Shoulder Arthritis

Shoulder arthritis is a painful condition that affects the ball and socket joint of the shoulder. There are a number of different types of arthritis that may affect the shoulder such as Osteoarthritis, inflammatory arthritis, arthritis after trauma, Rotator cuff tear arthritis and Arthritis resulting from Osteonecrosis.
Shoulder Conditions-Cyprus Orthopaedics

Shoulder Arthritis

Shoulder arthritis is a debilitating condition that affects many individuals. It occurs when the cartilage in the shoulder joint breaks down, causing pain, stiffness, and limited range of motion. Understanding the causes, symptoms, and treatment options for shoulder arthritis is crucial for those who are suffering from this condition.

Causes of Shoulder Arthritis

There are several factors that can contribute to the development of shoulder arthritis. One of the primary causes is age-related wear and tear. As we age, the cartilage in our joints naturally begins to deteriorate, leading to arthritis. Additionally, previous shoulder injuries or traumas can increase the risk of developing arthritis. Repetitive overhead movements, such as those performed by athletes or manual laborers, can also contribute to the development of shoulder arthritis. Finally, certain medical conditions, such as rheumatoid arthritis or gout, can cause inflammation in the joints and lead to arthritis.

Types of Shoulder Arthritis

There are different types of shoulder arthritis, each with its own unique characteristics and symptoms.

  • Osteoarthritis: Osteoarthritis is the most common type and is associated with the natural wear and tear of the joint.
  • Rheumatoid arthritis: Rheumatoid arthritis, on the other hand, is an autoimmune disease that causes inflammation in the joints, including the shoulder.
  • Post-traumatic arthritis: Post-traumatic arthritis occurs after a shoulder injury or fracture, while septic arthritis is caused by an infection in the joint.
  • Rotator Cuff Tear Arthropathy: Arthritis may arise subsequent to a significant and enduring tear of the rotator cuff tendon. Once torn, the rotator cuff fails to stabilize the humerus within the glenoid socket, leading to potential upward movement of the humerus and its friction against the acromion. Consequently, this friction may result in bone surface damage, ultimately triggering the onset of arthritis.
  • Avascular necrosis: This ailment, alternatively known as osteonecrosis, refers to the deterioration of a segment of the “ball” within your shoulder. Either trauma or illness disrupts the blood supply to the bone, leading to its demise. In the absence of bone reinforcement, the cartilage suffers harm, ultimately resulting in the deterioration of the shoulder joint.

Understanding the type of shoulder arthritis you have is essential for determining the most effective treatment options.

Symptoms of Shoulder Arthritis

The symptoms of shoulder arthritis can vary depending on the individual and the severity of the condition. Common symptoms include pain in the shoulder joint, particularly with movement or weight-bearing activities. Stiffness and limited range of motion are also typical, making it challenging to perform daily tasks. In some cases, swelling and tenderness may be present around the affected joint. Over time, shoulder arthritis can significantly impact a person’s quality of life, affecting their ability to work, exercise, and engage in everyday activities.

Diagnosing Shoulder Arthritis

If you suspect you may have shoulder arthritis, it is important to seek medical attention for an accurate diagnosis. Your doctor will perform a physical examination of your shoulder, assessing your range of motion, strength, and any signs of inflammation or tenderness. They may also order imaging tests, such as X-rays or an MRI, to visualize the condition of the joint. These tests can help confirm the presence of arthritis and determine the extent of the damage.

Treatment Options for Shoulder Arthritis

The treatment options for shoulder arthritis can vary depending on the severity of the condition and the individual’s specific needs. In most cases, the initial approach is conservative, focusing on non-surgical treatments to manage pain and improve function. However, if non-surgical options are ineffective, surgical intervention may be necessary.

Non-surgical Treatments for Shoulder Arthritis

Non-surgical treatments for shoulder arthritis aim to relieve pain and improve mobility. This may include the use of over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), to reduce inflammation and alleviate discomfort. Physical therapy can also be beneficial, with exercises and stretches designed to strengthen the muscles around the shoulder joint and improve range of motion. Additionally, corticosteroid injections can provide temporary relief by reducing inflammation in the joint.

Surgical Options for Shoulder Arthritis

If non-surgical treatments fail to provide adequate relief, surgery may be recommended. The specific surgical procedure will depend on the individual’s condition and the extent of the damage. In some cases, arthroscopy may be performed to remove loose fragments of cartilage or bone, or to smooth out rough surfaces within the joint. In more severe cases, a total shoulder replacement may be necessary, where the damaged joint is replaced with an artificial implant. This can help alleviate pain and restore function to the shoulder.

Rehabilitation and Physical Therapy for Shoulder Arthritis

Following surgery or as part of non-surgical treatment, rehabilitation and physical therapy play a crucial role in the recovery process. These programs are designed to rebuild strength, improve range of motion, and restore function to the shoulder joint. Physical therapists will guide patients through exercises and stretches that target the specific muscles and tissues affected by arthritis. They will also provide education on proper body mechanics and techniques to prevent further damage to the joint.

Lifestyle Changes for Managing Shoulder Arthritis

In addition to medical treatments, making certain lifestyle changes can help manage shoulder arthritis and reduce symptoms. Maintaining a healthy weight is important, as excess weight puts additional stress on the joints. Engaging in regular low-impact exercise, such as swimming or cycling, can help strengthen the muscles surrounding the shoulder and improve joint stability. It is also essential to avoid activities that aggravate the shoulder joint, such as repetitive overhead motions or heavy lifting. Finally, practicing good posture and using proper body mechanics when performing daily activities can help minimize stress on the shoulder joint.

Prevention and Long-Term Management of Shoulder Arthritis

While it may not be possible to prevent shoulder arthritis entirely, certain measures can be taken to reduce the risk of developing this condition. This includes avoiding repetitive overhead movements and maintaining a healthy lifestyle. Regular exercise, a balanced diet, and proper posture can all contribute to joint health. For individuals who have already been diagnosed with shoulder arthritis, long-term management is crucial. This may involve continuing with physical therapy exercises, taking prescribed medications, and regularly monitoring the condition with follow-up appointments.

A diagnosis of shoulder arthritis is made based on the history of a gradual onset of pain in the shoulder. Pain is usually aching in nature and experienced over the front of the shoulder or near the armpit. It is often associated with stiffness in the shoulder and a feeling of roughness when moving the shoulder. Examination shows painful restriction of movements of the shoulder. An X-ray may demonstrate narrowing of the joint, erosion and formation of spurs. An ultrasound scan may be performed to examine the state of the rotator cuff. Special imaging with a CT scan or an MRI scan is sometimes necessary to aid in planning treatment.

In the early phase, pain may be controlled with activity modification and the use of pain relieving or anti-inflammatory medication.

PhysiotherapyYou may be advised to see a physiotherapist to treat the stiffness and any associated muscle weakness.

The Versus Arthritis website has a helpful video and instructions on exercises for individuals with shoulder arthritis.

Steroid injection: A steroid injection placed accurately into the joint may provide short-term pain relief. Injections should be avoided if surgery is being contemplated. For further information on steroid injection in the shoulder click here.

Visco-supplement injection: Hyaluronic acid is found in normal joint fluid and helps to lubricate the joint and remove by-products of inflammation. Synthetic hyaluronic acid is available for injection into the joint and may provide substantial relief from pain for a period of 3-6 months in patients with mild to moderate arthritis. These injections are best performed under image guidance.

Arthroscopic Surgery: If symptoms persist despite adequate nonoperative treatment and if the arthritis is not severe, it may be appropriate to undertake arthroscopic treatment. This consists of “key-hole” surgery to remove loose fragments or bone spurs from the joint, release the tight capsule or sleeve of the joint and remove some bone from the undersurface of the acromion. The worn surface of the joint may be treated with microfracture or drilling. Following surgery symptoms will usually improve over a period of time. For further information on surgical treatment, please refer to the section on Arthroscopic surgery for shoulder arthritis. It is important to appreciate that this treatment may delay the need for shoulder replacement surgery for a period of time but will not prevent it.

Shoulder replacement surgery: If the arthritis or pain resulting from it is severe, it may be appropriate to consider joint replacement surgery. Shoulder replacements are often very successful at relieving pain and restoring function and quality of life. For further information please refer to the procedures section.

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