What Is Shoulder Arthritis?
Arthritis occurs when the cartilage that cushions your joints gradually deteriorates. Shoulder arthritis is a degenerative condition that affects the shoulder joint. During movement, the bones of the joint rub against each other, causing pain; this is often referred to as “bone on bone” arthritis. It leads to pain, stiffness and reduced mobility.
Types of Shoulder Arthritis
Shoulder arthritis is usually classified into one of five major types that affect the shoulder: avascular necrosis, osteoarthritis, post-traumatic arthritis, rheumatoid arthritis (RA) and rotator cuff tear arthropathy.
Avascular Necrosis
Avascular necrosis (AVN) of the shoulder occurs when there is a disruption in the blood supply to the humerus, leading to the destruction of the shoulder joint and the development of arthritis. AVN can be caused by underlying conditions such as sickle cell disease, excessive alcohol use, high doses of steroids and fractures of the shoulder bones.
Osteoarthritis
Osteoarthritis is a condition that damages the smooth outer covering of bone and is often called “wear and tear” arthritis. Over time, the cartilage deteriorates, resulting in a reduction of the protective space between the bones. In shoulder arthritis, the bones of the shoulder joint grind against one another, leading to pain.
Post-Traumatic Arthritis
Post-traumatic arthritis is a form of osteoarthritis that may arise following an injury. In cases of shoulder arthritis, a fracture or dislocation can affect both the acromioclavicular (AC) and glenohumeral joints.
Rheumatoid Arthritis
The joints in your body are coated with a lining known as synovium, which lubricates the joint and facilitates smooth movement. Rheumatoid arthritis leads to swelling of this lining, resulting in pain and stiffness in the joint. Rheumatoid arthritis is a chronic autoimmune disease that can affect multiple joints throughout the body.
Rotator Cuff Tear Arthropathy
Following a rotator cuff tendon tear, the rotator cuff can no longer hold the head of the humerus bone in the socket, allowing the humerus to move upward and rub against other bones. This friction affects the surfaces of the bones, resulting in arthritis, pain, weakness and limited mobility.
Causes of Shoulder Arthritis
The primary cause of shoulder arthritis is degeneration due to age, but injury or overuse can also contribute to the condition. The cartilage in our joints wears down gradually over time. When combined with overuse, repetitive motions, heavy lifting, obesity and smoking, this degeneration can lead to arthritis.
Risk Factors for Shoulder Arthritis
General risk factors for shoulder arthritis include age, obesity, prior injuries, family history, physical activities, occupation and overuse of muscles and joints. Individuals with other conditions, such as rheumatoid arthritis, osteoarthritis or other autoimmune disorders, face an increased risk of developing shoulder arthritis.
Screening for & Preventing Shoulder Arthritis
Prevention measures include exercising regularly, maintaining a healthy weight and avoiding activities that excessively strain the shoulder joint. In some cases, wearing a brace or sling can help reduce symptoms by keeping the shoulder in a neutral position.
Signs & Symptoms of Shoulder Arthritis
Symptoms of shoulder arthritis include pain, swelling, limited range of motion and difficulty sleeping due to pain. People may sometimes experience grinding or cracking sensations when moving the shoulder.
Diagnosing Shoulder Arthritis
The diagnosis of shoulder arthritis starts with a physical examination and a review of your medical history. Imaging tests, such as X-rays, magnetic resonance imaging (MRI) scans or computed tomography (CT) scans, may help confirm the diagnosis. Additional tests, including bloodwork or joint fluid analysis, may also be necessary.
Treating Shoulder Arthritis
Most people can manage their symptoms with treatments that don’t involve surgery. These may include over-the-counter medicines, exercise and alternating heat and ice to reduce pain, stiffness and swelling. The Montefiore Einstein Department of Physical Medicine and Rehabilitation experts can provide physical therapy, non-opioid pain management, ultrasound-guided cortisone injections and an individualized treatment plan with a specialized at-home exercise program.
In severe cases, your doctor might recommend shoulder replacement if you can barely move your shoulder, cannot do your daily activities, have lost a lot of cartilage and/or have tried medicine and other treatments without the desired results.
Living with Shoulder Arthritis
Living with shoulder arthritis can entail pain, stiffness and a limited range of motion. However, it is possible to manage symptoms and maintain an active lifestyle through treatments such as exercise, physical therapy, medication and lifestyle changes.