Arthritis of the Shoulder
Causes
To provide you with effective treatment, your physician will need to determine which joint is affected and what type of arthritis you have. Three major types of arthritis generally affect the shoulder.
Osteoarthritis, or “wear-and-tear” arthritis, is a degenerative condition that destroys the smooth outer covering (articular cartilage) of bone. It usually affects people over 50 years of age and is more common in the AC joint than in the glenohumeral shoulder joint.
Rheumatoid arthritis is a systemic inflammatory condition of the joint lining. It can affect people of any age and usually affects multiple joints on both sides of the body.
Posttraumatic arthritis is a form of osteoarthritis that develops after an injury such as a fracture or dislocation of the shoulder. Arthritis can also develop after a rotator cuff tear.
Symptoms
Pain is the most common symptom of arthritis of the shoulder. Often, the pain is aggravated by activity and progressively worsens. If the glenohumeral shoulder joint is affected, the pain is centered in the back of the shoulder and may intensify with changes in the weather. The pain of arthritis in the AC joint is focused on the front of the shoulder. Someone with rheumatoid arthritis may have pain in all these areas if both shoulder joints are affected. Limited motion is another symptom. It may become more difficult to lift your arm to comb your hair or reach up to a shelf. You may hear a clicking or snapping sound (crepitus) as you move your shoulder. As the disease progresses, any movement of the shoulder causes pain, night pain may be common and sleeping may be difficult.
Treatment
As with other arthritic conditions, initial treatment of arthritis of the shoulder is conservative. Your physician will recommend rest or a change in activities to avoid provoking pain; you may need to modify the way you move your arm. Icing the shoulder for 20 to 30 minutes two or three times a day may help reduce inflammation and ease pain. Taking nonsteroidal anti-inflammatory medications such as aspirin or ibuprofen can reduce inflammation. If you have rheumatoid arthritis, your doctor may prescribe a disease-modifying drug such as methotrexate or recommend a series of corticosteroid injections. Dietary supplements such as glucosamine and chondroitin sulfate may also be helpful.
Surgical Options
If conservative treatment does not reduce pain, there are surgical options. Arthritis of the glenohumeral joint can be treated by replacing the entire shoulder joint with a prosthesis (total shoulder arthroplasty) or by replacing the head of the upper arm bone (hemiarthroplasty).