Diagnosed With Shoulder Arthritis?

Although not as common as knee or hip osteoarthritis, shoulder arthritis can be just as debilitating. What is shoulder arthritis? How do you know if you have it? And what are the best treatment options?




Shoulder Anatomy

shoulder anatomy

The shoulder is technically comprised of a number of joints: the glenohumeral (GH) joint, the scapulothoracic (ST) joint, and the acromioclavicular (AC) joint. The specific joint that is involved with shoulder replacement is the glenohumeral joint. It is a ball and socked joint formed by the head of the humerus (arm bone) connecting with the glenoid of the scapula (shoulder blade).

The shoulder joint itself is not a very stable joint. The head of the humerus (ball portion) is much larger than the glenoid (socket). It is similar to a golf ball sitting on a golf tee. Fortunately the rotator cuff muscles of the shoulder provide dynamic stability for the joint.


What is Shoulder Arthritis?

Osteoarthritis (OA) simply means inflammation of the joint. A majority of joints in the body are lined with a thin protective coating called articular cartilage. When this cartilage becomes damaged, the underlying bone can become injured, inflamed and painful. Damage to this articular cartilage can come in the form of trauma or in the form of overuse.


The most common joint within the shoulder complex that becomes arthritic is the glenohumeral (GH) joint. This is the typical ball and socket joint that most people recognize as the shoulder joint. Most often the head of the humerus is the region that becomes arthritic.


What Causes Arthritis?

Most commonly, some previous injury or wear and tear of the joint is the root cause of the development of arthritis. For the shoulder, injuries such as a rotator cuff tear, shoulder dislocation, or labral tear are frequent types of injuries that can lead to the development of arthritis. Examples of wear and tear can include overhead activity such as swimming, throwing, or even having an occupation that requires frequent overhead use of the shoulder such as a painter.

Although osteoarthritis is the most common cause of joint arthritis, other arthritic conditions such as rheumatoid arthritis can also create degenerative changes within a joint.



Typical Signs and Symptoms

The most common symptom of shoulder arthritis is pain. Pain with arthritis generally occurs with motion, specifically overhead. Of course other types of shoulder injuries such as shoulder impingement and shoulder tendonitis can also cause pain with overhead motion.

Another typical symptom is a loss of normal range of motion. With arthritic shoulders, the range of motion can feel as if the joint ratchets as it goes through its motion.

Because of limited motion with overhead activity and shoulder pain, many typical functional activities can become difficult. Activities such as getting a shirt of jacket on or off can be painful of limited, washing or brushing your hair, and sleeping on the involved side are frequent complaints for those with shoulder arthritis.


Diagnosis

Shoulder arthritis can most often be diagnosed by a thorough evaluation by an orthopedic physician as well as an x-ray. An x-ray ma show a change in the space between the head of the humerus and glenoid as well as irregularity of the joint surfaces. Generally an MRI is not necessary in order to make a diagnosis.


Typical Treatment

shoulder pain

Treatment for shoulder arthritis follows the typical treatment plan for osteoarthritis of other joints. The first goal is to reduce inflammation. The typical recommendation includes over the counter anti-inflammatory medication such as ibuprofen or prescription medication such as Mobic, Bextra, or Celebrex.

Utilizing ice therapy (no heat!) is also an effective means of reducing joint inflammation. In cases in which oral medication is not effective, steroid injections are generally utilized to reduce joint inflammation.

Another typical treatment recommendation is physical therapy. Physical therapy can be greatly effective in restoring normal mobility and function. When the shoulder moves abnormally, either because of abnormal range of motion or impaired strength, the shoulder will continue to be under stress. Restoring normal mobility and muscle balance can be greatly effective in helping to reduce pain and restore function.


Surgery

If the typical conservative treatment plan of anti-inflammatory medication, physical therapy, and steroid injections are not effective, and if significant pain and limited function, surgery is an option. The surgical procedure that is performed is a shoulder replacement. This is a significant surgery and should not be considered lightly. The postoperative rehabilitation process is generally three months with patients often reporting the shoulder taking up to a year to feel functional.

Shoulder arthritis although not as common as the hip and knee can be equally limiting. Take an active role in your treatment plan to ensure the best outcome possible.



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