What is it and what are my treatment options?
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 occur in younger people as well.
Diagnosis of Shoulder Arthritis
The most common symptom of shoulder arthritis is pain, which is 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, which we call the road map to wellness.
Road Map To Wellness: Conservative Treatments
Identifying your goals is the first step of wellness. Seeking an active lifestyle? Avoiding surgery at all costs? Other medical reasons to consider? We will tailor a plan to fit your needs and goals.
Depending on the level of pain and damage suffered by a patient, we will recommend a treatment regimen that will 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 the younger patients, particularly athletes, and older patients who wish to remain active and delay shoulder replacement surgery.
During arthroscopic surgery, the joint is smoothed out 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, 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 personal medical history so a treatment plan can be developed.
Shoulder Joint Replacement
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, 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 medical history, goals and risks of options to determine the best treatment plan for each individual.
Shoulder Rehab: JPL Technique
One surgical rehab protocol Sano Orthopedic physicians follow is the JPL Technique. The exercises begin on post-op day 3 and progress until 6 months after surgery.
Watch a video of JPL technique.
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 is often able to be treated through improved flexibility, range of motion, and strength. Surgery is not necessary for most patients with shoulder arthritis.
I work awfully close with some of Dr. Witte’s patients after their surgery. He is very talented and his office is kind and great to work with. Highly recommended as his customer service does not stop with just his patients but his office staff is fantastic! Thank you for all you do!!
I trust these doctors and their conclusions and would certainly recommend them to anyone who is looking for orthopedic care.
Dr Daggett is an awesome shoulder surgeon. He has a great personality and a sense of humor. His education is outstanding. He helped me thru a rotator & bicep injury and I have recovered in record time. My 1st time with Sano. love em….
Let me start off by saying there aren’t enough stars to pick for Dr de Vere and the five they offer here are not quite enough. Dr. de Vere didn’t miss a beat from the first visit to my last she has a bed side manor that doctors just no longer have. The talent she exhibits is second to none. I am no longer dragging my feet and legs to walk and the sciatic never pain is gone. I am back in the gym in less then 90 days and was back at work in 10 weeks. I am so grateful for Dr de Vere, her awesome nurse, the folks at Lees Summit Medical and my wife. Today at 54 years young I am a new man!!