Shoulder arthritis (also known as shoulder osteoarthritis or glenohumeral osteoarthritis) is a degenerative condition that involves changes to the cartilage and other structures of the shoulder joint. The gradual loss of cartilage eventually causes the two shoulder bones to grind against each other, which can cause pain, stiffness, and inflammation in the joint. The condition is progressive and can often become debilitating. While the degenerative changes cannot be reversed, there are a variety of treatments used to control pain and slow the progression of the disease.
When you experience a flare-up, the shoulder may become inflamed and painful. Using your arm to lift or push is difficult when the rotation of the shoulder is inhibited. These flare-ups may result from overuse, progressive wear and tear and even changes in the weather.
Anatomy of the Shoulder
The bones of the shoulder consist of the humerus (the upper arm bone), the scapula (the shoulder blade), and the clavicle (the collar bone). The shoulder joint is formed where the humerus fits into the scapula, like a ball and socket.
As a ball and socket joint, the ball-shaped humeral head of the upper arm fits into a glenoid. Because the glenoid is small and shallow in relation to the humeral head, it relies on ligaments, tendons, and muscles for stability.
Ligaments connect the humeral head to the glenoid and work with muscles and tendons to keep the humeral head articulating with the glenoid in a normal fashion.
Other structures of the shoulder include:
Rotator Cuff. The rotator cuff is a collection of muscles and tendons that surround the shoulder, giving it support and allowing a wide range of motion.
Bursa. The bursa is a small fluid-filled sac that cushions and protects the tendons of the rotator cuff.
Labrum. The labrum is a cuff of cartilage that forms a cup for the ball-like head of the humerus to fit into.
Because the humerus fits relatively loosely into the shoulder joint, it gives the shoulder a wide range of motion that makes it vulnerable to injury.
Anatomy of the Shoulder
Anyone who has had shoulder joint trauma, a broken bone, dislocation (when the humeral head pops out of its socket), or other serious injury or surgery is at risk for developing shoulder osteoarthritis many years after the initial trauma. Trauma to the shoulder joint eventually leads to shoulder osteoarthritis.
Other persons who are risk are those whose jobs or recreational activities have required a lot of time lifting objects overhead, throwing, or doing high-impact activities such as chopping wood or using an air hammer. These repetitive motions over time cause wear and tear of the shoulder joint, causing the cartilage to thin and become less flexible.
Other risk factors include:
- Congenital defect or illness
- Family history
- Gender (glenohumeral arthritis is more common in women)
- Advanced age
Common symptoms of shoulder arthritis include:
- Mild to moderate stiffness
- Pain with movement
- Limited range of motion
- Episodes of inflammation (swelling)
- Grinding sound with movement
Your orthopedic surgeon will perform a comprehensive clinical examination to determine whether or not you have shoulder arthritis. This may include other tests such as X-rays or an MRI.
Medical History. Your doctor will ask you questions about your medical and family history and about any medications you may be taking. This information will help guide further treatment options.
Patient Interview. Your doctor will ask you about your work and lifestyle activities, and whether or not you have had any previous shoulder injuries. You will also be asked to describe your pain–the pattern, any limitations to range of motion–all vital information to rule out other potential sources of pain such as shoulder bursitis, shoulder impingement, rotator cuff tears or other common shoulder problems.
X-Rays. Digital imaging is ordered to arrive at clinical diagnosis–verifying whether or not there are significant signs of shoulder osteoarthritis.
MRI. Your doctor may order an MRI (magnetic resonance imaging) for you if x-rays of the shoulder are inconclusive or if it is suspected that your pain is due to damage to the shoulder’s labrum or rotator cuff. An MRI provides more detailed images of the soft tissue (ligaments, tendons, and muscles) and bone.
Lab Tests. Lab tests may be ordered to rule out other causes of shoulder pain, such as infection or gout.
Physical Exam. Your doctor will examine your shoulder for signs of a previous injury, tenderness, pain points, range of motion, and muscle weakness. Other joints may be examined as well to determine if you have any other joint problems that may indicate an inflammatory condition such as rheumatoid arthritis or gout.
There are both nonsurgical and surgical treatment options available for the treatment of shoulder arthritis. Conservative treatment may provide pain relief and reduce episodes of inflammation. In combination with beneficial lifestyle changes, your doctor can provide you with a treatment plan that can significantly improve the range of movement in the shoulder. Effective treatment and physical therapy can help manage your inflammation and slow down the progression of the disease.
Nonsurgical Treatment Options
Nonsurgical treatment options may provide pain relief and reduce episodes of inflammation. Such options may include:
Activity Modification. Modifying your daily activities and exercise will help to avoid pain, especially activities that involve intense shoulder activity like weight lifting or chopping wood.
Periodic Rest. When patients experience extreme bone-on-bone pain, they need to rest the joint and should not ignore it. Your body is telling you to take it easy, so listen.
Warm or Cold Compress. Warm or cold compresses applied to the joint can decrease swelling and provide some immediate pain relief.
Physical Therapy. Stretching and muscle strengthening exercises help to maintain the shoulder’s range of motion; however, they should not be too aggressive and patients should proceed slowly for the most benefit.
Injections. Steroid injections can help to alleviate severe pain from shoulder arthritis.
Surgical Treatment Options
Surgical treatment options to relieve symptoms of osteoarthritis, such as the following, may be necessary if patients don’t respond to conservative treatment:
Shoulder Arthroscopy. This is a minimally invasive procedure that is done to remove loose pieces of damaged cartilage.
Shoulder Osteotomy. This procedure is done to shave off osteophytes (bone spurs) and reduce friction between bones.
Shoulder Arthroplasty. This is a total joint replacement done to replace the ball and socket glenohumeral joint with an artificial one made of metal and plastic.
Hemiarthroplasty. This is a partial joint replacement where one half of the shoulder joint, the humeral head, is replaced with a prosthesis and the glenoid (socket) is left intact.
Shoulder Arthritis Treatment at Go To Ortho
If you are suffering from pain and swelling that is localized around the shoulder, seek advice and accurate diagnosis. Identifying shoulder arthritis in the early stages, when there is limited wear and tear, can improve treatment outcomes.