Shoulder arthritis is a relatively common condition in which the joint (ball and socket) becomes painful and dysfunctional as a result of wear and tear in the shoulder. In a normal shoulder, the ends of the bone are covered by a smooth surface known as articular cartilage. In patients with shoulder arthritis, this cartilage is progressively lost, exposing the bone beneath and causing chronic pain and in some cases, loss of movement.
There are 2 distinct joints in the shoulder that can be affected by arthritis—the AC joint (acromioclavicular), where the collarbone (clavicle) meets the bony roof of the shoulder (acromion); and the glenohumeral joint where the ball of the arm bone (humerus) meets the socket (glenoid).
There are several types of shoulder arthritis:
- Osteoarthritis is the gradual wearing down of the joint cartilage that occurs predominantly in those of a more mature age, or is the result of overuse in highly active athletes.
- Post-traumatic arthritis occurs within the shoulder joint after an acute or traumatic injury (such as a blunt force blow to the joint or a hard fall). Even after the injury itself is repaired, the joint can still be susceptible to early arthritis due to mechanical and chemical changes within the joint. This type of arthritis can also develop after a chronic rotator cuff tear.
- Rheumatoid arthritis occurs when the body’s immune system attacks its own cartilage and destroys it. This is often a hereditary or genetic form of arthritis that tends to affect more women than men.
The predominant symptom of shoulder arthritis is chronic pain, which is derived from the grinding of the bones against one another after the cushioning function of the cartilage is lost. Some patients may experience some weakness or stiffness in the joint as the condition progresses. Night pain and difficulty sleeping are also common symptoms of shoulder arthritis.
Dr. Anz will conduct a thorough examination of the shoulder joint to find areas of tenderness or pain and to also check overall mobility. A variety of tests may be utilized to confirm the diagnosis of shoulder arthritis, including X-rays (to look at the joint) or an MRI (to assess the soft tissue and cartilage).
The goal in treating shoulder arthritis is to reduce or eliminate the underlying symptoms associated with the condition. This includes alleviating the pain, swelling, and overall stiffness of the shoulder joint.
Arthritis of the shoulder is very common. Many patients are able to live with the side effects for years before finally seeking medical treatment. Most patients find that resting the shoulder and avoiding activities that exacerbate inflammation helps. Applying ice to the joint and taking anti-inflammatory pain medications also help with pain. Corticosteroid injections also are helpful to relieve the symptoms and these may be administered by Dr. Anz. Physical therapy exercises, such as swimming, can be soothing and may help maintain joint motion while strengthening the shoulder and avoiding impact.
In patients where the symptoms associated with shoulder arthritis are severe and continue to worsen, there are a number of surgical procedures that exist to help. Treatment for shoulder arthritis is based upon the cause and severity of the arthritis, the intensity of the symptoms, and the functional level of the patient. The effect of this disease on daily life can often be the deciding factor on treatment strategy.
In its early stages, shoulder arthritis can be treated via arthroscopic surgery, which is the least invasive approach. With this operation, Dr. Anz trims out the inflamed synovial lining tissue and removes pieces of the degenerated cartilage. This treatment will not completely cure the arthritis, but can relieve many of the symptoms.
In severe cases, the recommended surgical treatment is shoulder replacement surgery (or joint replacement). This operation often restores motion lost through the degeneration by replacing the damaged ball with a synthetic surface. Arthroplasty is the term generally used for replacement surgery.
Replacement surgery is not recommended for young patients. There are other joint restoration and joint preservation techniques that have been proven effective for younger patients (under the age of 70). Typically, a joint replacement procedure is the final opportunity to treat the arthritis and the longevity of the procedure can last up to 15 years.
A rehabilitation program will be prescribed at your first post-operative visit with Dr. Anz. Rehabilitation after surgery is as important as the surgical repair itself. Without proper rehab, the chance of full recovery is diminished. Depending on the exact surgical procedure that was performed, the patient will be required to do exercises and strengthening moves with a therapist.
For additional resources on arthritis of the shoulder, or to learn more about arthroscopic shoulder surgery, please contact the Gulf Breeze, Florida orthopedic surgeon, Dr. Adam Anz located at the Andrews Institute.