May is National Arthritis Awareness Month. Each year the Arthritis Foundation sponsors this campaign in an effort to educate the public about all facets of arthritis, including symptoms, causes, who is affected, and ways to improve quality of life for those impacted by this crippling disease.
Arthritis is not a single disease. In fact, the term “arthritis” includes more than 100 different conditions involving the joints, including not only rheumatoid and osteoarthritis but lupus, scleroderma, gout, and psoriasis. Arthritis is estimated to affect some 50 million adults and 300,000 children in the U.S. alone, and although it is extremely common, some people—particularly those who are middle-aged or older—mistakenly assume that any chronic joint pain is the onset of arthritis. In fact, there are various possible causes for non-arthritic joint pain, especially in the shoulder. One of the most common is bursitis.
Dr. Francis Mendoza, NYC-based orthopaedic surgeon specializing in the treatment of shoulder arthritis, explains the difference between osteoarthritis of the shoulder and shoulder bursitis.
Shoulder Osteoarthritis vs. Shoulder Bursitis
Osteoarthritis is the most common form of arthritis affecting the shoulder. Unlike rheumatoid arthritis, it is not an autoimmune disease but is caused by wear and tear.
In healthy joints, the ends of the bones are covered by a thin, slick layer of cartilage that lets the bones slide smoothly over each other like a well-oiled hinge. In osteoarthritis, the cartilage covering degenerates, and the rough bone surfaces scrape against one another, causing pain, inflammation, and limited range of motion. This friction can also cause bone spurs, which result in even greater pain and more limited mobility. Osteoarthritis can be due to advancing age, chronic overuse, or it can develop in the wake of a traumatic injury.
Bursitis also causes pain and limited mobility, but unlike arthritis does not result in inflammation within the ball-and-socket joint. Instead, bursitis is inflammation of the shoulder bursa, a fluid-filled sac that acts as a cushion between the rotator cuff and the tip of the shoulder blade (acromion). In bursitis, the bursa fills with excess fluid, which causes pain. Bursitis can be brought on by overuse, sudden injury, or by the bursa simply being under prolonged pressure.
Signs and Symptoms
Osteoarthritis of the Shoulder:
- Deep joint pain which is aggravated by movement—as time goes on, the pain will become more severe as arthritis is a degenerative disease
- Pain is usually less in the morning but gets worse with movement as the day wears on
- Morning stiffness lasting more than 30 minutes
- Limited range of motion when reaching, turning, or stretching the arm
- Painful clicking, snapping, or grinding of the joint, resulting from the bone ends grinding against each other
- The pain may increase when lying on the affected shoulder
- More superficial pain outside of the shoulder joint
- Pain may spread down the arm towards the elbow
- Pain may limit motion in an otherwise normal shoulder joint
- Pain when the arm is lifted above 90 degrees
- The pain may also increase when lying on the affected shoulder
Although osteoarthritis and shoulder bursitis both cause pain, when and where the pain occurs are quite different.
Treatment of Shoulder Osteoarthritis
Although there is no cure for arthritis, there are several options for treatment of osteoarthritis of the shoulder. The appropriate treatment depends on the severity of the condition.
Conservative treatments include:
- Resting the shoulder joint – simply reducing the amount of stress on the joint can make a marked difference for some arthritis sufferers
- Range-of-motion exercises
- Applications of heat or cold
- Over-the-counter NSAIDs like ibuprofen
- Cortisone injections
- Physical therapy can help patients understand how and why they move the way they do, and re-educate their bodies to new movement patterns which alleviate joint stress
In severe cases, surgical treatment may be an option. Surgical procedures can range from replacement of the head of the humerus—the “ball” part of the ball-and-socket shoulder joint—to total shoulder replacement or reverse shoulder joint replacement.
Don’t let arthritis limit your activities. If you think you may have shoulder osteoarthritis, schedule your consultation with Dr. Mendoza today and let us help you find a solution.