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Shoulder Arthritis

What is shoulder arthritis?

Your shoulder consists of three bones: the humerus (upper arm bone), scapula (shoulder blade bone), and clavicle (collarbone). The head, or ball, of the humerus fits into a shallow socket in your shoulder blade called the glenoid. A combination of tendons and muscles keep the arm bone in place and centered in your shoulder socket. These strong connective tissues are known as the rotator cuff.

The shoulder contains two joints, both of which may be affected by arthritis. The acromioclavicular (AC) joint is located where the collarbone intersects with the tip of the shoulder blade (acromion). The glenohumeral joint is located where the ball of the humerus fits into the shoulder socket.

Treatment for shoulder arthritis depends on its type. Five types of arthritis affect the shoulder.

Osteoarthritis

This condition results from the removal of cartilage that acts as a protective barrier between bone. As the cartilage wears down, it becomes rough and frayed and decreases this protective barrier. The bones of the joint rub against one another during movement, which results in pain.

Osteoarthritis most commonly affects the AC joint and people over the age of 50.

Rheumatoid Arthritis

A chronic autoimmune disease that affects joints throughout the body, rheumatoid arthritis damage cartilage and ligaments and soften bone. It often affects the same joint on both sides of the body, such as both shoulder joints. Rheumatoid arthritis affects the lining (synovium) covering the body’s joints. The synovium makes the joints easier to move by lubricating them. Rheumatoid arthritis causes the synovium to swell, which results in joint pain and stiffness.

Posttraumatic arthritis

Another form of osteoarthritis, this condition occurs after an injury such as a shoulder dislocation or fracture.

Rotator cuff tear arthropathy

Arthritis may also develop after a significant, lasting rotator cuff tear. The humerus can rub against the acromion when the torn rotator cuff no longer holds the ball of the humerus in the shoulder socket. This can cause arthritis to develop by causing damage to the surfaces of the bone.

Avascular necrosis

A painful condition, avascular necrosis occurs when the blood supply to the ball of the humerus is disrupted, resulting in the death of bone cells, prompting the destruction of the shoulder joint and the development of arthritis. This condition occurs in stages. At first, the condition only affects the ball of the humerus; however, over time the dead bone of the humerus can damage the shoulder socket.

What are the symptoms of shoulder arthritis?

  • Pain – Pain is the most common symptom of this condition, one that progressively worsens with activity and over time. Pain resulting from AC joint arthritis is focused on the top of the shoulder and may radiate to the side of the neck. Arthritis in the glenohumeral joint focuses the pain on the back of the shoulder, which may worsen with weather changes and result in a deep aching sensation in the joint.
  • Limited motion – Also a common symptom, limited motion may occur, making it difficult to lift your arm and producing sounds such as grinding, clicking, or snapping (crepitus) with shoulder movement.

How is shoulder arthritis evaluated?

To evaluate your condition, your doctor will perform a physical examination and order specific tests. This may include an X-ray to evaluate the presence of changes in your bone, the formation of bone spurs called osteophytes, and the narrowing of joint space. To support a diagnosis, your doctor may inject local anesthetic into the joint to see if it temporarily relieves pain.

How is shoulder arthritis treated?

Your doctor may recommend non-surgical or surgical treatment options.

Non-surgical treatments

  • Lifestyle changes – Your doctor may recommend a change in activities that result in pain.
  • Nonsteroidal anti-inflammatory medications – Your doctor may recommend over-the-counter medications such as ibuprofen or aspirin to reduce pain and swelling
  • Cortisone injections – Your doctor may recommend a cortisone injection in the shoulder to improve inflammation and pain.
  • Heat or ice therapy – Your doctor may recommend using moist heat on your shoulder, or icing your shoulder two to three times a day for 20 minutes to reduce pain and inflammation
  • Dietary supplements – Your doctor may recommend taking glucosamine and chondroitin sulfate to help relieve pain.
  • Other medications – If you have rheumatoid arthritis, your doctor may prescribe methotrexate or other disease-altering medications

Surgical treatment

  • Arthroscopy – Using an arthroscope (small camera) and miniature surgical instruments, this minimally-invasive procedure uses small incisions to enable your surgeon to clean out (debride) the inside of the joint. While this provides a relief from symptoms, it does not eliminate arthritis, which may require additional surgery in the future.
  • Arthroplasty – Arthroplasty, or shoulder joint replacement, is appropriate for advanced arthritis of the glenohumeral joint. This procedure removes damaged parts of the shoulder and replaces them with artificial components (prosthesis).
    • Hemiarthroplasty – The head of the humerus is replaced with an artificial component.
    • Total shoulder arthroplasty – The glenoid and head of the humerus are replaced with artificial components. A metal ball is affixed to the top of the humerus and a plastic cup is fitted into the glenoid.
    • Reverse total shoulder arthroplasty – Unlike a total shoulder arthroplasty, this procedure affixes the metal ball to the glenoid sock and the plastic cup to the top of the humerus.
  • Resection arthroplasty – For AC joint arthritis, this procedure is most common and entails removing small portions from the end of the collarbone, which creates space that fills gradually with scar tissue. This

Recovery

  • Surgical treatment of arthritis generally results in the reduction of pain and restoration of movement. After surgery, your doctor will focus on reducing your pain to improve your recovery. Your doctor may recommend taking over-the-counter nonsteroidal anti-inflammatory medications, or prescribe short-term pain relievers such as opioids, to minimize your symptoms.

Contact the Hand Center of Louisiana

If you recognize the signs and symptoms of shoulder arthritis, contact us today to schedule an appointment with one of our highly trained physicians. They can evaluate your condition and determine the best course of treatment.

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