Shoulder arthritis is a condition characterized by the breakdown of cartilage in the shoulder joint, leading to pain, stiffness, and reduced mobility. It can affect individuals of all ages, though it is more common in older adults. This article provides an in-depth look at shoulder arthritis, its symptoms, diagnostic methods, and various treatment options.

What Is Shoulder Arthritis?

Arthritis in the shoulder occurs when the smooth cartilage that lines the joint surfaces becomes worn or damaged, leading to inflammation, pain, and limited movement. The shoulder consists of two primary joints that can be affected by arthritis:

1. Glenohumeral Joint: The ball-and-socket joint where the humeral head (upper arm bone) meets the glenoid cavity of the scapula (shoulder blade). This joint is most commonly affected by shoulder arthritis.
2. Acromioclavicular (AC) Joint: The joint where the clavicle (collarbone) meets the acromion of the scapula. Arthritis in the AC joint is often associated with repetitive motion or previous injuries.

Types of Shoulder Arthritis

1. Osteoarthritis (OA)

Osteoarthritis, or degenerative joint disease, is the most common type of shoulder arthritis. It occurs due to the gradual wear and tear of the cartilage over time, leading to pain, stiffness, and the formation of bone spurs. OA is more prevalent in individuals over 50 but can also occur in younger patients due to previous injuries.

2. Rheumatoid Arthritis (RA)

Rheumatoid arthritis is an autoimmune condition in which the body’s immune system attacks the joint lining, causing inflammation, pain, and damage. RA can affect multiple joints, including the shoulders, and often leads to chronic symptoms and joint deformity.

3. Post-Traumatic Arthritis

This type of arthritis develops after a shoulder injury, such as a fracture, dislocation, or rotator cuff tear. The injury can damage the cartilage, leading to premature wear and arthritis.

4. Avascular Necrosis (AVN)

Avascular necrosis is when the blood supply to the humeral head is disrupted, causing the bone to deteriorate. This deterioration can lead to the collapse of the joint surface and arthritis. AVN can result from trauma, steroid use, or certain medical conditions.

Symptoms of Shoulder Arthritis

• Pain: This is a dull, aching pain that worsens with movement and activity. It may be felt deep in the shoulder or localized to the AC joint.
• Stiffness: Limited range of motion, especially when lifting the arm, reaching overhead, or behind the back.
• Swelling: Swelling and tenderness around the shoulder joint, particularly in cases of rheumatoid arthritis.
• Grinding or Popping: A grinding sensation, clicking, or popping sound during shoulder movement caused by the roughened joint surfaces.
• Weakness: Decreased strength in the shoulder, making it difficult to perform everyday tasks.

Diagnosing Shoulder Arthritis

1. Physical Examination

The doctor will evaluate the shoulder’s range of motion, check for areas of tenderness, and assess the strength of the surrounding muscles. They will also inquire about the patient’s medical history, symptoms, and any previous injuries.

2. Imaging Studies

• X-rays: X-rays are the most commonly used imaging method for diagnosing shoulder arthritis. They reveal joint space narrowing, bone spurs, and changes in the bone structure.
• MRI: Magnetic resonance imaging (MRI) provides detailed images of the soft tissues, including cartilage, tendons, and muscles. It can help identify damage that may not be visible on X-rays.
• CT Scans: Computed tomography (CT) scans offer a more detailed view of the bone surfaces, helping to assess the extent of joint damage.

Non-Surgical Treatments for Shoulder Arthritis

1. Medications

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter NSAIDs, such as ibuprofen and naproxen, can help reduce pain and inflammation associated with arthritis.
• Analgesics: Acetaminophen (Tylenol) may be recommended for pain relief, especially for patients who cannot tolerate NSAIDs.
• Corticosteroids: Injections into the shoulder joint can temporarily relieve pain and inflammation. However, repeated use should be cautiously approached due to potential side effects.

2. Physical Therapy

A physical therapist can design a tailored exercise program to improve shoulder strength, flexibility, and range of motion. Gentle stretching and strengthening exercises help maintain joint function and reduce stiffness.

3. Lifestyle Modifications

• Activity Modification: Avoiding activities exacerbating pain, such as heavy lifting and repetitive overhead motions, can help manage symptoms.
• Heat and Cold Therapy: Applying heat or cold packs to the shoulder can relieve pain and reduce inflammation.
• Ergonomic Adjustments: Changing the workstation, using supportive pillows, and practicing good posture can reduce shoulder strain.

4. Injections

• Hyaluronic Acid Injections: Hyaluronic acid injections can lubricate the joint and improve mobility, relieving patients with osteoarthritis.
• Platelet-Rich Plasma (PRP) Therapy: PRP therapy involves injecting the patient’s platelets into the shoulder to promote healing and reduce inflammation.

Surgical Treatments for Shoulder Arthritis

When non-surgical treatments fail to provide relief, surgery may be considered. The type of surgery depends on the severity of the arthritis and the patient’s overall health.

1. Arthroscopic Surgery

Arthroscopy is a minimally invasive procedure that uses small incisions and an arthroscope to remove damaged tissue, bone spurs, and loose fragments from the joint. It is typically used for mild to moderate arthritis.

2. Shoulder Replacement Surgery

Shoulder replacement surgery, also known as shoulder arthroplasty, is recommended for patients with severe arthritis and significant joint damage.

• Total Shoulder Replacement involves replacing both the humeral head (ball) and the glenoid cavity (socket) with artificial components.
• Partial Shoulder Replacement (Hemiarthroplasty): Replaces only the humeral head.
• Reverse Shoulder Replacement: Reverses the ball-and-socket structure to improve stability and function, especially for patients with rotator cuff tears and arthritis.

Conclusion

Shoulder arthritis is a debilitating condition impacting daily activities and overall quality of life. Early diagnosis and a tailored treatment plan, including lifestyle changes, medications, physical therapy, and surgical options, can help manage symptoms and improve shoulder function. If you experience persistent shoulder pain and stiffness, consult an orthopedic specialist to discuss your treatment options.