected by the cartilage tissue of the joint, its deformation and loss of mobility develops. In addition to these signs, a person may suffer from pain during palpation of the shoulder, dizziness and swelling of the joint.

2. Rheumatoid arthritis occurs as a complication of rheumatism. It is characterized by an increase in white blood cells in the patient’s blood (a clear sign of inflammation), swelling of the joint and a large stiffness of the arm.

3. Infectious arthritis causes an infection that develops in the human digestive tract or urogenital system. In this case, the disease begins to manifest itself already two weeks after ingestion.

Symptoms of this type of arthritis will be an increase in body temperature, joint pain and swelling.

4. The post-traumatic form of arthritis occurs as a complication from previously transferred herbs and bruises. Moreover, such a disease can develop over the years, causing first a crunch in the joint, and then its swelling and pain.

Shoulder inflammation: treatments

The treatment of shoulder arthritis involves the following types of therapies:

Drug therapy involves the appointment of such groups of drugs:

1. Nonsteroidal anti-inflammatory drugs. They are necessary for the patient to suppress inflammation and reduce pain. Typically, such drugs are prescribed for this purpose:

• Diclofenac (for local use).

2. Man needs analgesics to eliminate the pain that arthritis causes. Usually used for this:

• Paracetamol in tablets;

3. Ointments and creams for topical application are needed to relieve inflammation and partially pain. In addition, they will enhance the effect of oral medications. The best drugs in this area are:

These drugs need to be applied to the affected shoulder 3-4 times a day.

4. Glucocorticosteroids are drugs that will help restore the former mobility to the affected joint, relieve inflammation and pain. They need to be stabbed directly into the sore shoulder.

5. Chondroprotectors. They will help slow down the process of destruction of the diseased joint and restore already affected tissue. They should be selected by the attending physician depending on the severity and neglect of the disease in each case.

It is important to know that you can’t prescribe any drugs on your own, since they can cause severe complications in the condition. You can take only those medicines that your doctor will prescribe.

Shoulder inflammation: treatment features

After drug therapy, physiotherapeutic treatment is prescribed. It provides for the following procedures:

3. Therapeutic massage;

4. Therapeutic gymnastics;

Physiotherapeutic treatment is aimed at relieving pain and inflammation, as well as improving blood circulation.

Surgical treatment is carried out when the patient has advanced inflammation of the joint, its severe deformation and loss of mobility. In this case, the method of endoprosthetics or replacing your bone with an artificial implant is used.

The rehabilitation period after such an operation is quite long (from two to four months). Thanks to modern techniques, the patient after full recovery will be able to regain joint mobility and get rid of pain.

How to treat a shoulder joint

How to treat a shoulder joint? The issue is relevant for everyone who has encountered problems of the shoulder joint. These problems can be of completely different nature. These can be various bruises accompanying sprains, ruptures of ligaments, muscles and tendons, there may be bone fractures, and in some cases we can talk about chronic diseases that threaten disability and complete disability of the upper limb. Such diseases, as a rule, include otoearthritis, deforming arthrosis, tendonitis, bursitis, etc.

How to treat a shoulder joint after an injury?

Shoulder joint orthosis

Injury to the shoulder often leads to sprain. Moreover – this is the main damage to the shoulder joint, provoked by trauma. Ligaments play a very important stabilizing and fixing function, if treatment is not provided in time, the humerus can often fall out of the articular cavity – dislocation, arthrosis, bursitis, etc. can develop.

How to treat shoulder ligaments?

To relieve pain, it is necessary to resort to the use of anti-inflammatory drugs, for example, nimide, ketanova, analgin. In the fight against sprains, warming ointments, strengthening massage and performing rehabilitation exercises are also effective. This will be the main answer to the question if the shoulder joints hurt than to treat.

If only a sprain was diagnosed, then it is enough for the shoulder to ensure a state of rest for a certain period. You can also periodically (especially at first), apply cooling compresses.

If the stretching is more serious and burdened by partial tears of the soft tissues, then calipers are prescribed by doctors. These are reliable clamps that allow you to hold the shoulder in an anatomically correct position. Orthoses are also often prescribed.

Shoulder dislocation how to treat? Often injuries, especially falls on an outstretched arm, provoke dislocations. In this case, the humerus goes out of its position – the clavicular cavity. To treat a dislocation, you must first correct the joint, a competent specialist must do this, in no case should you deal with such a procedure yourself at home.

Further therapy, as a rule, involves wearing calipers, elastic bandages or orthoses. They normalize muscle tone, restore blood circulation, strengthen ligaments and tendons. If the dislocation did not lead to a rupture of the cuff, joint lip or capsule, then wearing retainers lasts an average of 2 weeks, in the event that a rupture of the lip or capsule occurs, then stitching is carried out, and then the calipers are worn.

Treatment of chronic serious shoulder diseases

Osteochondrosis of the shoulder joint

Salt warmer for osteochondrosis of the shoulder joint

If the patient suffers from osteochondrosis of the shoulder, then all the victims are forced to know how to treat osteochondrosis of the shoulder joint. As a rule, the treatment is long, it covers a whole range of measures, for example, medication, physiotherapy, massage procedures, restorative exercise therapy, etc.

Osteochondrosis of the shoulder joint develops due to degenerative and degenerative changes in the cervical vertebrae.

Since the shoulder joint is closely connected with the thoracic region and neck with ligaments and nerve endings, thoracic and cervical osteochondrosis often end in this disease in the shoulder as well.

In this case, compression of the nerves occurs, which provokes a burning, stitching, sharp pain. Also, osteochondrosis of the shoulder is characterized by stiffness, a decrease in the amplitude of movements, and rapid tiredness of the joint.

How to treat chondrosis of the shoulder joint? Physiotherapy is required to eliminate osteochondrosis: magnetic therapy, wave therapy, warming up, electrophoresis and treatment with hot wax. Indispensable are also exercise therapy exercises that help strengthen muscles, tendons and ligaments, prevent rapid fatigue of the shoulder, restore blood circulation. Especially effective gymnastics with abduction and adduction movements of the shoulder to the head, neck, and rotational movements of the shoulder also help.

Shoulder bursitis

How to treat bursitis of the shoulder joint? To answer this question you need to know what bursitis implies. Bursitis is a disease characterized by severe inflammatory processes in the joint capsule and synovial membrane. It is characterized by lesions of the synovial membrane, which generates synovial fluid synthesis. This fluid has a lubricating and shock-absorbing function, so that the articular bones do not rub. With bursitis, this fluid is released in excess, therefore, among the symptoms: severe swelling of the shoulder joint, swelling, possible redness of the skin, pain in the shoulder, a feeling of excessive pressure in the joint. If you do not provide proper treatment, then you can get arthrosis. Before you know how to treat arthrosis of the shoulder joint, you need to get rid of bursitis.

An effective method of treating bursitis is puncture – puncture of the synovial membrane, ridding the joint cavity of excess fluid and disinfection of the joint with an anti-inflammatory solution. Exercise gymnastics, physiotherapy and anti-inflammatory ointments are also effective. In the event that bursitis has reached the last stage, they resort to surgery and removal of part of the joint capsule.

Arthritis of the shoulder joint

How to treat shoulder arthritis? Actual question for those who were diagnosed. The thing is. That the treatment of arthritis is significantly complicated, since it will completely depend on the form of the disease.
Electrophoresis for polyarthritis of the shoulder joint

All types of arthritis are characterized by inflammatory processes in the joint. In this case, cartilage, ligaments, and bone tissues with dystrophy, atrophy, and degeneration are affected. Therefore, arthritis can lead to disability.

However, their danger lies in the fact that they are often diagnosed in the late stages, when all joints of the body begin to be affected. If a diagnosis of polyarthritis of the shoulder joints has been made, then this may be a signal to combat the disease in all other joints of the body.

How to treat polyarthritis of the shoulder joint? This form of arthritis requires intensive exposure through physiotherapeutic procedures. For this, electrophoresis, warming, wave therapy and wax applications are prescribed. Of the medicines, chondroprotectors are used that support the elasticity of the ligaments, as well as the integrity of the cartilage, anti-inflammatory drugs, for example, diclofenac, ketalorak, ketans, analgin and nimesil. Warm ointments are also prescribed.

Arthritis can affect primarily tendons, muscles and ligaments, then we are talking about periarthritis. How to treat periarthritis of the shoulder joint? Here, the main role is played by chondroprotectors, physiotherapy and exercise therapy procedures that must be developed by an exercise therapy trainer so that the complex corresponds to the stage at which the disease is located, otherwise there is a risk of aggravation of the disease.

Shoulder pain
why the shoulder hurts, the cause of shoulder pain

Most often, shoulder pains are unsharp, bruising or aching. But sometimes shoulder pains are so severe that they are comparable to toothache — they deprive a person of sleep and peace. And almost always perceived by the sick as a disaster.

Nevertheless, to cope with pain in the shoulder or shoulders, no matter how strong it is, in the vast majority of cases it is not too difficult. It is only necessary to make the correct diagnosis and prescribe the correct treatment for the shoulder joint.

So. Why does my shoulder hurt?

Doctors who are not well versed in diseases of the shoulder joint usually have only 2 answers to this question. If any patient complains of shoulder pain, these doctors will say that “it hurts because of the neck,” or they will diagnose “arthrosis of the shoulder joints”.

In fact, arthrosis of the shoulder joints is quite rare – only about 5-7% of the total number of cases of shoulder pain account for arthrosis.

Can my shoulder hurt from my neck? Yes maybe. But this is also not the most common cause of shoulder pain.

The most common cause of pain in the shoulder joint is a widespread disease called shoulder-shoulder periarthritis. It accounts for more than 50% of all cases of shoulder pain.

The second place is really “pain due to the neck,” that is, damage to the cervicothoracic spine with a backache in the arm or shoulder. About 30% of cases of shoulder pain.

Arthrosis of the shoulder joint, as we found out, is about 5-7% of cases of shoulder pain.

Another 5-7% is accounted for by arthritis, which occurs with inflammation of the shoulder joint. For example, the shoulder often hurts or becomes inflamed with rheumatoid arthritis, ankylosing spondylitis, rheumatism, psoriatic arthritis, polymyalgia rheumatism.

And a few percent of people suffer from shoulder pain that has arisen for other reasons: due to vascular disorders, stiffness of the neck muscles, and liver diseases.

Acute shoulder pain

Attention! Suddenly occurring acute pain in the left shoulder, which began literally in a second against the background of full health, may be the first symptom of a heart attack! Seem to the cardiologist!

Suddenly started acute pain in the right shoulder, also arising against the background of full health, may be the first symptom of an attack of gallstone disease!

Shoulder pain that lasts longer than a few days: causes

Below I will briefly talk about the distinctive features of those shoulder diseases that occupy several of the top lines of our “rating” and are quite common.

1. Periarthritis of the shoulder blade

This disease usually begins after an unsuccessful movement of the hand, after sleeping in an uncomfortable position, or after overloading the hands with unusual physical work.

In case of shoulder-shoulder periarthritis, one shoulder can become ill – right or left. But it often happens that both shoulders become inflamed at once.

The main symptom of brachiocephalic periarthritis is a significant restriction of certain movements in the arm.

For example, the hand does not rotate well around its axis clockwise or against it, it is difficult to wind up behind the back and rises poorly through the side up. When trying such movements, very sharp pains in the shoulder can occur.

Sometimes the mobility of a hand with periarthritis is reduced so much that a sick person can’t raise his hand behind his back, can’t raise his hand, comb his hair or put his hand in the sleeve of a shirt or jacket.

Pain in the shoulder with shoulder-shoulder periarthritis can be unsharp, aching. But often the pains are very severe. They can occur even at night, and with the most severe forms of periarthritis, shoulder pain just at night becomes completely unbearable.

2. Shoulder pain caused by damage or a hernia in the cervical spine

Most often, pain from the neck shoots only in one hand – in the right or left. In both hands, neck pain rarely shoots. The second hand either does not hurt at all, or it hurts less and in other areas.

At the same time, a sick hand is often “shot” not only in the shoulder, but also along its entire length – to the very tips of the fingers.

Pain in the shoulder with a backache from the neck can be quite severe. Moreover, in some people the injured hand hurts during the day, when moving. And others hurt at night, in the middle of sleep.

A key feature of the lumbago: in contrast to the shoulder-shoulder periarthritis or shoulder arthrosis, in this case normal mobility of the arm is almost always maintained. Only sometimes the ability to raise a sore arm above the head and fully extend it upwards is slightly reduced.

3. Arthrosis of the shoulder joints

Most people over the age of 45 suffer from arthrosis. Often sick men who have worked for many years in hard physical work: builders, locksmiths, blacksmiths. And also – professional athletes: weightlifters, tennis players, shot putters, etc.

Pain sensations with arthrosis of the shoulder joints are usually very weak, quite tolerable. And these pains arise only when moving.

When moving in an arthritic joint, a crunch is heard. The mobility of the shoulder joints with arthrosis is reduced, but not much.

The appearance of sick shoulder joints with arthrosis is practically unchanged. The general condition of patients and body temperature remain normal.

Read more about arthrosis of the shoulder joints “material is being prepared.

4. Inflammation of the shoulder joints with arthritis

Of all arthritis, inflammation of the shoulder joints most often develops with ankylosing spondylitis and rheumatoid arthritis, less commonly with articular rheumatism and psoriatic arthritis, very rarely with gout.

A distinctive feature of inflammation of the shoulder joints with arthritis: usually some other joints become inflamed first. For example, knees or feet, or fingers or toes. And only then the shoulders get sick.

Arthritis begins quite rarely with the shoulder joints – although sometimes it does.

Pain in the shoulders with arthritis is most pronounced at rest, late at night or in the morning, but subside in the afternoon and evening. When moving or after a light warm-up, such pain is most often noticeably reduced.

The mobility of the shoulder joints with arthritis is almost always reduced in the morning, but by noon, especially after a light warm-up, the range of motion in the shoulders can fully recover (except in cases of chronic arthritis).

The general condition of patients with arthritis is often unsatisfactory – the patient may have a fever, weakness, chills, body aches.

5. Other, more rare causes of shoulder pain, in the article – 3 diseases that most doctors do not know about

A video with gymnastics for treating shoulder pain can be seen here.

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Anatoly Kudravets

Anatoly Kudravets, Orthopedic Traumatologist. He works with severe cases, practices operative methods of treating connective tissues