National Arthritis Awareness Month is a time designated to raising the profile of a disease that affects more than 50 million Americans. Arthritis is the leading cause of disability in the U.S., affecting one in five adults. In this simple guide, Francis Mendoza, M.D., a NYC-based orthopaedic shoulder surgeon specializing in the treatment of shoulder arthritis and elbow and shoulder injuries, explains shoulder arthritis symptoms, causes, treatments and more.
What is Shoulder Arthritis?
Arthritis is defined as an inflammation of tissues in the joints. This inflammation is caused when the articular cartilage that keeps the bones from rubbing together breaks down. Without this protective coating, the friction of grinding bones results in pain and swelling. In some cases, bone spurs may also occur.
With shoulder arthritis, cartilage can break down around the acromioclavicular (AC) joint, located where the collarbone meets the tip of the shoulder blade, and the glenohumeral joint, located where the top of the arm bone meets the shoulder blade. Shoulder arthritis symptoms may occur as the result of several types of arthritis.
What are the Types of Shoulder Arthritis?
Typically, shoulder arthritis symptoms such as swelling, pain and limited range of motion that occur around the AC joint are caused by osteoarthritis, also known as degenerative joint disease. While it’s most often associated with advancing age, osteoarthritis can also be hereditary and it affects a number of children and young adults.
Injuries to the joint can also cause what is known as post-traumatic arthritis, a condition that can occur at any age.
Rheumatoid arthritis is an autoimmune disease that affects both the cartilage and lining of the joints and is known to erode bone and cause joint deformity. In addition to the pain and swelling associated with osteoarthritis, rheumatoid arthritis sufferers many also experience fever and fatigue. Stiffness and pain may occur even when the patient is at rest, and the disease is often symmetrical, meaning it affects joints on both sides of the body, such as both shoulders.
Avascular necrosis (AVN) is the death of bone cells in the humeral head at the top of the arm bone. These cells die off due to an interruption in blood flow. If left untreated, this can result in shoulder arthritis. Alcoholism and high levels of corticosteroid usage can play a role in AVN.
Distinction Between Arthritis, Bursitis & Synovitis
Bursitis and synovitis are often brought up in the context of shoulder arthritis and degenerative joint disease, but each condition is unique.
With bursitis, pain is caused by an inflammation of the bursae—the fluid-filled sacs that cushion the bones, tendons and muscles surrounding your joints. Bursitis is commonly caused by repetitive shoulder motions such as throwing a baseball or lifting weights. But bursitis can also be caused by injury, infection or even rheumatoid arthritis.
Synovitis occurs when the capsule of ligaments and tendons surrounding the synovium membrane becomes inflamed. When healthy, the synovium membrane lubricates the shoulder joint and provides cartilage with nourishment. But when the membrane is traumatized by injury or a disease such as rheumatoid arthritis, it produces enzymes that can actually destroy cartilage and bone and even damage surrounding ligaments and tendons.
Shoulder Arthritis Symptoms
If you suspect you or someone you love is suffering from shoulder arthritis, be on the lookout for these three key symptoms:
- Pain – Arthritis causes pain and general discomfort, especially during and directly after shoulder movement. This pain tends to increase over time and may eventually interfere with normal sleep habits.
- Limited range of motion – Pain and swelling is often accompanied by a decrease in mobility. This may be experienced when attempting to stretch, reach or turn the shoulder.
- Joint noise – Affected shoulder joints may creak, click or pop when in motion. This noise, called crepitus, occurs when the bones rub together in the joint.
If you are having these shoulder arthritis symptoms, you should consult an orthopaedic shoulder physician who will conduct an exam to assess your range of motion, level of pain, and your joint and muscle condition.
This exam may include the following:
- X-ray and MRI
- Blood testing to differentiate between osteoarthritis and rheumatoid arthritis and rule out other possible causes of shoulder pain
- Sampling and analysis of synovial fluid that lubricates joint
Treating Shoulder Arthritis Symptoms
Treatment options depend on the type of shoulder arthritis and the severity of pain. Simply changing your day-to-day routine and resting the shoulder can often provide relief. For example, you may switch to button-down shirts instead of wrestling with pullovers.
Relief can also be found through conservative treatment options, including the application of gentle heat or ice and taking over-the-counter medicines such as ibuprofen or aspirin. Your doctor may also recommend physical therapy and at-home exercises to increase mobility and flexibility.
When non-invasive measures fail to produce results, a surgical procedure may be recommended to restore the integrity and function of your shoulder joint. Surgical options may include:
- Total shoulder arthroplasty – Replaces both the ball and socket of the glenohumeral joint (also known as shoulder joint replacement)
- Hemiarthroplasty – Replaces only the ball of the glenohumeral joint
- Reverse shoulder arthroplasty – Treats glenohumeral joints that are affected by the degeneration of rotator cuff tendons
- Resection AC joint arthroplasty – The most common method of treating AC joint and associated rotator cuff problems it involves removing the AC joint at the end of the collarbone
For more information on this condition, visit our shoulder arthritis page. If you’re suffering from shoulder arthritis symptoms, learn how we can help you get back to your normal activities without pain by scheduling an appointment at our NYC practice.