Shoulder osteoarthritis (degenerative arthritis of the shoulder)
Osteoarthritis in the shoulder joints is a common cause of shoulder pain.
Shoulder osteoarthritis can affect a person's range of movement and daily life.
Osteoarthritis is the 'wear and tear' form of arthritis affecting the joints.
The shoulder is made up of two joints, the acromioclavicular (AC) joint and the glenohumeral joint, also called scapulothoracic joint. The AC joint is the point where the collarbone (clavicle) meets the acromion, which is the tip of the shoulder bone. 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 osteoarthritis of the shoulder?
Osteoarthritis most often occurs in people who are over 50 years old. In younger people osteoarthritis can result from an injury or trauma such as a fractured or dislocated shoulder. This is known as post-traumatic arthritis. Osteoarthritis may also have an inherited component.
What are the symptoms of osteoarthritis of the shoulder?
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 as well as after moving the shoulder. The person can even have pain while sleeping.
Another symptom may be a limited range of movement. 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 movement. Moving the shoulder might also produce a clicking or creaking noise.
How is osteoarthritis of the shoulder diagnosed?
The doctor will look at your medical history and do a physical examination to assess pain or tenderness and to look for signs of injury to surrounding tissues. These tissues include ligaments, muscles and tendons. The doctor will also assess range of movement. 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 arranged to diagnose osteoarthritis of the shoulder, or rule out other forms of arthritis, include:
- X-rays and scans such as MRI
- 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
- Arthroscopy, a surgical procedure that looks inside the joint and can also be used sometimes to make repairs
With arthroscopy, the doctor can pinpoint the location of the arthritis by using very small instruments inserted through a small incision.
How is osteoarthritis of the shoulder treated?
The initial 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 or she moves his or her arm while performing the activities of daily life. For example, the person might wear clothing that zips up at the front instead of clothing that goes over the head. Or the person might prop up a hairdryer instead of holding it up for a long period of time.
- Taking over-the-counter nonsteroidal anti-inflammatory drugs such as ibuprofen or aspirin. These medications will reduce inflammation and pain. Check with your doctor to make sure you can take these drugs safely.
- Performing physiotherapy as recommended.
- Performing range-of-movement exercises. These exercises are used in 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 or hyaluronic acid into the joint.
If non-surgical treatments do not work effectively, there are surgical treatments available. As with any surgery, there are certain risks and potential complications including infection or problems with anaesthesia. 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 procedure for treating arthritis of the AC joint. After the removal of the end of the bone, the space fills with scar tissue.