Shoulder arthritis

What is it?
Shoulder arthritis occurs when the cartilage surface of the ball and socket joint of the shoulder is damaged or becomes worn. Cartilage normally covers the ends of bones and forms a smooth gliding surface. Shoulder arthritis most commonly occurs as a result of osteoarthritis (or wear and tear arthritis). In osteoarthritis the cartilage becomes thinner and spurs of extra bone (osteophytes) may form which alter the shape of the joint and make it stiff and painful. Eventually the bones may start to rub together. Cartilage damage may occur because of a previous injury such as a shoulder dislocation or fracture. It may also be the result of degeneration of the joint cartilage from age.

Arthritis can also occur as a result of Inflammatory Arthritis, of which Rheumatoid Arthritis is the best known. This affects the cartilage in a similar way but results from a process where the lining of the joint and surrounding soft tissues are affected by an inflammatory process.

What are the Symptoms?

Pain, which is often described as dull and constant. This pain is often made worse by lying on the affected side or by using the arm, especially undertaking activities that place the hand above shoulder height. The pain is usually localised to the shoulder itself and in the muscles around the shoulder. Stiffness of the shoulder is also a common complaint. Both of these symptoms may not occur at the same time. They can make simple tasks such as washing your hair very difficult. Patients may also report a “grating” sensation in the shoulder. The “grating” is due to loss of the normal smooth joint surface. This is caused by cartilage damage or wear.

Diagnosis

A doctor can usually diagnose osteoarthritis of the shoulder based on symptoms and X-rays. Advanced diagnostic imaging, such as CT (computed tomography) or MRI (magnetic resonance imaging), is typically not needed to diagnose osteoarthritis of the shoulder.

Treatment options

Here are a few treatment options for Shoulder Arthritis

Treatment options depend on the stage of the disease, prior history, what the patient desires, overall medical condition, and the results of diagnostic X-rays.

Nonsurgical Treatment
For the early stages of osteoarthritis of the shoulder, the most common treatment is nonsurgical. This includes painkillers and anti-inflammatory medication to reduce or alleviate pain. This is combined with modification of activities and sometimes physiotherapy.

Corticosteroid injections are sometimes used to treat osteoarthritis symptoms. Steroid medication has typically been used with good results. Although the effects of injections are temporary, they can provide significant pain relief until symptoms progress enough to need additional treatment.

An alternative to steroids has been the injection of hyaluronic acid in various forms. This is known as visco-supplementation, by surrounding the diseased cartilage with a thicker and more “cushioned” environment. This treatment has been recently studied in people with osteoarthritis of the knee. Although there was initial enthusiasm for this treatment, research has not shown it to be better than traditional steroid injections. The long-term results of these “viscosupplementation” injections in the shoulder or other joints have not yet been investigated.

Surgical Treatment
In the majority of people shoulder arthritis, the symptoms can be successfully controlled by the above interventions. If these fail to provide sufficient improvement, then surgery in the form of shoulder replacement may be considered.

We’re ready to give expert advice on Shoulder arthritis

Request an appointment

Shoulder arthritis