Shoulder Arthritis: Causes, Symptoms, and Treatment

What is Shoulder Arthritis?

Shoulder arthritis involves the breakdown of the cartilage that cushions the bones in the shoulder joint. This deterioration can lead to bones rubbing together, causing pain, swelling, and decreased joint mobility.

Types of Shoulder Arthritis

1. Osteoarthritis (Degenerative Joint Disease):

   • The most common type of arthritis, osteoarthritis occurs when the protective cartilage that cushions the bones in the shoulder joint wears down over time, often due to aging or repeated stress on the joint.

2. Rheumatoid Arthritis:

   • This is an autoimmune disease that causes the immune system to attack the synovial membrane, leading to joint inflammation. Over time, it can cause damage to the cartilage and bone.

3. Post-Traumatic Arthritis:

   • This form of arthritis develops after an injury to the shoulder, such as a fracture or dislocation, which can lead to long-term damage to the joint.

4. Rotator Cuff Tear Arthropathy:

   • This type of arthritis occurs when a severe rotator cuff tear is left untreated, leading to arthritis as the shoulder’s mechanics are compromised.

Causes of Shoulder Arthritis

Shoulder arthritis can result from a variety of causes, including:

1. Age:

• As people age, the cartilage in their joints naturally wears down, making osteoarthritis more common in older adults. This gradual wear and tear can lead to shoulder arthritis.

2. Injury:

• Previous shoulder injuries, such as fractures, dislocations, or rotator cuff tears, can increase the likelihood of developing arthritis later in life. Repeated shoulder trauma or overuse can contribute to cartilage breakdown.

3. Genetics:

• A family history of arthritis can increase the risk of developing shoulder arthritis, as certain genetic factors may predispose individuals to joint degeneration.

4. Inflammatory Conditions:

• Conditions like rheumatoid arthritis, which involves an autoimmune response, or gout can lead to arthritis in the shoulder joint.

5. Repetitive Stress:

• Repeated overhead movements or strenuous activity that puts stress on the shoulder can result in wear and tear, increasing the risk of developing arthritis.

Symptoms of Shoulder Arthritis

The symptoms of shoulder arthritis can vary in severity, but the most common signs include:

1. Pain:

• Shoulder arthritis often causes dull, aching pain in the shoulder joint, which may worsen with activity. It can also be felt when the shoulder is at rest.

2. Stiffness:

• As the cartilage wears down, the shoulder joint becomes stiff, making it difficult to move the arm in certain directions. Over time, the range of motion may be significantly limited.

3. Swelling and Inflammation:

• The shoulder joint may become swollen and warm to the touch due to inflammation, particularly in the morning or after physical activity.

4. Grinding or Cracking Sensation:

• A grinding sensation (crepitus) may be felt when moving the shoulder, due to the roughened surface of the bones rubbing against each other as cartilage deteriorates.

5. Weakness:

• Muscle weakness in the shoulder may occur due to reduced use of the joint to avoid pain or discomfort. This can lead to a decrease in shoulder strength over time.

Diagnosing Shoulder Arthritis

A healthcare provider will typically diagnose shoulder arthritis through a combination of medical history, physical examination, and imaging tests.

1. Physical Examination:

• The doctor will assess the shoulder joint for signs of pain, swelling, and restricted range of motion. They may also test muscle strength to evaluate weakness.

2. Imaging Tests:

• X-rays: X-rays are used to check for joint space narrowing, bone spurs, and other signs of arthritis.

• MRI: An MRI provides detailed images of the soft tissues, including cartilage, muscles, and tendons, and can reveal the extent of damage to the shoulder joint.

• CT Scan: This may be used to obtain more detailed images, especially when planning for surgical intervention.

Treatment for Shoulder Arthritis

The goal of treatment for shoulder arthritis is to relieve pain, reduce inflammation, and improve shoulder function. Treatment can range from conservative (non-surgical) approaches to surgical intervention, depending on the severity of the arthritis.

Non-Surgical Treatment

1. Pain Management:

   • NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) like ibuprofen or naproxen can help reduce pain and inflammation in the shoulder joint.

   • Corticosteroid Injections: Injections into the shoulder joint can provide significant relief from inflammation and pain, although their effects are typically temporary.

2. Physical Therapy:

   • A physiotherapist will guide you through exercises designed to improve shoulder flexibility, strengthen muscles, and restore joint function. Stretching and strengthening exercises can help prevent the stiffness associated with arthritis.

   • Range-of-motion exercises: These can help keep the shoulder joint moving and reduce pain.

   • Strengthening exercises: Strengthening the muscles around the shoulder joint can help support the joint and relieve stress on the damaged cartilage.

3. Heat and Cold Therapy:

   • Applying heat or cold packs can help reduce pain and inflammation. Cold therapy is typically used to reduce swelling, while heat therapy helps relax muscles and improve circulation.

4. Assistive Devices:

   • In some cases, a shoulder brace or sling may be recommended to provide support and limit motion, especially during flare-ups of pain.

5. Lifestyle Modifications:

   • Maintaining a healthy weight, avoiding activities that exacerbate the pain, and modifying exercise routines can help reduce strain on the shoulder joint.

Surgical Treatment

If conservative treatments do not provide relief and the pain and disability continue to worsen, surgery may be considered. Surgical options include:

1. Arthroscopic Debridement:

   • This minimally invasive procedure involves using a small camera and surgical tools to remove damaged tissue, smooth out rough areas on the joint, and remove bone spurs that may be causing pain.

2. Shoulder Arthroplasty (Total Shoulder Replacement):

   • In severe cases, a total shoulder replacement may be recommended. During this procedure, the damaged shoulder joint is replaced with an artificial joint, restoring function and reducing pain.

3. Partial Shoulder Replacement:

   • In some cases, only part of the shoulder joint is replaced, such as the ball of the shoulder (humeral head) while preserving the natural socket (glenoid).

4. Reverse Shoulder Replacement:

   • This option is sometimes recommended for people with rotator cuff arthritis or those who have a severe rotator cuff tear in addition to arthritis. The procedure reverses the normal anatomy of the shoulder to improve the mechanics of the joint.

Recovery and Rehabilitation

Recovery time after surgery depends on the type of procedure performed and the individual’s overall health. For shoulder arthroplasty, physical therapy is a crucial part of the recovery process to regain strength and mobility.

• Post-surgery rehab: Physical therapy will focus on regaining range of motion, improving strength, and restoring function to the shoulder.

• Gradual Return to Activities: It is important to gradually return to normal activities to avoid overloading the shoulder during the recovery phase.

Prevention of Shoulder Arthritis

While arthritis cannot always be prevented, the following strategies may reduce the risk:

1. Regular Exercise: Strengthening the muscles around the shoulder joint can help reduce wear and tear on the cartilage.

2. Avoid Overuse: Avoid activities that put excessive stress on the shoulder joint, especially if they involve repetitive overhead movements.

3. Injury Prevention: Use proper techniques during sports or physical activities to prevent injuries that can lead to arthritis.

4. Weight Management: Maintaining a healthy weight reduces the load on the shoulder joint and may lower the risk of developing arthritis.

Expert Care at Palms Physiotherapy & Allied Health

At Palms Physiotherapy & Allied Health, our expert physiotherapists specialize in the treatment and rehabilitation of shoulder arthritis. We offer individualized treatment plans that may include physical therapy, pain management, and exercise guidance to help improve your shoulder function and reduce pain. If you're experiencing shoulder pain or symptoms of arthritis, contact us today for a comprehensive assessment and treatment plan.