5 types of shoulder arthritis

Understanding the 5 Types of Shoulder Arthritis

Throughout your life, the shoulder joints are put through continuous wear and tear. Shoulder arthritis is known to be one of the most common conditions of the joint, causing significant pain and discomfort.

There are five different types of shoulder arthritis according to the American Academy of Orthopaedic Surgeons. Here, we look at the different types of arthritis and the symptoms to watch out for.

  1. Osteoarthritis

Caused by the breakdown of cartilage in the joint, shoulder osteoarthritis is one of the most preventative forms of arthritis. More prominent in those aged 50 and over, the condition can worsen if it is left untreated.

As the cartilage breaks down at the end of the bones where they join and form joints, the bone begins to rub together. This leads to pain and stiffness, as well as a loss of mobility. If you have this type of shoulder arthritis, you will notice the pain worsening when you carry out activity.

  1. Rheumatoid arthritis

Commonly affecting both sides of the body, Rheumatoid arthritis is an autoimmune condition. Causing the lining of the joints to swell, it could lead to erosion within the bones of the shoulder, and cause the joints to become deformed over time.

The main symptoms of Rheumatoid arthritis include a warm, tender feeling in the joints, stiffness, the development of Rheumatoid nodules, and fatigue.

  1. Post-traumatic arthritis

Post-traumatic arthritis usually develops after a dislocation or fracture of the shoulder. This typically resolves itself over time, but some patients may find it lasts more than six months. If the condition isn’t treated, eventually the bones could change shape, form bumps, and harden.

The symptoms experienced with post-traumatic arthritis are similar to those experienced with osteoarthritis. They include swelling, pain, stiffness, tenderness, and grinding.

  1. Rotator cuff tear arthropathy

Connecting the top of the arm and the shoulder blade, the rotator cuff consists of a collection of muscles and tendons. If you suffer a common rotator cuff injury, it could lead to a form of arthritis known as rotator cuff tear arthroplasty.

If the tear is large, or it is unable to heal, bone and cartilage damage can occur. If you don’t get it treated, the condition can cause severe pain and weakness within the arm. You will also find it difficult to raise your arm above your head.

  1. Avascular Necrosis

Although it typically occurs in the hip, avascular necrosis is another type of arthritis that can impact the shoulder. If the supply of blood to the bone is disrupted, the bone cells will start to die off. In time, the bone will eventually collapse, causing the surrounding cartilage to become damaged.

Caused by everything from steroid use to traumatic injury, this type of shoulder arthritis can eventually cause severe pain and bone damage.

If you are experiencing pain, stiffness, or weakness in the arm and shoulder, book a consultation with our London Shoulder Specialists today for an accurate diagnosis and treatment plan.

Shoulder decompression surgery

The Benefits of Shoulder Decompression Surgery

New research has shown that shoulder decompression surgery may help to eliminate shoulder pain caused by shoulder impingement syndrome. Revealed at the American Orthopaedic Society for Sports Medicine annual meeting 2022, the findings suggest shoulder decompression could be beneficial in the treatment of rotator cuff tears.

Here, we look at the findings of the study, and delve into the benefits of shoulder decompression surgery.

Understanding the findings

The latest Canadian two-part study followed a total of 86 patients who were due to undergo a rotator cuff repair. They were split into two groups, with one undergoing the repair with shoulder decompression surgery, and the other without.

After 24 months, a follow up study was carried out, which included 57 of the initial 86 patients. This included 31 patients who didn’t undergo the shoulder decompression surgery, and 25 patients who did.

At the follow up, a clinical assessment, patient-reported outcomes, and the Western Ontario Rotator Cuff score was reviewed. The researchers discovered no real difference between the Western Ontario Rotator Cuff score in both groups. However, both did show a significant improvement compared to their pre-operative scores.

It was discovered that those who underwent shoulder decompression surgery were at a reduced risk of requiring revision surgery.

What is shoulder decompression surgery?

Shoulder decompression surgery is a procedure that aims to relieve shoulder pain caused by shoulder impingement syndrome. Also commonly referred to as Acromioplasty, or subacromial decompression, the surgery removes irritated, swollen soft tissue and bone spurs. This helps to widen the acromial space around the rotator cuff tendons.

The surgery is largely carried out using an arthroscopic method, and it helps to release the pressure from the inflamed rotator cuff. The procedure itself takes around an hour to complete, and it is typically carried out under general anaesthetic.

What are the benefits of shoulder decompression surgery?

As well as reducing the risk of revision surgery, shoulder decompression surgery provides excellent pain relief. Although the latest study reveals little difference between the pain relief experienced in those who do and don’t undergo the surgery, it is shown to be more effective when used.

As the procedure removes the inflamed ligament or bursa, it creates a lot more room within the acromial space. This allows the tendon of the rotator cuff to move around freely, helping to ease any swelling.

Like any keyhole surgery, the recovery for shoulder decompression surgery is faster and less problematic than open surgical methods. If your symptoms have not subsided after trying non-operative methods, shoulder decompression surgery will typically be recommended.

To find out if shoulder decompression surgery could help you to eliminate your shoulder pain, book a consultation with one of our leading shoulder experts today.

AC Joint Arthritis

What is AC Joint Arthritis?

If you find it difficult to reach your arm across your body and there is pain or tenderness located in the top of the shoulder, it could be a sign of AC joint arthritis.

Shoulder problems can be caused by a wide range of factors and AC joint arthritis is one of them. So, what is it and how do you know if arthritis is the cause of your pain and tenderness? Read on to discover everything you need to know

What is AC joint arthritis?

Acromioclavicular arthritis (AC joint arthritis) develops at the very top of the shoulder. The AC joint is located where the collar bone meets the top part of the scapula and, like other joints, it can be susceptible to wear and tear.

AC joint arthritis typically refers to progressive joint damage, typically affecting those aged 40 and over. As the cartilage wears away, it causes the ends of the bone to rub together. There is no cure, but there are ways to manage the condition.

What are the symptoms and causes of AC joint arthritis?

Identifying the symptoms of AC joint arthritis can help you to get the treatment you need quickly. However, it is worth pointing out that you may not experience any symptoms at all in the early stages of the condition.

The most common symptoms include:

  • Pain right at the top of the shoulder
  • Pain that worsens when you place your arm across the chest
  • Restricted movement, limiting your ability to carry out daily activities

You may also find that it affects your sleep with the pain worsening at night. So, what causes AC joint arthritis to occur?

In some cases, there is no clear cause. However, for most patients it develops due to overuse of the joint. This makes it a common concern for athletes. Other times, the condition can develop after a direct injury.

Whatever the cause, seeking treatment is important if you want to manage the condition and prevent it from impacting your daily life.

Treating AC joint arthritis

If you are diagnosed with AC joint arthritis, there are treatments that can ease the pain and make it more manageable to live with.

Pain medication can help to control any pain you feel, alongside heat or cold compressions. Physiotherapy is another common treatment option, helping to not only reduce the pain, but improve the patient’s range of motion.

Other treatment options include local anaesthetic and steroid injections, and keyhole surgery. In severe cases, surgery may be required to remove the AC joint. While this will help to stop the pain, it will not necessarily give you back your range of motion.

To find out if you are dealing with AC joint arthritis and the treatment that is best suited to you, call +44 (0) 203 195 2442 to book a consultation with one of our expert surgeons today.

shoulder surgery risks

Shoulder Surgery Risks Are Low but Some Patients Require Further Surgery, New Study Finds

A new study carried out by the University of Oxford has revealed that shoulder surgery risks are low, but some patients do require additional surgery. Published in the British Medical Journal, the results provide reassurance to those who may be putting off going under the knife through fear of complications.

Here we will look at what the study revealed, and what patients can expect if they need to undergo shoulder surgery.

Just 1.2% of patients experience serious complications from shoulder surgery

The study, which assessed data from 288,250 arthroscopic shoulder procedures carried out from 2009-2017, showed risks of shoulder surgery are low. Just 1.2% of patients went on to develop serious complications such as pneumonia, a pulmonary embolism, heart attack, and death.

Approximately one in every 81 patients is at risk of developing one of these complications within 90 days. This does depend upon the type of procedure carried out, alongside other risk factors. However, it does show that complications are generally quite rare after undergoing shoulder surgery.

The most common complication that arose in the study, was Pneumonia, affecting one in every 303 patients. Pulmonary embolisms were the least common complication, affecting one in every 1428 patients.

One in 26 patients require additional shoulder surgery

The number of patients requiring additional surgery was also low, affecting one in 26 patients. An additional procedure was required either due to complications arising, or because the first operation didn’t work.

Repeat procedures caused by an infection were rare and occurred more frequently in rotator cuff repairs. They are also higher in frozen shoulder release surgery, likely down to its unpredictable nature and a lack of understanding about the condition.

The study didn’t reveal the exact cause of the increased complications. However, it does give surgeons and healthcare professionals a better idea of the risks and safety of shoulder surgery.

Understanding the risks of shoulder surgery

Any patient who requires shoulder surgery should go into the procedure understanding the risks. While they may be low, being aware of the complications gives patients the opportunity to make the most informed decision over their treatment.

Over the course of the study, the number of arthroscopic shoulder procedures increased. There is expected to be a continued rise in the number of procedures carried out each year. With more surgeries being conducted, being aware of the risks is crucial.

Generally speaking, the main risks of shoulder surgery include:

  • Pain
  • Stiffness
  • Bleeding
  • Infection
  • Nerve injury
  • Unsightly scarring

The risks and complications will vary depending upon your individual circumstances, as well as the severity of the condition.

If you are concerned about the risks of shoulder surgery, book a consultation with one of our friendly and knowledgeable surgeons. They will be able to address any fears you may have, and give you a better idea of your personalised risk factors.

younger rugby players at risk of shoulder injuries

Younger Rugby Players at Most Risk of Shoulder Injuries

A new study carried out on young rugby players has revealed they have an increased risk of getting hurt in the sport. Those who play numbers 1-8 were shown to have a particularly increased risk of injury.

So, why are younger rugby players most at risk of shoulder injuries and what did the study reveal? Discover everything you need to know below.

What the latest study revealed

The latest study was carried out by researchers at the University of Limerick, assessing 15 Irish school boy teams. The results showed that young players were more at risk of shoulder injuries than professionals.

Nearly a quarter of injuries in younger players were sprains and dislocations, followed by head and neck injuries. Forward players were also discovered to be three times more susceptible to suffering a concussion than back players.

This isn’t the first study to highlight the risk of injury for younger rugby players. A previous study carried out by the University of South Africa, revealed that male rugby players aged 12-18 had an increased risk of labral injuries. Back players were found to have an increased risk of bony pathology. Interestingly, the study also showed forward players had a 21% increased risk of injury reoccurrence.

Common rugby shoulder injuries

Rugby is a high-contact sport, which means the risk of injury is quite high. There is a lot of direct physical force and tackles involved, making it incredibly easy to suffer a shoulder injury. So what injuries are most common in young players? Here’s a rundown of some of the most common shoulder injuries young rugby players are at risk of developing. 

Sprains and dislocations: The most common shoulder injuries in rugby are sprains and dislocations. Most sprains impact the acromioclavicular joint, while dislocations largely affected the glenohumeral joint. Players who suffer a fracture followed by a dislocation tend to experience more severe injury, while dislocations resulted in more days away from the sport.

Labral tears: Young rugby players are also susceptible to labral tears. These include Bankart tears, Superior Labrum Anterior to Posterior (SLAP) tears, and posterior shoulder instability. Bankart tears tend to occur in players who dislocate their shoulder, while SLAP tears occur at the top of the glenoid where the biceps tendon attaches.

These are some of the most common shoulder injuries young rugby players experience. The good news is a shoulder injury doesn’t need to end your career. With the right treatment, players can often return to the sport in a matter of months, depending upon the severity of their injury.

Treating shoulder injuries in young rugby players

There are various lines of treatment that can be used to treat shoulder injuries in young players. Most of the time, surgery will not be required. Instead, physical therapy, rest, and over the counter medications to control the pain will be all that is needed. However, in severe cases, surgery may be the only option.

To find out which type of treatment is right for you, book a consultation with one of our shoulder specialists today.

hormones and shoulder tendon tear

Low Oestrogen or Testosterone Linked to Higher Rates of Rotator Cuff Tear

A new study has revealed that low oestrogen or testosterone levels in men and women, increase the risk of rotator cuff tears. The observational study was carried out by researchers at the University of Utah, and its results have been published within The Journal of Bone & Joint Surgery.

Here, we will look at what the study found and what you need to know about tears of the rotator cuff.

Hormone levels and a shoulder tendon tear

The observational study looked at the impact of low oestrogen and testosterone levels on the rotator cuff. It revealed that women with low oestrogen are 48% more likely to experience a rotator cuff tear. Men with low testosterone levels were found to be 89% more likely to experience a tear.

Having lower oestrogen and testosterone levels has long been known to contribute towards weaker bones. When the bones weaken, tendon-bone attachments, such as the rotator cuff, become compromised.

While the study didn’t reveal the reason low oestrogen and testosterone levels contribute towards rotator cuff tears, theories do exist. For example, testosterone builds up muscle. As the muscle builds, so too does the surrounding tendon. If levels of testosterone are low, the tendons don’t grow in line with the muscle. This in turn causes a weakened attachment.

The study also suggested that low levels of sex hormones can impact the body’s ability to heal.

What is a rotator cuff tear?

Rotator cuff tears are common, affecting approximately 30% of the UK population by the age of 70. They are especially popular in older patients aged over 60, and they range in severity.

The rotator cuff is surrounded by tendons helping to keep the joint in place. Any of them can become torn due to overuse, or trauma. When a tear occurs, it typically happens in the supraspinatus tendon. The severity of the tear will vary, and they are categorised as full-thickness or partial tears.

A full-thickness tear is diagnosed when the tendon becomes completely detached from the bone. A partial tear damages the tendon but doesn’t sever it from the bone.

Treating a shoulder tendon tear

There are several treatment options available for a rotator cuff tear. First, you will need to be assessed by a shoulder specialist to determine how severe the tear is. This will help to identify the best course of treatment to suit you.

Most patients find that a non-surgical approach is enough to fix the problem. This includes rest, physical therapy, anti-inflammatory pain medication, and steroid injections. However, in severe tears, surgery may be the only option. This typically involves re-attaching the tendon to the upper arm bone.

To find out which treatment option is right for you, book a consultation with one of our friendly and experienced shoulder specialists today.

What does a torn shoulder ligament feel like

What Does a Torn Shoulder Ligament Feel Like?

Wondering whether you may have a torn shoulder ligament? The shoulder is one of the most used joints in the body. It is made up of many different components, each of which can become damaged or torn over time. So, how do you know if it is a torn ligament or something else?

Torn ligaments typically present the following symptoms:

  • Pain and discomfort
  • Tender to the touch
  • Bruising and swelling around the shoulder
  • Difficulty moving the joint

These can all be symptoms of other shoulder injuries, so an accurate diagnosis will be required.

What is a torn shoulder ligament?

The ligaments in your shoulder are strong bands of fibrous tissue. They are responsible for connecting bones, as well as bone to cartilage. While they may be tough, they aren’t immune to getting stretched or torn.

Ligament tears typically occur when extreme force is placed onto the joint. This could be from a direct impact, or a fall. They cause immediate pain, and you may hear a popping sound or feel the tear as it occurs.

How are ligament tears diagnosed?

To diagnose a torn ligament, a physical examination will be carried out. An X-Ray will then be used to look for any broken or fractured bones. In some cases, an MRI scan may be performed to detect a complete or partial ligament tear.

The tear will be graded to determine its severity. There are three grades in total, including:

Grade I: These tears are minor, with minimal damage caused to the ligament.

Grade II:  A partial tear is present, and the joint may be loose.

Grade III: The most severe type of tear, often resulting in complete loss of use of the arm.

Your treatment options

All ligament injuries are initially treated with rest, ice, compression, and elevation. Ice can help to relieve the pain, while compressing the shoulder with an elastic bandage can help to reduce swelling. You may also be prescribed over the counter treatments to eliminate any pain you experience while the ligament heals.

If you have a Grade II injury, you may need to wear a brace to support the shoulder. Your healthcare provider will let you know how long you need to wear it for.

For Grade III tears, surgery will usually be recommended. There are different types of surgery you can undergo, including:

  • Arthroscopic surgery
  • Open surgery

Arthroscopic surgery is the most common technique used as it is less invasive for the patient. This reduces the risks and complications involved with the procedure. However, if the tear is especially severe or difficult, open surgery may be the best approach.

To discover if the cause of your shoulder pain is down to a torn shoulder ligament, book a consultation with one of our friendly shoulder specialists now.

what causes a rotator cuff tear?

What Causes a Rotator Cuff Tear?

Rotator cuff tears are usually caused by one of two things – degeneration or trauma.

Tears due to wear and tear occur gradually over time, while tears that are the result of an injury are usually immediate. Whichever type of tear you experience, you can expect to feel varying levels of pain and muscle weakness. We look at what causes a rotator cuff tear:

Understanding degenerative rotator cuff tears

Degenerative rotator cuff tears tend to be the most common type experienced by patients. While some level of degeneration occurs naturally as we age, other factors that can contribute include:

  • Repetitive stress
  • Bone spurs
  • Limited blood supply

Repetitive movements of the shoulder can lead to gradual degeneration of the rotator cuff. This means that those who participate in sports and activities such as tennis, weightlifting, rowing, and cricket, are most at risk of developing this type of injury.

Bone spurs are another potential culprit. They can develop naturally underneath the acromion bone as we age. Whenever you lift your arm, the bone spurs will rub against the tendon of the rotator cuff, leading to shoulder impingement. Over time, this will weaken the rotator cuff, increasing the risk of tearing.

Another thing that happens as you age, is the blood supply to the rotator cuff reduces. With a limited blood supply, the body will struggle to naturally repair any tendon damage that may occur. In time, this could cause the rotator cuff to tear.

What is an acute Rotator Cuff Tear?

While degenerative rotator cuff tears are the most common type, acute tears are also possible. These develop due to an injury, and will cause a sudden, sharp pain. Potential causes of an acute rotator cuff tear include:

  • An accident, such as a car accident.
  • Falling onto an outstretched arm
  • Lifting something too heavy with a lurching movement

These are the most common causes of acute tears and unfortunately many acute injuries go undiagnosed. You will feel an immediate weakness and pain in the affected arm and shoulder. You also won’t be able to lift the arm above the head.

How are rotator cuff injuries treated?

Treatment for rotator cuff tears will vary depending upon their severity, alongside individual patient circumstances. In most cases, non-surgical treatment can help to improve function and reduce pain. Options include rest, physical therapy, steroid injections, and medications.

If non-surgical methods don’t work, surgery may be recommended. Typically, surgery is offered to those who have had symptoms for six to 12 months, alongside patients with larger tears. During surgery, the tendon is reattached to the humerus head, and several techniques may be used.

If you are concerned that you may have a rotator cuff tear, book a consultation with one of our friendly specialists today.

What Causes Shoulder Pain That Radiates Down the Arm

What Causes Shoulder Pain That Radiates Down the Arm?

Shoulder pain is a common issue that most people will experience at some time in their life. However, when the pain starts to radiate down the arm, it can understandably be alarming.

There are several potential causes of shoulder pain that spreads to the arm. In some cases, the pain can even spread to the chest and back. Here, we will look at what causes shoulder pain that radiates down the arm.

What might the problem be?

The rotator cuff of the shoulder is supplied by the same nerve roots that provide feeling to the arm. When an issue occurs within the shoulder, it can cause the nerve roots to trick the brain into thinking there is something wrong with the arm too.

While you will need to be examined properly to determine the cause, there are some common shoulder issues that are known for causing pain down the arm. These include:

  • Subacromial impingement: At the top of your arm bone, there is a gap between the acromion known as the subacromial space.  This is where the subacromial bursa and rotator cuff tendons are located. If the tendons become inflamed, it is referred to as subacromial impingement. This is one of the most common types of shoulder issues, and it causes pain at the top of the shoulder, as well as down the arm. You may also experience weakness in your arm if subacromial impingement is to blame.
  • Tendonitis: When the biceps tendon or rotator cuff becomes inflamed, it can lead to tendonitis. This mostly occurs due to inflammation of the rotator cuff, and the issue can range from mild to severe. You may notice the pain runs down the arm, and you may also struggle to place your arm behind your back.
  • Rotator cuff tear: Tears within the rotator cuff can occur for all kinds of reasons. It could be down to an acute injury, or through repetitive use of the shoulder. Tears can be mild to severe, with full tears requiring surgery to fix them. Depending upon how severe the tear is, it can lead to pain in the shoulder and down the arm.
  • Osteoarthritis: A common cause of shoulder pain that spreads to the arm is Osteoarthritis. Caused by wear and tear, cartilage in the shoulder begins to wear down over time. Eventually, the bones of the shoulder start to rub against one another, leading to stiffness and pain. This pain can sometimes radiate down the shoulder.

To determine what the problem is, patients will need to undergo an assessment. There are a lot of different causes of shoulder and arm pain, and each require a different type of treatment to correct them. Book a consultation with Ms Susan Alexander or our shoulder specialists now to diagnose and begin treating the root cause of the problem.

What is the Rotator Cuff Tear Recovery Time?

What is the Rotator Cuff Tear Recovery Time?

Rotator cuff tears are a common shoulder issue, sometimes requiring surgery to fix them. While a full recovery can take several months after surgery, patients usually begin physical therapy within four to six weeks. This helps to build up strength in the shoulder, while also preventing the joint from stiffening up.

Most patients regain full strength and function within four to six months. However, actual recovery time will depend upon the severity of the tear and the treatment used to correct it. Your surgeon will provide a recovery timeline, alongside advice you can follow to speed it up.

Discover more about rotator cuff tears and what to expect from the recovery process below including what is the rotator cuff tear recovery time?

What to expect from rotator cuff tear recovery

If you have surgery for a rotator cuff tear, the procedure will either be carried out as a day case which means you return home the same day as surgery or with one overnight stay in hospital. Your arm will be put into a sling to keep it immobilised. Surgery is normally performed under a general anaesthetic augmented with regional/local anaesthetic so your arm will feel numb immediately after surgery. Once the local anaesthetic wears off, you will experience some pain and then discomfort for at least a few days, and likely a few weeks. Pain relief medication can be prescribed to help manage the level of pain while the shoulder heals.

Patients are advised to place ice on the shoulder as an additional pain relief measure. This will also help to control any swelling that may occur. Sleeping may be difficult so you might want to change to lying in a semi-upright position.

Rotator cuff repair is usually performed as an arthroscopic procedure which is a type of keyhole surgery. The incisions will be very small and heal within just a couple of weeks. If the procedure is performed as open surgery, the stitches will either be dissolvable or removed at two weeks.

After a few weeks you’ll be able to reduce the amount of time that you need to wear the sling and you’ll be able to start light physiotherapy. At your check-up with your London shoulder specialist Mr Andy Richards, they will be able to advise when you can begin strengthening exercises.

Rotator cuff tear treatments

Your recovery will be determined by a variety of factors such as the severity of the tear, and whether any complications arose during or after treatment. There are a variety of treatment options available and not all of them include surgery.

If the rotator cuff tear is minor, you may require physical therapy and pain relief medication. This alone could help you make a speedy recovery.

To find out what to expect from your rotator cuff tear recovery, book a consultation with one of Mr Andy Richards or one of our other shoulder specialists today.