What Is Osteoarthritis?
Osteoarthritis, also known as degenerative joint disease occurs when the cartilage that covers the tops of bones, known as articular cartilage, degenerates or wears down. This causes swelling, pain, and sometimes the development of osteophytes bone spurs when the ends of the two bones rub together.
What Is Osteoarthritis of the Shoulder?
The shoulder is made up of two joints, the acromioclavicular (AC) joint and the glenohumeral joint. The AC joint is the point where the collarbone, or clavicle, meets the acromion, which is the tip of the shoulder blade. The glenohumeral joint is the point where the top of the arm bone, or humerus, meets the shoulder blade, or scapula. Osteoarthritis is more commonly found in the AC joint.
Who Gets Shoulder Osteoarthritis?
Osteoarthritis most often occurs in people who are over age 50. In younger people, osteoarthritis can result from an injury or trauma, such as a fractured or dislocated shoulder. This is known as posttraumatic arthritis. Osteoarthritis may also be hereditary.
What Are the Symptoms of Shoulder Osteoarthritis?
As with most types of osteoarthritis, pain is a key symptom. A person with shoulder arthritis is likely to have pain while moving the shoulder and after moving the shoulder. The person can even have pain while sleeping.
Another symptom may be a limited range of motion. This limitation can be seen when you are trying to move your arm. It can also be evident if someone is moving your arm to assess range of motion. Moving the shoulder might also produce a clicking or creaking noise.
How Is Shoulder Osteoarthritis Diagnosed?
To diagnose shoulder osteoarthritis, the doctor will take a medical history and do a physical exam to assess pain, tenderness, and loss of motion and to look for other signs in surrounding tissues. At this point, the doctor may be able to tell if the muscle near the joint has signs of atrophy, or weakness, from lack of use.
Tests that might be ordered to diagnose osteoarthritis of the shoulder include:
- Blood tests, mainly to look for rheumatoid arthritis, but also to exclude other diseases
- Removal of synovial fluid, the lubricating fluid in the lining (synovium) of the joint, for analysis
- MRI scans
How Is Osteoarthritis of the Shoulder Treated?
The first treatments for osteoarthritis, including osteoarthritis of the shoulder, do not involve surgery. These treatments include:
- Resting the shoulder joint – This could mean that the person with arthritis has to change the way he moves the arm while performing the activities of daily living. For example, the person might wear clothing that zips up the front instead of clothing that goes over the head. Or the person might prop up hairdryers instead of holding them up for long periods of time.
- Taking over-the-counter nonsteroidal anti-inflammatory drugs, such as ibuprofen or aspirin. These drugs, also called NSAIDS, will reduce inflammation and pain. Check with your doctor to make sure you can take these drugs safely.
- Performing physical therapy as assigned by the doctor.
- Performing range-of-motion exercises. These exercises are used as an attempt to increase flexibility.
- Applying moist heat.
- Applying ice to the shoulder – Ice is applied for 20 minutes two or three times a day to decrease inflammation and pain.
- Using other medications prescribed by the doctor. These might include injections of corticosteroids, for example.
- Taking the dietary supplements glucosamine and chondroitin – Many people claim relief with these supplements. Evidence is conflicting as to whether they really help. You should discuss using these with your doctor because the supplements may interact with other drugs.
If nonsurgical treatments do not work effectively, there are surgeries available. As with any surgery, there are certain risks and potential complications, including infection or problems with anesthesia.
Surgical treatments include:
- Shoulder joint replacement (total shoulder arthroplasty). Replacing the whole shoulder with an artificial joint is usually done to treat arthritis of the glenohumeral joint.
- Replacement of the head of the humerus, or upper arm bone (hemiarthroplasty). This option, too, is used to treat arthritis of the glenohumeral joint.
- Removal of a small piece of the end of the collarbone (resection arthroplasty). This option is the most common surgery for treating arthritis of the AC joint and associated rotator cuff problems. After the removal of the end of the bone, the space fills with scar tissue.