Shoulder Arthritis

Your Painful Shoulder May Be Due to Shoulder Arthritis

Patient with shoulder pain
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Osteoarthritis is the most common type of shoulder arthritis. Also called wear-and-tear arthritis or degenerative joint disease, osteoarthritis is characterized by progressive wearing away of the cartilage of the joint. As the protective cartilage surface of the joint is worn away, bare bone is exposed within the shoulder.

The other common type of shoulder arthritis is rheumatoid arthritis. Rheumatoid arthritis is a systemic autoimmune condition that causes inflammation of the tissue (synovium) that surrounds joints.

This inflammation can, over time, invade and destroy the cartilage and bone.

Shoulder arthritis typically affects patients over 50 years of age. It is more common in patients who have a history of prior shoulder injury.  There is also a genetic predisposition for this condition, meaning shoulder arthritis tends to run in families.

Symptoms of Shoulder Arthritis

Shoulder arthritis symptoms tend to progress as the condition worsens. What is interesting about shoulder arthritis is that symptoms do not always progress steadily with time. Often patients describe good months and bad months, or symptom changes associated with weather changes. This is important to understand because comparing the symptoms of arthritis on one particular day may not accurately represent the overall progression of the condition.

The most common symptoms of shoulder arthritis are:

  • Pain with activities
  • Limited range of motion
  • Stiffness of the shoulder
  • Swelling of the joint
  • Tenderness around the joint
  • A feeling of grinding or catching within the joint

Evaluation of a patient with shoulder arthritis should begin with a physical examination and x-rays. These can serve as a baseline to evaluate later examinations and determine the progression of the condition.

Shoulder Arthritis Treatment

Treatment of shoulder arthritis should begin with the most basic steps, and progress to the more involved, possibly including surgery. Not all treatments are appropriate for every patient, and you should have a discussion with your doctor to determine which treatments are appropriate for your shoulder arthritis.

  • Activity Modification
    Limiting certain activities may be necessary, and learning new exercise methods may be helpful. Shoulder exercises are excellent for patients who have a weak shoulder.
  • Physical Therapy
    Stretching and strengthening of the muscles around the shoulder joint may help decrease the burden on the shoulder. Preventing atrophy of the muscles is an important part of maintaining functional use of the shoulder.
  • Anti-Inflammatory Medications
    Anti-inflammatory pain medications (NSAIDs) are prescription and nonprescription drugs that help treat pain and inflammation. Talk to your doctor before taking anti-inflammatory medication for shoulder arthritis.
  • Cortisone Injections
    Cortisone injections may help decrease inflammation and reduce pain within a joint. While this will not cure shoulder arthritis, it may diminish the symptoms and help control pain.
  • Joint Supplements (Glucosamine)
    Glucosamine appears to be safe and may be effective for treatment of shoulder arthritis, but research into these supplements has been limited. Many patients find moderate relief with glucosamine for symptoms of shoulder arthritis.
  • Shoulder Arthroscopy
    Exactly how effective shoulder arthroscopy is for the treatment of arthritis is debatable. For some specific symptoms of shoulder arthritis, it may be helpful.
  • Shoulder Replacement Surgery
    In this procedure, the arthritic cartilage is removed, and a metal and plastic ball-and-socket implant is placed in the shoulder. This is an excellent option to relieve pain associated with severe shoulder arthritis.
  • Reverse Shoulder Replacement
    This is called a reverse shoulder replacement because the ball and socket are reversed; the ball is placed on the shoulder blade, and the socket is placed on the top of the arm bone. This reverse technique allows better function with there is a non-functioning rotator cuff.

Sources:

University of Washington Department of Orthopaedic Surgery: Total Shoulder Replacement

Chen, AL, et al. "Rheumatoid Arthritis of the Shoulder" J. Am. Acad. Ortho. Surg., January/February 2003; 11: 12 - 24.

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