Shoulder Arthritis

One of the more common shoulder conditions Midwest Orthopaedics at Rush (MOR) physicians treat is pain from arthritis of the shoulders. Shoulder arthritis is not as prevalent as hip and knee arthritis, but it is relatively common. It typically affects patients over 50.

Critical to the elimination of pain and restoration of function is a specific and appropriate diagnosis. MOR physicians have significant experience and clinical expertise in diagnosing and treating shoulder arthritic conditions. The physicians at MOR are ranked by U.S.News & World Report as the top Orthopedic group in Illinois and among the top in the country. The MOR shoulder physicians place significant emphasis on identifying a specific pain generator and developing an individualized treatment plan for each patient.

What is shoulder arthritis?

The shoulder is made up of two joints, both of which can develop arthritis. The acromioclavicular joint (the AC joint) connects the collarbone and the tip of the shoulder. The glenohumeral joint (the GH joint) is the ball and socket joint that connects the upper arm to the shoulder blade and provides the shoulder its wide range of motion. Arthritis of the shoulder occurs when the cartilage wears out. Cartilage is the smooth, frictionless lining of the joint that cushions the ends of bones and prevents rubbing.

Arthritis literally means "inflammation of the joint" and there are two types that predominantly affect the shoulder: osteoarthritis and rheumatoid arthritis.

What is osteoarthritis?

Osteoarthritis is one of two kinds of arthritis that affects the shoulder. Osteoarthritis, also called OA or degenerative joint disease (DJD), is the most common type of arthritis. Called "wear and tear" arthritis, it affects more than 25 million people in the United States. While common in the shoulders, OA can also affect the knees, hips and hands.

Who is most likely to get osteoarthritis?

Although OA affects people of all races and cultures, it is more likely to strike women than men. Because of its degenerative nature, it also is more common in adults over the age of 50. Post-traumatic arthritis is a subset of osteoarthritis that develops in those who have suffered a traumatic injury, such as a fracture.

What are the symptoms of shoulder osteoarthritis?

While each person experiences the effects of shoulder osteoarthritis differently, there are some common symptoms. It's also important to note that the symptoms of shoulder osteoarthritis can change daily and don't necessarily progress steadily or predictably. Common symptoms include:

  • Pain and aching in the joint, especially at night or in the morning
  • Pain centralized at the top or front of the shoulder
  • Motion loss with stiffening in the shoulder after activity
  • Difficulty completing daily activities
  • Limited range of motion in the joint
  • Grinding sound that accompanies motion
  • The joint becomes aggravated by activity
  • Sleep disturbance

What are the causes of shoulder osteoarthritis?

To date, there is no known cause for shoulder osteoarthritis, but MOR shoulder physicians believe many factors contribute to the condition.

  • Overuse: If your job requires repetitive motion, your risk of developing shoulder osteoarthritis increases due to the increased stress on the joints.
  • Genetics: Family history can play a role.
  • Age: The older you are, the more wear and tear your joints have endured.
  • Weight: Any additional weight, especially in the obese, adds stress to the body's joints.
  • Injury: Traumatic injury to a joint increases your risk.

What are the treatments for shoulder osteoarthritis?

To date, there is no cure for shoulder osteoarthritis, but initiating therapies as soon as possible can substantially assist most patients. The goal of an MOR treatment program for shoulder osteoarthritis is to relieve pain and restore range of motion. Because the shoulder is not a weight-bearing joint, many patients are able to find relief through the following conservative treatments:

  • Exercise and physical therapy: Keeping joints moving keeps them lubricated and flexible as well as builds up the muscles surrounding the affected joint.
  • Pain relief: Analgesics, topical pain relievers, corticosteroids and steroidal injections to reduce inflammation and non-steroidal anti-inflammatory (NSAID) drugs all can assist in reducing pain and swelling.
  • Weight loss: Losing weight will reduce stress on the joints.
  • Rest: Resting the joint is necessary to reduce pain.

When conservative treatments fail, your doctor may suggest a surgical solution to restore function and eliminate pain caused by shoulder osteoarthritis. Recent advances make surgery a reliable option to repair injury to both joints of the shoulder.

What is shoulder rheumatoid arthritis?

Rheumatoid arthritis, known as RA, is one of two kinds of arthritis that affects the shoulder. It is a form of inflammatory arthritis and an autoimmune disease. The auto immune system is supposed to protect our health, but in the case of an autoimmune disease, the body attacks its own tissues, especially the synovium, a membrane that lines and lubricates the joints. When the synovium is compromised, injury to the bones and cartilage can result. The long-term affects of painful shoulder rheumatoid arthritis can include joint deformity and disability. The disease can even affect the organs and the internal systems.

RA is chronic, meaning it can't be cured, and can affect multiple joints of the body. In fact, RA is symmetrical, meaning that if one joint is affected, the corresponding joint on the opposite side of the body is affected as well.

Who is most likely to get shoulder rheumatoid arthritis? Unlike shoulder osteoarthritis that affects older adults, shoulder rheumatoid arthritis can affect people of any age. Most affected adults range in age from 30 to 60, but children can get a subset of the disease called juvenile arthritis. It is estimated that 1.3 million people in the United States have rheumatoid arthritis, and women are three times as likely to get the disease as men.

What are the symptoms of shoulder rheumatoid arthritis?

While each person experiences the effects of shoulder rheumatoid arthritis differently, there are some common symptoms. It's also important to note that the symptoms of shoulder rheumatoid arthritis can change daily and don't necessarily progress steadily or predictably. Shoulder experts at MOR say common symptoms include:

  • Pain
  • Swelling and inflammation around affected joints
  • Limited range of motion
  • Overall fatigue, low-grade fever and loss of appetite
  • Lumps or nodules beneath the skin
  • Tenderness
  • Overall feeling of stiffness

What are the causes of shoulder rheumatoid arthritis?

To date, there is no known cause for shoulder rheumatoid arthritis, but several factors are believed to contribute to the condition.

  • Combination of environmental and genetic factors
  • Possibly female hormones
  • Smoking may play a role
  • Possibly bacteria or viruses

What are the treatments for shoulder rheumatoid arthritis?

There is no cure for shoulder rheumatoid arthritis, but initiating therapies as soon as possible can substantially assist most patients. The goal of a treatment program for shoulder rheumatoid arthritis is to relieve symptoms and decrease inflammation. Because the shoulder is not a weight-bearing joint, many patients are able to find relief through the following conservative treatments:

  • Exercise and physical therapy: Keeping joints moving keeps them lubricated and flexible and builds up the muscles surrounding the affected joint.
  • Medications: Drugs can modify the disease and put it into remission.
  • Pain relief: Analgesics, topical pain relievers, corticosteroids and steroidal injections to reduce inflammation and non-steroidal anti-inflammatory (NSAID) drugs all can assist in reducing pain and swelling.
  • Weight loss: Losing weight will reduce stress on the joints.
  • Rest: Resting the joint is necessary to reduce pain.

When conservative treatments fail and depending on the condition, MOR physicians may suggest a surgical procedure, such as shoulder arthroplasty or a total shoulder replacement to restore function and eliminate pain caused by shoulder rheumatoid arthritis. Recent advances make surgery a reliable option to repair injury to both joints of the shoulder.