Shoulder Arthritis Symptoms, Treatment and Recovery
Your shoulders happen to be one of the most “freely movable” areas on your body, made up of the upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle). The shoulder joint, also known as the glenohumeral joint, is a ball and socket joint which allows for the shoulders extensive range of motion. Since the shoulder can move so freely, this opens up a lot of room for wear and tear on your shoulder joints, which can lead to shoulder arthritis.
A painful condition that may affect the shoulder joint is shoulder arthritis. The term arthritis refers to the pain, swelling, and stiffness in a joint. Shoulder arthritis often causes shoulder pain and limited range of motion. According to the American Academy of Orthopedic Surgeons (AAOS), there can be five distinct forms of shoulder arthritis. Today, we will go into further detail regarding those five types, followed by recommended treatment and recovery methods used at JIS Orthopedics.
Types of Shoulder Arthritis
Listed below are the five forms of shoulder arthritis. Each may have different origins, with some causes still being unknown.
Osteoarthritis of the Shoulder: The most common form of shoulder arthritis, also known as degenerative joint disease. This form is often associated with wear and tear, which can also relate to aging. During osteoarthritis, the articular cartilage (smooth outer layer protecting the edges of your bones) begins to wear away, causing your bones to rub against each other, resulting in pain.
Rheumatoid Arthritis (RA) of the Shoulder: A chronic disease where your immune system attacks its own tissues. This often occurs in multiple joints throughout the body.
The joints in your body are covered with a lining called synovium, which lubricates the joint and makes it easier to move. During RA, the lining in your shoulder’s swells, causing pain and stiffness in the joint. This form of arthritis is symmetrical, meaning that it usually effects the same joint on both sides of the body.
Post-Traumatic Shoulder Arthritis: This develops after an injury, such as a fracture, dislocation, or another serious form of injury to the shoulder. Eventually, this damage can cause the cartilage surface to wear out and disappear.
Rotator Cuff Tear Arthropathy: This type of arthritis can develop after a severe rotator cuff tear. Your rotator cuff contains four tendons, responsible for holding the “ball” of the shoulder joint in place. If any of these tendons are heavily torn, it may cause the humeral head to elevate creating increased pressure on the ball and socket, typically resulting in arthritis down the line.
Shoulder Arthritis due to Avascular Necrosis: Also known as osteonecrosis. This condition refers to the “death” of part of the “ball” of your shoulder. This is commonly seen as a result of trauma or disease, cutting off the blood flow to the bone. Without strong bone support, the cartilage weakens and eventually, the shoulder joint breaks down.
Causes, Signs, and Symptoms of Shoulder Arthritis
Depending on the condition, there are several different causes for shoulder arthritis. At JIS Orthopedics, we find shoulder arthritis to be more common in people ages 50 and above. Typically, these people have undergone the most wear and tear on their joints. However, younger people are still potential candidates for shoulder arthritis, as fractures, dislocations, and infections can all lead to the condition. Additionally, arthritis can be hereditary, meaning it can run in families.
If you think you may be experiencing shoulder arthritis, you might notice these symptoms present:
- Pain: This is the main sign of arthritis being present. You can experience it in the back, front, or side of the shoulder. Some people may experience pain when they aren’t using their shoulder, while others may experience pain when they are. The pain can even spread to the arm, or if severe, the elbow and wrist.
- Stiffness: A dull or achy pain in the shoulder.
- Limited Range of Motion: Refers to how far you can move or stretch your shoulder. In this case, the movability of your shoulder has decreased, preventing you from doing certain everyday activities. If the condition worsens, you may have even less range of motion over time.
- Crepitus: A clicking, grinding, or snapping sound as you move your shoulder. Crepitus can be painful, and sometimes loud enough for other people to hear. Occasionally, you may feel the shoulder slide in certain positions, due to the bone surfaces no longer being smooth.
Shoulder Arthritis Diagnosis
During the diagnosis, your doctor will perform a physical examination, as well as ask you questions about your medical history and symptoms you might be experiencing. In some cases, they may even perform an X-ray to get detailed pictures of bone structure. During the physical examination, your doctor will look for:
- Weakness in the muscles
- Tenderness to touch
- Extent of passive and active range of motion
- Signs of injury surrounding the joint
- Pain when pressure is place on the joint.
Treatment for shoulder arthritis typically begins with non-surgical methods. Your doctor may recommend range of motion exercises, lifestyle modifications, and a few options for pain control.
Range of Motion and Strengthening Exercises: These are exercises that help build back the shoulder’s range of motion and strength. Loss of motion tends to be gradual, and can be hard to notice over time. It is recommended that you stretch for two to three minutes every day. Strengthening of muscles around the shoulder can also decrease symptoms of pain as well as compensate for deficient rotator cuff tendons.
Lifestyle Modifications: Your doctor may recommend a few lifestyle modifications as a part of your treatment. This means avoiding activities that cause shoulder pain. These can include lifting heavy objects, golfing, swimming, and any other activity that puts stress on the shoulder.
Pain Control: There are several different methods that can be used to control the pain caused by shoulder arthritis. Icing the shoulder three to four times a day can help reduce inflammation significantly. If you happen to experience pain in the middle of the night, try icing your shoulder for 20-30 minutes before you go to sleep.
On the other hand, some people feel that heat is a better treatment method for controlling the pain. Heat is typically good for warming up the joint before stretching or performing any stress-inducing activities. However, there is no certain method recommended, as patients should use whichever works best for them.
Over-the-counter medications like acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or Naproxen (Aleve) are all effective choices to alleviate short term pain. One of the most common treatment methods used are cortisone injections, which relieve the pain by reducing inflammation in the joint. Because cortisone injections only last a few months, you may need several injections throughout the year.
If non-surgical treatment methods do not seem to be working, then your doctor will recommend some form of surgery.
Arthroscopy: A minimally invasive operation requiring anesthesia. During this procedure, a small camera is inserted through small incisions in your shoulder, pointing out and removing any loose fragments of damaged cartilage in the shoulder joint and possibly repairing damaged tendons. Once finished, the pain should be relieved significantly, however, this operation does not provide a permanent solution. This type of surgery is typically reserved for patients with mild arthritis and pain also coming from torn tendons.
Shoulder Replacement (Arthroplasty): In more serious cases, shoulder arthritis can be treated with a shoulder replacement surgery. In this form of surgery, damaged parts of the shoulder are removed and replaced with artificial ones, also known as prosthesis. There are several different forms of shoulder replacement surgery that can be executed:
- Hemiarthroplasty: The head of the humerus is replaced by an artificial component.
- Standard Total Shoulder Replacement: Both the head of the humerus and glenoid are replaced.
- Reverse Total Shoulder Replacement: Works better for people with cuff tear arthropathy because it relies on different muscles to move the arm.
Shoulder Arthritis Recovery/Healing
Although there is no cure for shoulder arthritis, there are several effective treatment methods available that can allow you to continue living an active life. Many factors can affect the speed of your recovery, such as treatment methods undergone, age, activity level, and more.
If you underwent an arthroscopy surgery, you can expect a healing time of 1-6 months. For replacement surgeries, depending on the type, you can expect a healing time anywhere from 3-12 months, but can resume most activities around 4 months after surgery. It is important that you follow your doctors personalized rehabilitation program to get you back on track and healthy as soon as possible.
JIS Orthopedics can diagnose and treat your injury, and help you recover
Think you might be experiencing shoulder arthritis? It is important to diagnose the condition early on and get treatment before the symptoms worsen. That’s where JIS Orthopedics can help. Give us a call today and begin your road to recovery with us!