May 21, 2018
Inflammation in your joints may be a result of degeneration called arthritis. This can cause symptoms ranging from pain, stiffness, loss of mobility to other consequences that can limit your lifestyle. Because your shoulder is comprised of three major bones (the humerus, scapula, and clavicle), inflammation results in discomfort and limited range of motion. In this article we will explore frequently asked questions about shoulder arthritis to help you get to the bottom of symptoms, treatment options, and concerns you might have.
What are the symptoms of shoulder arthritis?
- In the front, side or back of the shoulder
- While shoulder is in motion or staying still
- At night or in the morning
- While you sleep/after waking up
- While lifting or carrying heavy objects
- Worse after exercise
- Warmth in the joint
- Swelling and inflammation
- Loss of range of motion
- Grinding, clicking or cracking (crepitus)
- Shoulder joint locking up or sliding in certain positions
What are the different types of shoulder arthritis?
There are two joints in the shoulder, the acromioclavicular (AC) joint and the glenohumeral joint. Your shoulder can take a lot of wear and tear, but once your shoulder joint begins to show symptoms of pain, swelling and lowered mobility, there are higher chances that you are beginning to develop arthritis in the shoulder.
To provide you with effective treatment, your physician will need to determine which type of arthritis you have. There more common types of arthritis seen in the shoulder have been listed below.
Rheumatoid Arthritis (RA)
Patients who experience symptoms of rheumatoid arthritis—a chronic inflammatory disease of the joints that can cause erosion and deformation of your shoulder bones—are experiencing the consequences of their own immune system attacking their synovium (the thin membrane that lines your bones at the ends where they meet to create your joints).
There is symmetrical joint involvement in rheumatoid arthritis—if one shoulder is affected, your chances of experiencing symptoms in the corresponding joint on the other side of your body is high. This means you will not only have RA in one shoulder, hip, hand or knee, but you will likely have RA in both (or more). There are many other types of inflammatory arthritides. Most of them, including rheumatoid arthritis are treated with disease modifying medications to prevent your immune system from attacking the synovial lining of the joint.
Osteoarthritis—a degenerative condition, also known as wear-and-tear arthritis, that destroys the smooth articular cartilage of the shoulder bones—is the most common type of arthritis in the shoulder and appears more common in the AC joint than in the glenohumeral joint, and is usually diagnosed in people over 50 years of age. The degenerative nature of OA leads to the rough bone ends in the shoulder rubbing against each other—resulting in irregular motion within the joint.
Osteophytes (bone spurs) play a big factor in the resulting irregular motion of the shoulder joint in OA, because when you combine the friction from the osteophytes that form as the bone tries to heal itself with the developing inflammation, your shoulder loses range of motion, and results in more pain and weakness as you try to move your arm. Many people will say that their motion has become “ratcheting”.
Other Joints OA Can Affect
In the event of a shoulder injury, there is a chance you can develop arthritis in the shoulder joint—this type of arthritis is called post-traumatic arthritis (PA)—because shoulder injuries are commonly due to the shoulder joint’s instability, and the consequences of that instability. When you fracture or dislocate your shoulder joint, fluid can build up in your shoulder, causing pain and swelling and potentially leading to your shoulder developing PA. Trauma from sporting injuries and other accidents can also cause this condition.
How is arthritis diagnosed?
It’s important to find out what type arthritis you have because treatments vary for each type. Early diagnosis and treatment of arthritis is important to help slow or prevent further joint damage that can occur if you leave it untreated. But, to go a step further, it’s even more pertinent to gain clarity on which type of arthritis you have, and—because it sometimes takes a long time to clearly diagnose the type of arthritis you’re experiencing—it’s of critical importance to schedule your consultation as soon as possible if you believe you might have arthritis in the shoulder.
- Your doctor will examine the injured joint.
- What your physician is looking for:
- Pain level
- Range of motion
- Grinding severity
- Joint weakness
- Tenderness to touch
- Swelling and skin rashes
- Your doctor will also conduct some laboratory tests on the injured joint:
- Lab work is commonly performed when your physician is worried about an inflammatory arthritis. This may include bloodwork or joint fluid analysis.
- X-rays or advanced imaging such as MRI or CT scan
- What your physician is looking for:
- Loss of joint space
- Bone cysts and spurs
- Bone quality
- Bone wear
- Integrity of the soft tissue, mainly the rotator cuff
What are common arthritis treatments?
Once you’ve been diagnosed with arthritis, talk to your physician about the best treatment plan for you. Some patients see more benefits in recommended medications, but there are many things you can do to help manage pain and fatigue and regain some range of motion. Below is a list of some treatments you might discuss with your physician.
Many different medicines—both prescription and over-the-counter medicine—can treat arthritis. However, before you purchase or seek out any medication, you should always check with your doctor to be sure it’s ok to take them.
- Anti-inflammatories (NSAIDs)
- Acetaminophen (Tylenol)
- Corticosteroids (injection or in pill form)
- Disease modifier medications (inflammatory arthropathies)
- Sleep medications
Regular exercise is important to keep you moving—it helps lessen pain, reduce fatigue, increases range of motion and increases overall stamina. Be sure to exercise at a level that allows you to talk comfortably during the activity—and don’t be afraid to lower your level of impact and resistance to further reduce the amount of pressure on your shoulder. If you experience pain after exercising for more than two hours you may have done too much and need to take a rest.
Three types of exercises can help people with arthritis:
- Range of motion
Heat and Cold Therapy
Applying hot or cold packs over joints and muscles help reduce inflammation and provide short-term relief from pain and stiffness. While using hot or cold packs to clear up some of your symptoms in the short-term, it’s important to use heat and cold safely in the long-term. Don’t use either treatment for more than 20 minutes at a time, because the longer exposure to drastic changes in temperature could damage your skin if you don’t let it return to normal temperature between applications.
If nonsurgical treatments fail to relieve symptoms, your physician could recommend one of the below surgical treatments. When conservative measures fail, surgery can help reduce pain and increase movement in the shoulder.
Joint Replacement Surgery: Also called arthroplasty, this involves replacing the humeral head and the glenoid socket with an artificial prosthetic joint.
Arthroscopy: Arthroscopy is not as successful for glenohumeral arthritis. It is very successful for treating acromioclavicular joint osteoarthritis. Surgeon will use small incisions to clean out the shoulder joint—a tiny camera is inserted into the joint and this camera guides the surgeon to help remove the debris, and bone spurs.
Resection Arthroplasty: This is primarily for treating acromioclavicular joint osteoarthritis. It involves surgically removing 8-10 mm of the distal bone from your collarbone. In its place, scar tissue develops, decreasing the pain that resulted from the arthritic bone of the clavicle rubbing with the arthritic bone of the acromion.
Get a Consultation with Beacon and Say Goodbye to Your Arthritis
The inflammation from arthritis increases over time —leaving you with pain, fatigue, lack of mobility and constant frustration. While there is no cure for arthritis, especially arthritis in the shoulder, there are several treatment options available to you to help manage the pain and treat your symptoms like those noted above. If you are experiencing any of the symptoms discussed in this article, schedule an appointment today and Beacon Orthopaedics and Sports Medicine will work with you to create a detailed treatment plan to get you back to the activities you love most.