Understanding Parsonage Turner Syndrome

What is Parsonage Turner Syndrome?

Parsonage Turner Syndrome sounds scary, but think of it like this: your shoulder's electrical system has gone haywire. Just like when the lights flicker in your house during a storm, the nerves that control your shoulder muscles get inflamed and stop working properly.

This condition goes by several names - you might hear it called brachial neuritis, neuralgic amyotrophy, or acute brachial neuropathy. But they all describe the same thing: inflammation of the nerves that run from your neck down to your shoulder and arm.

Here in Durango, I've seen this condition affect everyone from retired ranchers to grandparents who love to garden. One patient described it perfectly: "Doc, it felt like someone hit my shoulder with a baseball bat in the middle of the night, and then my arm just wouldn't work right."

What Causes It?

The honest answer is that we don't always know exactly what triggers Parsonage Turner Syndrome. Sometimes it happens after:

• A viral infection (like a cold or flu)

• Recent surgery or medical procedures

• Vaccinations

• Physical trauma or injury

• Severe stress on the body

But sometimes it just appears out of nowhere. I've had patients in Cortez and Pagosa Springs who developed it after seemingly normal activities like lifting grandchildren or working in their gardens.

How Common Is It?

This isn't something you hear about every day. It affects about 1 in 1,000 people each year. Men get it slightly more often than women, and while it can happen at any age, I see it most commonly in people between 40 and 60 years old.

What Are the Symptoms?

The symptoms usually come in two stages, like a storm that hits hard and then settles into a steady drizzle.

Stage 1: The Pain Phase (Usually lasts 2-4 weeks)

The pain is often the first and worst symptom. Patients tell me it's unlike anything they've felt before:

• Sudden, severe shoulder pain that can wake you from sleep

• Sharp, burning, or aching pain that may spread down your arm

• Pain that gets worse at night

• Pain so intense that even gentle touch hurts

One rancher from Farmington told me, "I've been thrown by horses and broken bones, but this pain was something else entirely. I couldn't even wear a shirt without it hurting."

Stage 2: The Weakness Phase (Can last months to years)

As the pain starts to fade, you'll likely notice:

• Weakness in your shoulder, arm, or hand

• Difficulty lifting your arm overhead

• Trouble with daily activities like combing your hair or reaching into cabinets

• Your shoulder blade might "wing out" or stick out from your back

• Muscle shrinkage (atrophy) in affected areas

Which Muscles Are Usually Affected?

The most commonly affected muscles control:

• Lifting your arm away from your body

• Rotating your shoulder

• Moving your shoulder blade

• Sometimes finger and wrist movement

How Do We Diagnose It?

When patients come to my office in Durango with these symptoms, I use several approaches to confirm the diagnosis:

Physical Examination

I'll check:

• Your range of motion

• Muscle strength in different positions

• Reflexes

• Sensation in your arm and hand

Medical Tests

Nerve Studies (EMG/NCS): These tests measure how well your nerves are working. Think of it like testing the wiring in your house. The test involves small electrical impulses - most patients find it uncomfortable but tolerable.

MRI: This helps us see the muscles and can show if there's inflammation or other problems we need to rule out.

Blood Tests: Sometimes we check for infections or other conditions that might cause similar symptoms.

What We're Looking For

The key signs that point to Parsonage Turner Syndrome:

• Sudden onset of severe shoulder pain followed by weakness

• Specific pattern of muscle weakness

• Normal sensation (feeling) in most cases

• EMG changes that show nerve inflammation

Treatment Options

The good news is that most people with Parsonage Turner Syndrome do get better, though it takes time and patience. Treatment focuses on managing pain and maintaining function while your nerves heal.

Pain Management

Early Phase (First few weeks):

• Strong anti-inflammatory medications

• Sometimes steroid medications to reduce inflammation

• Pain medications as needed

• Ice or heat (whichever feels better to you)

I often tell patients in Pagosa Springs, "Think of this like treating a severe sunburn from the inside out. We need to calm down the inflammation first."

Physical Therapy

Once the severe pain settles down, physical therapy becomes your best friend. A good therapist will help you:

• Maintain range of motion in your shoulder

• Prevent stiffness and frozen shoulder

• Strengthen muscles that aren't affected

• Learn new ways to do daily activities

• Gradually rebuild strength as nerves heal

I work closely with excellent physical therapists throughout the Four Corners area who understand this condition.

Activity Modification

While you're healing:

• Avoid heavy lifting or repetitive overhead activities

• Use adaptive equipment when needed (long-handled shoehorns, reachers)

• Take breaks during activities

• Listen to your body - some days will be better than others

Advanced Treatment Options

For severe cases or when conservative treatment isn't enough, we might consider:

Platelet-Rich Plasma Therapy: This uses your own blood components to potentially speed healing.

Nerve Blocks: Injections that can provide longer-lasting pain relief.

Surgery: Rarely needed, but sometimes we perform nerve repair surgery or tendon repair surgery if certain nerves don't recover.

What to Expect: The Recovery Timeline

Recovery from Parsonage Turner Syndrome is like watching grass grow - it happens, but you have to be patient. Here's what most patients experience:

Weeks 1-4: Pain Phase

• Severe pain gradually decreases

• Weakness becomes more noticeable as pain improves

• Focus on pain management and gentle range of motion

Months 2-6: Early Recovery

• Pain continues to improve

• Weakness may seem worse (but it's just more noticeable)

• Physical therapy becomes more important

• Some muscle wasting may be visible

Months 6-12: Active Recovery

• Gradual return of strength

• Continued improvement in function

• May still have some limitations with overhead activities

1-3 Years: Long-term Recovery

• Most people see their best recovery by 2 years

• Some may have lingering weakness or occasional discomfort

• Many return to full activities, though some adapt their approach

Success Stories from Durango

I've treated a retired teacher who thought she'd never be able to write on a whiteboard again. With patience and therapy, she returned to substitute teaching within 18 months.

A rancher from Cortez was devastated when he couldn't lift hay bales. We worked together on alternative techniques, and while he approaches some tasks differently now, he's back to managing his property.

Living with Parsonage Turner Syndrome

Daily Life Adaptations

In the Kitchen:

• Use lightweight cookware

• Keep frequently used items at waist level

• Consider a small cart to move things around

Getting Dressed:

• Button-front shirts are easier than pullovers

• Adaptive tools can help with buttons and zippers

• Dress the affected arm first, undress it last

Around the House:

• Use long-handled tools for cleaning

• Reorganize storage so you don't need to reach overhead

• Ask for help with heavy tasks - your neighbors in Durango are usually happy to lend a hand

Emotional Support

Dealing with sudden disability is tough. Many patients go through stages similar to grief:

• Shock and denial ("This can't be happening")

• Anger and frustration ("Why me?")

• Depression ("Will I ever be normal again?")

• Acceptance and adaptation ("I can work with this")

This is completely normal. Consider:

• Joining support groups (online communities can be helpful)

• Counseling if you're struggling emotionally

• Staying connected with friends and family

When to Call Dr. Butzen

Contact our office in Durango if you experience:

• Sudden worsening of symptoms

• New areas of weakness or numbness

• Signs of infection if you've had injections

• Severe depression or anxiety

• Questions about your recovery progress

Follow-up Care

Regular check-ins help us monitor your progress and adjust treatment. Typical follow-up schedule:

• 2-4 weeks after initial diagnosis

• Every 2-3 months during active recovery

• Every 6 months during long-term recovery

Frequently Asked Questions

Will I get this again? Parsonage Turner Syndrome rarely affects the same person twice, though it can occasionally happen on the opposite side.

Can I prevent it? Since we don't know exactly what causes it, there's no sure way to prevent it. Staying healthy overall is always good advice.

Should I avoid vaccinations? No. While vaccinations can rarely trigger Parsonage Turner Syndrome, the benefits of vaccination far outweigh this small risk.

Will I need surgery? Most people don't need surgery. We only consider surgical options like nerve repair surgery or tendon repair surgery in severe cases where conservative treatment hasn't helped.

Can I still work? Many people return to work, though you might need accommodations initially. We can provide documentation for your employer if needed.

What about driving? Once the severe pain phase passes and you have adequate strength and range of motion, most people can return to driving. Start with short trips close to home.

Resources and Support

Local Resources in Durango and the Four Corners:

• Animas Orthopedic Associates: (970) 259-3020

• Local physical therapy clinics

• Durango Community Recreation Center (adapted fitness programs)

• Southwest Colorado Area Agency on Aging (adaptive equipment loans)

Online Resources:

• The Foundation for Peripheral Neuropathy

• American Chronic Pain Association

• Occupational therapy self-help resources

Remember:

Recovery takes time, but most people with Parsonage Turner Syndrome do get significantly better. Some have complete recovery, others adapt and find new ways to do the things they love.

You're not alone in this journey. Here in Durango, we're committed to helping you through every step of your recovery. Whether you need rotator cuff surgery, shoulder pain evaluation, or non-operative shoulder treatment, our team has the experience to help you get back to the activities that matter most to you.

Tennis Elbow and Cortisone Injections: What You Need to Know

Understanding Tennis Elbow

Tennis elbow, also called lateral epicondylitis, happens when the tendons on the outside of your elbow get irritated and painful. Despite the name, you don't need to play tennis to get it. I see patients in Durango every week who developed tennis elbow from activities like gardening, painting, or even using a computer mouse too much.

The condition affects the common extensor tendon, which connects your forearm muscles to the bony bump on the outside of your elbow. When this tendon gets overused or strained, it becomes inflamed and causes that familiar aching pain that gets worse when you grip things or twist your wrist.

For years, doctors - including myself early in my practice here in Durango - would often recommend cortisone injections as a quick fix for tennis elbow pain. The thinking made sense: cortisone reduces inflammation, and tennis elbow involves inflammation, so injecting cortisone should help, right? Well, it turns out the story is more complex than we first thought.

Why Cortisone Injections Seemed Like a Good Idea

When cortisone injections first became popular for tennis elbow, they seemed like a miracle treatment. Patients would come to my office in significant pain, get an injection, and feel much better within days. I remember one patient, a contractor from Pagosa Springs, who couldn't hold his hammer without wincing. After a cortisone injection, he was back to work the next week, pain-free.

The relief was real, but we started noticing something troubling. Many of these patients would return months later with the same problem, often worse than before. That contractor? He came back three times over two years, each time needing stronger treatment.

What Research Has Taught Us

Medical research has shown us why cortisone injections for tennis elbow can actually do more harm than good in the long run. Here's what we've learned:

Short-term relief, long-term problems: While cortisone can provide quick pain relief, studies show that patients who receive cortisone injections often have worse outcomes after six months compared to those who didn't get injections. The pain relief is temporary, but the underlying problem gets worse.

Tendon weakening: Cortisone doesn't just reduce inflammation - it can also weaken the tendon itself. Tennis elbow isn't just about inflammation; it's about the tendon breaking down and not healing properly. Cortisone can actually slow down the healing process and make the tendon more fragile.

Higher recurrence rates: Patients who receive cortisone injections for tennis elbow are more likely to have their symptoms return, often requiring more aggressive treatment later. This is the opposite of what we want to achieve.

The Real Problem with Tennis Elbow

We now understand that tennis elbow isn't simply an inflammatory condition that needs to be "cooled down" with cortisone. Instead, it's what we call a degenerative tendinopathy. This means the tendon has small tears and areas where the normal, healthy tendon tissue has been replaced with weaker, disorganized tissue.

Think of it like a rope that's starting to fray. You can't fix a fraying rope by just reducing swelling - you need to help the rope repair itself with stronger fibers. That's exactly what happens with tennis elbow treatment when we avoid cortisone and focus on helping the tendon heal properly.

Better Treatment Options

The good news is that we have much better treatments for tennis elbow now. In my practice at Animas Orthopedic Associates, I've seen excellent results with these approaches:

Physical therapy: A good physical therapist can teach you specific exercises that help the tendon heal properly. These aren't just stretches - they're carefully designed exercises that gradually load the tendon in a way that promotes healthy tissue growth.

Activity modification: Sometimes simple changes in how you perform daily activities can take pressure off the healing tendon. This might mean using different tools, changing your grip, or taking more frequent breaks.

Bracing: A tennis elbow brace can help reduce strain on the tendon during daily activities while it heals.

Platelet-rich plasma therapy: This newer treatment uses your own blood to promote healing. While still being studied, early results are promising for patients with stubborn cases of tennis elbow.

Time and patience: Most cases of tennis elbow will heal on their own with proper rest and gradual return to activity. This can take several months, but the results are usually much better than quick fixes.

When Surgery Might Be Needed

If non-operative treatments don't work after several months, surgery might be necessary. The good news is that tennis elbow surgery has a very high success rate when done for the right reasons. The procedure involves removing the damaged tendon tissue and promoting healthy healing.

I've performed many tendon repair surgeries for patients throughout the Four Corners area, including folks from Cortez, Farmington, and right here in Durango. Most patients return to their normal activities within a few months and have long-lasting relief.

What This Means for You

If you're dealing with tennis elbow, resist the urge to look for a quick fix. While cortisone injections might seem appealing because they can provide rapid pain relief, they're likely to make your problem worse in the long run.

Instead, work with your doctor to develop a comprehensive treatment plan that addresses the root cause of your tennis elbow. This might take longer, but you're much more likely to get lasting relief and return to the activities you love.

Remember, healing takes time, but it's worth doing it right the first time. Your elbow - and your future self - will thank you for choosing treatments that promote real healing rather than just masking the symptoms.

References

1. Coombes BK, Bisset L, Brooks P, Khan A, Vicenzino B. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA. 2013;309(5):461-469.

2. Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006;333(7575):939.

3. Smidt N, van der Windt DA, Assendelft WJ, Devillé WL, Korthals-de Bos IB, Bouter LM. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Lancet. 2002;359(9307):657-662.

4. Ahmad Z, Siddiqui N, Malik SS, Abdus-Samee M, Tytherleigh-Strong G, Rushton N. Lateral epicondylitis: a review of pathology and management. Bone Joint J. 2013;95-B(9):1158-1164.

5. Krogh TP, Bartels EM, Ellingsen T, et al. Comparative effectiveness of injection therapies in lateral epicondylitis: a systematic review and network meta-analysis of randomized controlled trials. Am J Sports Med. 2013;41(6):1435-1446.

Dr. Brian Butzen is a double board-certified orthopedic surgeon specializing in shoulder, wrist and hand problems. He has been serving the Durango, Colorado community and surrounding Four Corners area since 2013 as part of Animas Orthopedic Associates, with a satellite clinic in Pagosa Springs, Colorado.

When a Small Bump on Your Finger Turns Out to Be More: A Neurofibroma Case

Last week, I had a patient come into my Durango office with what looked like a simple bump on their index finger. They'd noticed it growing slowly over several months, and it was starting to cause some numbness and tingling. What we discovered during surgery was a 16mm neurofibroma - about the size of a small grape - wrapped around one of the finger's nerves.

What Exactly Is a Neurofibroma?

Think of a neurofibroma as nature's bubble wrap around a nerve. These benign tumors grow from the cells that normally protect and insulate our nerves. While they sound scary, they're not cancerous. The tricky part is that they grow right within the nerve tissue itself, like a knot in a rope.

In the finger, where space is tight and every millimeter matters for function, even a small neurofibroma can cause big problems. My patient described it perfectly: "It felt like someone was constantly pressing on a bruise, and my fingertip kept going numb."

Why Do They Develop?

Most of the time, we simply don't know why someone develops a solitary neurofibroma. They can pop up in anyone, at any age. The good news is that a single neurofibroma on its own is usually just a random occurrence - not part of a larger condition.

However, if someone has multiple neurofibromas or certain skin markings, we might be looking at a genetic condition called neurofibromatosis type 1. That's why careful examination and sometimes genetic counseling become important parts of the process.

The Symptoms That Bring People In

The patients I see in Durango with finger neurofibromas typically describe:

• A slowly growing, firm bump

• Numbness or tingling in part of the finger

• Sharp, shooting pains when they bump the area

• Difficulty with fine motor tasks like buttoning shirts

• A feeling that their finger "isn't quite right"

One thing that sets neurofibromas apart from other finger bumps is that tapping on them often sends an electric shock down the finger. We call this Tinel's sign, and it's a dead giveaway that we're dealing with nerve tissue.

How We Make the Diagnosis

When a patient comes to my office at Animas Orthopedic Associates with a suspicious finger bump, I start with a thorough examination. I'll test sensation in different parts of the finger and look for that telltale Tinel's sign.

Sometimes an MRI helps us see the relationship between the tumor and the surrounding nerve, but often the clinical examination tells us everything we need to know. The definitive diagnosis always comes from the pathologist after we remove the tumor.

The Surgical Solution

Removing a neurofibroma requires delicate nerve repair surgery. These aren't like cysts that we can simply pop out. The tumor is intimately connected with the nerve fibers, so the surgery becomes a careful dissection under magnification.

In my patient's case, we were able to remove the entire 16mm x 12mm x 8mm tumor while preserving most of the nerve function. The key is using microsurgical techniques and sometimes nerve grafts to bridge any gaps we create during removal.

Recovery and What to Expect

After neurofibroma removal, patients typically experience immediate relief from the pressure-related pain. However, nerve healing takes time - often several months for full recovery.

My Durango patients usually return to light activities within a week or two, but we protect the finger from heavy use for about six weeks while the nerve heals. Hand therapy can help  restore full function and sensation, but it is frequently not necessary.

The best part? Recurrence is rare when we achieve complete removal. Most patients tell me months later that they'd forgotten what the numbness felt like.

When to Seek Help

If you notice a growing bump on your finger that causes numbness, tingling, or sharp pains, don't wait. Early treatment often means easier surgery and better outcomes.

Here in the Four Corners region, I see patients from Cortez, Farmington, and Pagosa Springs who've waited months or even years before seeking treatment. While neurofibromas aren't dangerous, they don't improve on their own and can make daily activities increasingly difficult.

The Bottom Line

A solitary neurofibroma might sound intimidating, but it's a manageable condition with excellent treatment outcomes. The combination of careful surgical technique and proper rehabilitation typically restores normal finger function.

If you're dealing with a mysterious finger bump that's affecting your quality of life, specialized hand surgery evaluation can provide answers and relief. After more than a decade of practicing orthopedic surgery in Durango, I've learned that addressing these problems early leads to the best results for my patients.

Whether you're a weekend warrior hitting the trails around Durango or someone whose livelihood depends on their hands, getting back to full function is the goal we work toward together.

Should You Have Surgery for Your Torn Supraspinatus? A Guide to Help You Decide

Understanding Your Injury

Your supraspinatus is one of four muscles that make up your rotator cuff. Think of it as the "lifter" muscle – it helps raise your arm out to the side and keeps your shoulder stable. When this muscle tears, everyday activities like reaching for a coffee mug or combing your hair can become painful or impossible.

I've been treating shoulder injuries in Durango for over a decade, and I see patients struggle with this decision regularly. A rancher from Cortez once told me he'd been putting off surgery for two years, trying to "tough it out." By the time he came to see me, simple tasks like opening gates had become unbearable.

When Surgery Makes Sense

Not every torn supraspinatus needs surgery. Your body has remarkable healing abilities, and smaller tears often respond well to non-operative shoulder treatment. However, certain situations typically require rotator cuff surgery:

Full-thickness tears – When the muscle is completely separated from the bone, it rarely heals on its own. These tears often get larger over time.

Active lifestyle demands – If you're an athlete, work with your hands, or have hobbies that require overhead motion, surgery often provides the best chance of returning to your activities.

Failed conservative treatment – If you've tried physical therapy, injections, and other treatments for 3-6 months without improvement, surgery may be your next step.

Significant weakness – When you can't lift your arm without assistance, the tear is likely too large to heal without surgical repair.

What Non-Surgical Treatment Involves

Before considering surgery, most patients benefit from trying conservative approaches. This might include:

• Physical therapy to strengthen surrounding muscles

• Anti-inflammatory medications

• Platelet-rich plasma therapy

• Lifestyle modifications

• Steroid injections for pain relief

A teacher from Pagosa Springs came to my satellite clinic last year with a partial supraspinatus tear. She was worried about taking time off for surgery during the school year. After six months of physical therapy and activity modification, her pain decreased significantly, and she returned to all her normal activities without needing rotator cuff surgery.

The Reality of Rotator Cuff Surgery

Rotator cuff surgery involves reattaching the torn muscle to the bone using small anchors. The procedure is typically done arthroscopically (through small incisions) as an outpatient surgery.

Recovery takes patience. Most patients wear a sling for 6-8 weeks, then begin physical therapy. Full recovery can take 4-6 months, sometimes longer for heavy laborers or athletes.

One construction worker from Farmington asked me, "Doc, will I ever be able to swing a hammer again?" The honest answer is that most people do return to their previous activities, but it requires commitment to rehabilitation and realistic expectations about timing.

Questions to Ask Yourself

How is this affecting your daily life? Can you sleep through the night? Are you avoiding activities you love?

What are your goals? A weekend golfer might have different needs than someone who works overhead all day.

How long have you been dealing with this? Acute tears (less than 6 weeks old) often have better surgical outcomes than chronic tears.

What's your support system like? Recovery requires help with daily tasks, especially in the first few weeks.

Red Flags That Suggest Surgery

Some situations make surgery more urgent:

• Sudden loss of strength after an injury

• Inability to lift your arm at all

• Severe pain that prevents sleep despite medication

• Muscle wasting (your shoulder looks noticeably smaller)

Making Your Decision

This choice is deeply personal. I've had patients who were thrilled with non-surgical treatment and others who wished they'd had surgery sooner. The key is understanding your specific situation.

During your shoulder pain evaluation, we'll discuss your tear size, activity level, and goals. We'll also review your imaging studies together so you can see exactly what's happening in your shoulder.

Remember, there's no "right" answer that applies to everyone. A postal worker from Durango chose surgery because her job required repetitive overhead reaching. Her neighbor with a similar tear chose physical therapy and modified his gardening techniques instead. Both made the right choice for their situations.

What Happens Next

If you're still unsure, that's completely normal. Many patients benefit from a second opinion or additional time to consider their options. The decision doesn't have to be made immediately unless you're experiencing significant weakness or your tear is getting larger.

Whether you choose surgery or conservative treatment, the goal remains the same: getting you back to the activities you love with less pain and better function. After eleven years of practicing in the four corners area, I've learned that the best outcomes happen when patients feel confident in their decision and committed to their treatment plan.

Your shoulder problem is unique to you, just like your lifestyle and goals. Take the time you need to make the choice that feels right for your situation.

You can feel free to email Doctor Butzen at doctorbutzen@gmail.com if you have any questions. He may request to see you in the office to discuss face-to-face if it requires a lengthy discussion instead of a simple answer.

Why Seeing a Specialist Makes All the Difference for Shoulder, Wrist, and Hand Pain

When your shoulder aches after a weekend of yard work, or your wrist starts tingling during long days at the computer, you might wonder where to turn for help. Many people start with their family doctor, and that's a natural first step. But when it comes to shoulder, wrist, and hand problems, there's a compelling case for going straight to someone who lives and breathes these conditions every day.

Think of it this way: if your car's engine was making strange noises, you could take it to any mechanic. But wouldn't you rather take it to someone who works on your specific make and model all day long? The same logic applies to your body's upper extremity.

The Training Makes the Difference

Dr. Brian Butzen has been treating shoulder, wrist, and hand conditions in Durango, Colorado since 2013. What sets him apart isn't just his years of experience – it's his double board certification in both orthopedic surgery and hand surgery. This specialized training means he's seen thousands of cases just like yours, and he's developed the expertise to spot problems that might be missed by someone who sees these conditions less frequently.

When someone comes to see Dr. Butzen at Animas Orthopedic Associates, they're not getting generic advice. They're getting insights from someone who has performed countless rotator cuff surgeries, endoscopic carpal tunnel release surgeries, and trigger finger release surgeries. He's helped everyone from weekend warriors trying to get back on the slopes to ranchers who need their hands working perfectly for their livelihood.

Speed Matters When You're in Pain

One of the biggest advantages of seeing a specialist right away is time. Studies of clinical outcomes for generalist vs specialist care for diagnoses within a specialist's narrow domain have tended to favor specialty care, particularly when it comes to getting an accurate diagnosis quickly.

Here's what often happens when you start with general care: you describe your symptoms, get some basic tests, maybe try some medication or physical therapy, and if that doesn't work, you get referred to a specialist anyway. That whole process can take months, and during that time, you're still dealing with pain that's affecting your sleep, work, and daily activities.

Dr. Butzen can often diagnose conditions like rotator cuff tears, carpal tunnel syndrome, or trigger finger during your first visit. His trained eye can spot the subtle signs that point to specific problems. Sometimes he can recommend non-operative shoulder treatment or platelet-rich plasma therapy that gets you better without surgery. Other times, he knows right away that you'll need something like reverse total shoulder replacement surgery or distal radius fracture surgery to get back to feeling like yourself.

The Right Tools for the Job

Specialists don't just have different training – they have different equipment and techniques. Dr. Butzen performs procedures like endoscopic carpal tunnel release surgery, which is less invasive than traditional methods. He stays current with the latest advances in tendon repair surgery and nerve repair surgery because that's his world.

When you see a specialist, you're also getting access to treatment options that might not be available elsewhere. Dr. Butzen offers procedures ranging from simple trigger finger release surgery to complex wrist arthritis surgery and thumb arthritis surgery. He's also skilled in newer treatments like de quervain tendinitis surgery using minimally invasive techniques.

Understanding Your Lifestyle Matters

What makes Dr. Butzen's approach particularly effective is his understanding of life in the Four Corners region. Whether you're dealing with shoulder pain from skiing in Durango, hand pain from ranch work near Cortez, or wrist problems from your job in Farmington, he gets it. He's been serving patients from Durango, Cortez, Pagosa Springs, and Farmington for over a decade, and he understands the activities that matter to people here.

His satellite clinic in Pagosa Springs makes specialized care more accessible to that community too. He's seen how shoulder pain can sideline someone from hiking the beautiful trails around Pagosa Springs, or how carpal tunnel syndrome can affect someone's ability to work effectively.

Research Backs Up the Specialist Advantage

The medical literature supports what many patients already know intuitively. There are increasing demands for orthopaedic specialist services due to the increasing burden of musculoskeletal (MSK) disorders, and specialists consistently show better outcomes for conditions within their expertise.

Musculoskeletal disorders comprise diverse conditions affecting bones, joints, muscles, and connective tissues. These disorders may result in pain and loss of function and are among the most disabling and costly conditions in the United States. Given how much these conditions can impact your quality of life, getting the right care from the start makes both medical and economic sense.

Real Stories from Real Patients

Over the years, Dr. Butzen has helped patients get back to the things they love. There was the competitive cyclist from Durango whose wrist pain was affecting her performance – a quick wrist and hand pain evaluation led to a targeted treatment plan that had her back on the bike within weeks. Then there was the carpenter from Cortez who thought his shoulder pain was just part of getting older, until Dr. Butzen's shoulder pain evaluation revealed a problem that could be fixed with rotator cuff surgery.

These aren't unusual cases – they're the kind of success stories that happen when someone with the right training applies their expertise to solve specific problems.

When to Make the Call

You don't have to live with shoulder, wrist, or hand pain. If you're experiencing symptoms that interfere with your daily activities, sleep, or work, it's time to see someone who specializes in these problems. Dr. Butzen and his team are here to help people throughout the Four Corners region get back to living their lives without pain.

Sometimes the solution is simple – like platelet-rich plasma therapy or non-surgical treatment. Other times, procedures like shoulder replacement surgery, clavicle fracture surgery, or carpal tunnel release surgery provide the lasting relief you need.

The bottom line is this: when you're dealing with specialized problems, you deserve specialized care. Dr. Butzen's commitment to the Durango community and the broader Four Corners region means you can get that expert care close to home, without the need to travel to larger cities.

Your hands, wrists, and shoulders do a lot of work for you every day. When they're not working right, you deserve someone who understands exactly what's wrong and knows the best way to fix it. That's what specialist care is all about – getting you back to the activities and lifestyle that matter most to you, as quickly and effectively as possible.

Rotator Cuff Surgery Options: A Guide for Patients Over 70

Understanding Your Supraspinatus Tear and Treatment Choices

You've been dealing with shoulder pain for months now. Physical therapy didn't give you the relief you hoped for, and those cortisone shots only helped temporarily. Now you're facing a decision that many of my patients in their 70s wrestle with: should you have your rotator cuff repaired, or is it time to consider a reverse total shoulder replacement?

I've been performing both rotator cuff surgery and reverse total shoulder replacement surgery here in Durango since 2013, and I've helped hundreds of patients just like you make this choice. Let me walk you through what each option means for someone in your situation.

Your supraspinatus tear is like a rip in the fabric of your shoulder. This muscle and tendon help lift your arm overhead and provide stability. When it tears, simple tasks like reaching for a coffee mug or brushing your hair become painful reminders of what you've lost.

Option 1: Arthroscopic Rotator Cuff Repair Surgery

Think of rotator cuff repair as mending that torn fabric. During this procedure, I use small incisions and a tiny camera to reattach your torn supraspinatus tendon back to the bone where it belongs.

What makes you a good candidate for rotator cuff repair:

• Your tear is still repairable (not too large or retracted)

• The muscle hasn't shrunk (atrophied) significantly

• You have good bone quality

• You're motivated to follow the lengthy rehabilitation process

The recovery process: Recovery from rotator cuff surgery takes patience. You'll wear a sling for about six weeks followed by a 2 week weaning process, and it typically takes four to six months before you feel like your shoulder is truly back to normal.

One of my patients, a 72-year-old rancher from Pagosa Springs, had his rotator cuff repaired two years ago. He was back to handling his cattle and fixing fence posts within eight months. But he'll tell you those first few months required discipline with his physical therapy.

The advantages:

• Preserves your natural shoulder joint

• Generally less invasive than joint replacement

• Good long-term results when the repair heals properly

• You keep your own bone and cartilage

The challenges:

• Healing depends on your tendon growing back to bone

• Re-tear rates are higher in patients over 70

• Recovery can be slower and more demanding

• May not restore full strength if the tear is large

• Very small risk of a major complication (like infection)

Option 2: Reverse Total Shoulder Replacement Surgery

A reverse total shoulder replacement is different from traditional shoulder replacement. Instead of trying to fix what's broken, we essentially redesign how your shoulder works. The ball and socket are reversed, allowing your deltoid muscle to do the heavy lifting that your rotator cuff can no longer handle.

What makes you a good candidate for reverse shoulder replacement:

• Large, irreparable rotator cuff tears

• Failed previous rotator cuff repairs

• Significant weakness when lifting your arm

• Arthritis along with your rotator cuff tear

• You want more predictable pain relief

The recovery process: Recovery from reverse total shoulder replacement surgery is often more straightforward than rotator cuff repair. Most patients start moving their arm within days of surgery. You are in a sling for 2 weeks, and then starting to use the shoulder for light activity. Many of my patients are driving within two weeks.

A 74-year-old teacher from Cortez had her reverse shoulder replacement last year. She was back to playing with her grandchildren and tending her garden within three months. She tells everyone that her only regret was waiting so long to have the surgery.

The advantages:

• More predictable pain relief

• Faster return to daily activities

• Doesn't rely on tendon healing

• Works well even with massive rotator cuff tears

• Lower risk of needing repeat surgery

The challenges:

• It's a bigger surgery with implants

• Some activities may always be limited

• Small risk of implant problems over time

• Not easily reversible

• Very small risk of a major complication (like infection)

Making the Right Choice for Your Lifestyle

The decision between these surgeries isn't just medical—it's personal. I always ask my patients to think about what they want to get back to doing.

Consider rotator cuff repair if:

• You're in good health and motivated for a longer recovery

• Your tear is repairable

• You want to preserve your natural joint

• You're willing to accept some uncertainty about the outcome

Consider reverse shoulder replacement if:

• You want more predictable pain relief – more certainty of success

• Your tear is large or you have significant weakness

• You have arthritis in addition to your rotator cuff tear

• You prefer a faster return to daily activities

Questions to Discuss During Your Next Visit

Before we make this decision together, think about these questions:

1. What activities do you miss most because of your shoulder pain?

2. How important is it to you to preserve your natural joint?

3. Are you prepared for a longer, more uncertain recovery with rotator cuff repair?

4. Would you prefer a more predictable outcome even if it means joint replacement?

5. Do you have other health conditions that might affect your healing?

Success Rates and Realistic Expectations

Let me be honest about what the research shows for patients in your age group. Success rates help guide this decision, but they're not the whole story.

Rotator cuff repair success rates for patients over 70:

• Pain relief occurs in about 85-90% of patients

• However, re-tear rates are higher - around 30-40% for patients your age

• Even when tears happen again, many patients still feel better than before surgery

• Full strength recovery is less predictable, especially with larger tears

Reverse shoulder replacement success rates:

• Pain relief occurs in 90-95% of patients

• Satisfaction rates are consistently high - around 95%

• The surgery works reliably even when rotator cuff muscles are severely damaged

• Most patients regain good function for daily activities

The numbers favor reverse shoulder replacement for predictable outcomes, but that doesn't make it automatically right for everyone. Your goals matter more than statistics.

Take Your Time With This Decision

Both rotator cuff surgery and reverse total shoulder replacement surgery have helped countless patients in Durango, Farmington, Cortez, and Pagosa Springs get back to their active lifestyles. Based on your MRI and examination, either option could work for you - that's why this choice is yours to make.

Take this information home. Talk it over with your family. Think about what matters most to you in your recovery. There's no rush, and there's no wrong choice here.

When you're ready to move forward, just call the office and let us know which direction feels right for you. I've been helping patients navigate these choices for over a decade, and I'm confident that whichever option you choose, we can get you back to a more comfortable, active life.

Your shoulder pain has already taken enough from you. Let's work together to get you back to living the life you want in our beautiful corner of Colorado and New Mexico.

Please email me at doctorbutzen@gmail.com if you have any questions about this topic.