While most people are familiar with knee and hip arthritis, the shoulder is the 3rd most commonly affected joint. Arthritis is inflammation in a joint, usually caused by wear and tear. In a diseased shoulder, inflammation causes pain and stiffness. Although there is no cure for arthritis of the shoulder, there are many treatment options available.
There are many types of arthritis that can affect the shoulder. The most common type is osteoarthritis. Osteoarthritis is also known as “wear and tear” arthritis and is a condition that destroys the smooth outer covering of the joint. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. During movement, the bones of the joint rub against each other, causing pain. Osteoarthritis usually affects people over 50 years of age.
Arthritis can also develop after a large, long-standing rotator cuff tendon tear. The torn rotator cuff can no longer hold the ball in the socket. This can damage the surfaces of the bones, causing arthritis to develop. The combination of a large rotator cuff tear and advanced arthritis can lead to severe pain and weakness, and the patient may not be able to lift the arm away from the side.
The most common symptom of arthritis of the shoulder is pain. Limited motion is another common symptom. It may become more difficult to lift your arm to comb your hair or reach up to a shelf. You may hear a grinding sound as you move your shoulder. As the disease progresses, any movement of the shoulder causes pain. Night pain is common and sleeping may be difficult.
After discussing your symptoms and medical history, your Orthopaedic Clinic doctor will examine your shoulder. During the physical examination he will look for:
- Weakness in the muscles
- Tenderness to touch
- Range of motion
- Signs of injury to the muscles, tendons, and ligaments
X-rays can help distinguish among various forms of arthritis. X-rays of an arthritic shoulder will show a narrowing of the joint space, changes in the bone, and the formation of bone spurs.
As with other arthritic conditions, initial treatment of arthritis of the shoulder is nonsurgical. Your doctor may recommend the following treatment options:
- Rest or change in activities
- Physical therapy exercises
- Nonsteroidal anti-inflammatory medications (NSAIDs)
- Corticosteroid injections in the shoulder
- Moist heat
Your doctor may consider surgery if your pain causes disability and is not relieved with nonsurgical options. Cases of mild arthritis may be treated with arthroscopy. During arthroscopy, your surgeon inserts a small camera, called an arthroscope, into the shoulder joint. During the procedure, your surgeon can clean out the inside of the joint. Although the procedure provides pain relief, it will not eliminate the arthritis from the joint. If the arthritis progresses, further surgery may be needed.
Advanced arthritis of the shoulder can be treated with shoulder replacement surgery, in which the damaged parts of the shoulder are removed and replaced with artificial components. Replacement options include:
- Hemiarthroplasty. Just the ball is replaced
- Total shoulder arthroplasty. Both the ball and socket are replaced
- Reverse total shoulder arthroplasty. The socket and metal ball are replaced but are opposite a conventional total shoulder replacement. A reverse total shoulder replace-ment works better for people with rotator cuff tears because it relies on different muscles — not the rotator cuff — to move the arm. The shoulder specialists at The Orthopaedic Clinic are the only surgeons in the area offering this innovative procedure.
Surgical treatment of arthritis of the shoulder is generally very effective in reducing pain and restoring motion. Recovery time and rehabilitation plans depend upon the type of surgery performed.
If you are experiencing shoulder pain, come see us at The Orthopaedic Clinic for a consultation and let us help get you back to the life you once knew.