Shoulder Arthritis

When a person develops an arthritic shoulder, it is due to inflammation in the shoulder joint, which, over time, can lead to a loss of cartilage. Treatments for shoulder arthritis are available and range from home remedies for pain to exercises and surgery for more severe arthritis. 

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What is Shoulder Arthritis?

Shoulder arthritis is inflammation in the shoulder joint, causing stiffness, and pain and making the arm uncomfortable to lift. 

The shoulder consists of a ball and socket joint, where the ball of the humerus (upper arm) rests against the socket at the edge of the scapula (shoulder blade). The joint is known as the glenohumeral joint, but shoulder arthritis can also develop in the second shoulder joint where the collarbone meets the acromion on the shoulder blade. This joint is called the AC joint or acromioclavicular joint. 

The cartilage that covers the head of the humerus and the socket of the shoulder joint is affected by arthritis. The cartilage acts as a cushion between the bones, but when arthritis develops, it causes loss of cartilage which creates pain and discomfort as the bones are rubbing against each other.

Shoulder Arthritis Symptoms

Pain felt by shoulder arthritis depends on which shoulder joint is affected:

  • If pain is felt at the side of the shoulder or the ache feels deep in the joint, it is likely the glenohumeral joint is affected by arthritis.
  • If pain is felt at the top of the shoulder and sometimes travels to the side of the neck, it is likely the AC joint. 

Other shoulder arthritis symptoms, besides pain, include:

  • Stiffness and loss of range of motion, making everyday tasks more difficult
  • Grinding, clicking, popping, or cracking sounds/felt in the shoulder joint due to the loss of cartilage. They can occur with or without pain.
  • Loss of sleep due to not finding a comfortable sleeping position.

Shoulder Arthritis Causes

Shoulder arthritis has several potential causes, including:

  • Rheumatoid arthritis: an autoimmune disease where the body’s defense system attacks its healthy tissues and results in cartilage damage.
  • Osteoarthritis: the most common type of arthritis, also called “wear and tear” arthritis due to it being age-related. As the cartilage gets soft, it cracks, flakes, or frays and wears away.
  • Rotator cuff tear arthropathy: the rotator cuff is made up of four tendons that surround the shoulder joint and keep it stable as the ball of the upper arm rotates in the shoulder blade’s socket. When these tendons tear from wearing away over time, becoming larger, the head of the humerus slides out of its normal position and rubs against the shoulder bones, leading to cartilage loss and arthritis. 
  • Shoulder trauma: injury to any of the bones that make up the shoulder, such as dislocation, fracture, or severe impact, can damage the cartilage surface.

Shoulder Arthritis Treatment & Diagnosis

Diagnosing shoulder arthritis requires a physical exam that includes checking the range of motion and its strength, but also imaging tests like:

  • X-rays: To show the condition the shoulder bones are in, as they cannot show damage to the cartilage. It can show space between the bones which can indicate cartilage loss.
  • CT Scan: To provide a more detailed look at the bones in the shoulder and can help with surgery planning.
  • MRI: This test can show the surrounding soft tissues of the shoulder joint and provide a better look at the rotator cuff tendons.

To treat arthritis in the shoulder, there are several home-based treatments to reduce pain, including:

  • Shoulder exercises to improve and retain range of motion. These exercises are usually provided by a physical therapist.
  • Activity and lifestyle adjustments, such as cutting back or avoiding activities that cause shoulder pain.
  • Ice and heat to reduce inflammation.

Medications are available to help reduce inflammation and pain as well, including:

  • Over-the-counter medications such as Tylenol, nonsteroidal anti-inflammatory drugs like ibuprofen, or Aleve
  • Corticosteroid injections from a medical provider, are injected into the joint, to relieve inflammation. The effect of this medication lasts for months.

Shoulder Arthritis Surgery

If conservative arthritis treatment fails to bring relief or the arthritis is getting worse, a healthcare provider may recommend surgery. There are several types of shoulder arthritis surgery treatments available, including:

  • Reverse total shoulder replacement surgery: the location of the ball and socket are reversed and a metal head is attached to the shoulder blade, and the socket attaches to the humerus
  • Total shoulder replacement surgery: the diseased sections of the bones in the shoulder joint are replaced with plastic or metal prosthetics. 
  • Arthroscopic shoulder debridement: small tools and a camera are inserted through small incisions made in the shoulder and loose fragments of damaged cartilage in the shoulder joint are removed. 

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A woman experiencing pain in her shoulder.

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