What is Shoulder Arthritis?
Arthritis is inflammation of a joint (the area where two bones meet in order to allow movement). The condition results in loss of cartilage (the smooth lining on the joint surfaces) and in severe cases results in the bones rubbing directly against each other. Without the cartilage lining, the typical features of arthritis arise including pain, swelling and stiffness.
Because this happens over time, osteoarthritis is most common in people over age 50, although it may also occur in younger people.
Diagnosis of Shoulder Arthritis
The most common symptom of shoulder arthritis is pain, aggravated by activity and progressively worsens. Limited motion is another common symptom. Doing daily activities, like brushing your hair, may cause pain.
To diagnose shoulder arthritis, the physician and care team will review medical history and perform a physical exam. Images (x-ray and/or MRI) may be taken and can show arthritis development.
Many people are aware of shoulder pain relating to arthritis, and yet many are surprised to receive this diagnosis. Whatever the case may be, conservative and surgical treatment options exist. At Sano Orthopedics, we take an individualized treatment approach called the road map to wellness.
Identifying your goals is the first step of wellness. Seeking an active lifestyle? Avoiding surgery at all costs? Other medical reasons to consider? Your surgeon will tailor a plan to fit your needs and goals.
Depending on the level of pain and damage a patient suffers, we recommend a treatment regimen to relieve symptoms. Some of the most common recommendations include:
- Activity modification
- Using over-the-counter anti-inflammatory medications and/or paracetamol (acetaminophen)
- Physical therapy
For many patients, injections to the shoulder may be an option for relieving pain. Depending on patient history, several different types of injections may be available.
Platelet-Rich Plasma – or PRP injections – use platelet-rich blood to support healing. In PRP therapy, blood is drawn from the patient and then spun in a centrifuge. This is done to separate the platelets from other blood cells. These platelets are then injected into the damaged knee joint. It’s the growth factors in the platelets that can aid healing of the shoulder joint.
Corticosteroids are steroids that are injected directly into the shoulder joint to reduce inflammation. Patients who find corticosteroids successful receive these injections regularly every 3 to 4 months. Due to side effects, there is a limit to the time frame between injections.
Regenerative medicine via stem cells is another less invasive option that may help reduce inflammation, promoting new blood flow, and set up body to heal itself.
Arthroscopic Shoulder Surgery
If conservative treatment fails, surgery becomes an option.
Arthroscopic surgery of the shoulder aims to reduce pain and restore movement. It is typically used in younger patients, particularly athletes, and older patients who wish to remain active and delay shoulder replacement surgery.
During arthroscopic surgery, the joint is smoothed by removing loose and damaged cartilage tissue, bony spurs, and loose bodies. Movement can be improved by releasing the scarred joint capsule. In some cases, nerve release may also be used to alleviate pain.
As with all surgery, arthroplasty does come with risks. Infection, nerve injury, stiffness, and failure to improve all symptoms are some risks to consider. Patients may still require joint replacement in the future. It’s important for every patient to discuss these and their personal medical history so a treatment plan can be developed.
Shoulder Joint Replacement Surgery
If conservative treatment fails, shoulder replacement surgery becomes an option. Shoulder replacement is a very successful surgery, but it does have risks.
Joint replacement provides excellent pain relief for patients with advanced arthritis. Several different types of shoulder replacement are available and the choice depends of the type of arthritis and whether the rotator cuff (tendons responsible for shoulder movement) are involved or not.
All types require an incision (rather than arthroscopic surgery), the arthritic joint surfaces are removed and replaced with an artificial shoulder joint made of metal
Risks of shoulder replacement include infection, nerve/blood vessel injury, stiffness, failure to improve all symptoms, and revision (the need for the procedure to be performed again if it wears out, becomes loose or dislocates, or if you have a fracture). Sano Orthopedics reviews patient’s medical history, goals and risks of options to determine the best treatment plan for each individual.
Risk Factors for Developing Shoulder Arthritis
Patients often ask, “Is this arthritis or am I at risk for getting shoulder arthritis?” There are a few key risk factors for developing arthritis:
- Repetitive overuse and/or overtraining
- Muscle imbalances
- Increase age
- Excessive muscle tightness
- Poor body mechanics
The good news is shoulder arthritis can often be treated through improved flexibility, range of motion, and strength. Surgery is not necessary for most patients with shoulder arthritis.