Shoulder Arthritis

Shoulder Arthritis Treatment in NYC

The most common type of shoulder arthritis is osteoarthritis, or degenerative joint disease. This occurs when the cartilage, which normally acts as a protective cover for the bones, degenerates. Without this cartilage to act as a buffer, the affected bones rub against one another, wearing each other down and resulting in pain and swelling. Sometimes, this friction also results in the development of bone spurs which are painful and interfere with movement.

Treatment Options

Shoulder arthritis treatment in NYC may consist of simple home remedies, physical therapy or, in more severe cases, surgical intervention. To some degree, treatment of arthritis of the shoulder depends on the causes of the disorder. Shoulder arthritis may be of two types, osteoarthritis and rheumatoid arthritis, each due to several causes.

Treatment of Osteoarthritis of the ShoulderWoman with shoulder pain

The most common type of shoulder arthritis is osteoarthritis, or degenerative joint disease. It occurs when the cartilage covering the bones of the shoulder joint, the humerus, the scapula and the clavicle, wears away. Since the cartilage normally acts as a protective cover, without it the affected bones scrape against one another. This friction results in pain and swelling and may also cause the development of outgrowths of bone called bone spurs. This type of arthritis results not only in pain, but in a limited range of motion in the affected area. Osteoarthritis may be caused by hereditary factors, advancing age, overuse or traumatic injury. Osteoarthritis may be treated in a number of ways. The simplest, least invasive methods are usually tried first.

Resting the Shoulder Joint

Alterations to the ways in which patients perform routine daily activities may make a marked difference in their comfort level. Examples of such changes may include:

  • Wearing clothing with front closures
  • Propping instead of holding appliances like hairdryers
  • Using reaching tools to access items on high shelves

Home Remedies to Ease Pain and Increase Range-of-Motion

Doctors and therapists may recommend one or more of the following:

  • Range-of-motion exercises
  • Application of moist heat
  • Ice packs
  • Over-the-counter medications
  • Dietary supplements such as glucosamine and chondroitin

There are some conflicting reports of the efficacy of dietary supplements. Over-the-counter medications and dietary supplements should only be taken after medical consultation.

Physical and Occupational Therapy

A prescribed course of physical or occupational therapy may do wonders for a patient suffering from arthritis. In addition to teaching the patient exercises to increase mobility and flexibility, such treatment enables the patient to become more aware of how arthritis affects the movements of the body and vice versa. Understanding the nature of the condition helps the patient to avoid putting stress on the shoulder joints. In addition, such therapies help patients to respect their own pain levels and to avoid exacerbating damage and discomfort.

Surgical Procedures

When nonsurgical treatments do not produce effective results and the patient is unable to continue with normal activities due to severe pain, surgical intervention may be necessary. Surgical procedures for shoulder arthritis treatment in NYC may include:

  • Total shoulder arthroplasty – Performed to treat arthritis of the glenohumeral joint, this procedure, also called shoulder joint replacement, involves replacing the ball and socket of the  shoulder joint.
  • Hemiarthroplasty – This surgical procedure, also used to treat arthritis of the glenohumeral joint, involves a replacement of the head (ball) of the humerus.
  • Reverse shoulder arthroplasty – Performed to treat arthritis of the glenohumeral joint associated with  degenerated rotator cuff tendons.
  • Resection AC joint arthroplasty – During this surgery only a small piece of the end of the collarbone (AC joint) is removed. This is the most common surgery used to treat arthritis of the acromioclavicular, or AC, joint.

Anatomy of the ShoulderMan with shoulder arthritis

The shoulder is made up of three bones: the humerus or upper arm bone, the scapula or shoulder blade, and the clavicle or collar bone. There are four joints where these bones connect: the acromioclavicular or AC joint, where the collarbone attaches to the tip of the shoulder blade (acromion); the glenohumeral joint, where the ball (humeral head) at the top of the arm bone connects with the glenoid socket of the shoulder blade; the sternoclavicular or SC joint, where the collar bone connects to the breast bone (sternum); and the scapulothoracic or ST joint, where the shoulder blade connects to the back of the ribcage.  Osteoarthritis is commonly found in the AC joint and the glenohumeral GH joint.

Causes of Shoulder Arthritis

There are several contributing factors to the development of arthritis.

  • Hereditary factors
  • Advancing age
  • Overuse
  • Traumatic injury
  • Autoimmune disease
  • Alcoholism or high dose corticosteroid usage

Types of Shoulder Arthritis

There are several types of shoulder arthritis.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease. In rheumatoid arthritis, the lining of the joints as well as the cartilage is affected, causing painful swelling and redness and potentially resulting in bone erosion and even deformity of affected joints. Unlike osteoarthritis, RA may cause symptoms of fever and fatigue and is a symmetrical disease, usually affecting the same joint on both sides of the body. Another distinction is that in rheumatoid arthritis, stiffness and pain occur even at rest, whereas with osteoarthritis the symptoms are more apparent with movement than after periods of rest.

Post-traumatic Arthritis

Post-traumatic arthritis is a form of osteoarthritis that develops after a traumatic injury, such as a fracture or dislocation of the shoulder, and may occur at any age.

Avascular Necrosis

Avascular necrosis (AVN) occurs when the blood supply to the ball (humeral head) at the top of the arm bone is interrupted. AVN can ultimately lead to the death, or necrosis, of the bone cells in the humeral head and may eventually result in shoulder arthritis. In addition to occurring after injury, AVN may be caused by alcoholism or use of steroids.

Symptoms of Shoulder Arthritis

There are two major symptoms of arthritis of the shoulder. These are the same symptoms common to osteoarthritis affecting other parts of the body.

Pain

The predominant symptom of arthritis is pain which is aggravated by active or passive movement and which becomes increasingly severe over time. As the disease progresses, patients may also experience pain at night which interferes with sleep.

Limited Range of Motion

The other presenting symptom of arthritis is limited range of motion. When attempting to move the arm during normal activity, the patient may be unable to reach, turn or stretch the arm to the usual extent.

Abnormal Joint Sound

The patient’s shoulder may also produce a clicking, snapping or grinding sound called crepitus, resulting from the bones at the affected joint making contact with one another.

Diagnosis of Shoulder Arthritis

In order to diagnose osteoarthritis of the shoulder, the doctor must first take a complete medical history and do a thorough physical examination to assess family history and past injuries. Through physical examination, the doctor will be able to evaluate pain level and range of motion, muscle weakness and possibly the involvement of other joints. Once a physical examination has made the physician suspicious of shoulder arthritis, other diagnostic tests may be done, including:

  • X-ray
  • MRI
  • Blood tests to screen for other diseases
  • Removal of fluid that lubricates the joint for analysis

Distinction Between Arthritis and Bursitis

The shoulder bursa is a lubricating membrane between the rotator cuff and the shoulder blade (acromion).  When functioning properly, it decreases friction between these structures.  Bursitis is the inflammation of this membrane. Bursitis, like arthritis, may result in pain and limited range of motion. Unlike bursitis, arthritis results in inflammation within the ball and socket joint due to erosion of the bone and cartilage.