What are the causes of shoulder arthritis?
The bones in the shoulder joint are covered with cartilage which minimises friction and lubricates the joint. Over time, the cartilage gradually thins, causing the bones to rub against each other. The shoulder then becomes very painful, inflamed, stiff and there may be a clicking sound, particularly when you raise your shoulder above your head. Arthritis affecting the glenohumeral joint typically presents on the back of the shoulder whereas if the AC joint is affected, pain is centred on the top of the shoulder and can travel up the neck.
The most common form of arthritis to affect the shoulder is osteoarthritis which is the result of wear and tear and commonly affects middle-aged and older patients. Osteoarthritis is more common in the acromioclavicular joint than the glenohumeral joint. Other forms of arthritis that might affect the shoulder include rheumatoid arthritis that is a swelling of the synovium lining, causing pain and stiffness.
How will your arthritis be diagnosed?
During your consultation at London Shoulder Specialists, your consultant will identify the particular joint that is affected and assess the amount of discomfort and lack of mobility you are experiencing. They will usually arrange investigative tests such as X-rays, blood tests, and MRI or CT scans.
Treatment of osteoarthritis depends on a number of factors. This typically focuses on your age, lifestyle and the degree of activity that you are hoping to return to. Non-surgical treatment options include anti-inflammatory medications and steroid injections. Surgery can focus on cleaning up the joint in a process called debridement, but you may require shoulder replacement surgery if osteoarthritis is severe.
For more information on the management and treatment of osteoarthritis of the shoulder, please get in touch with the London Shoulder Specialists.
Frequently Asked Questions on Shoulder Arthritis
CAN SHOULDER ARTHRITIS BE MANAGED WITHOUT SURGERY?
Most cases of significant shoulder arthritis are managed with surgical intervention. The main symptoms of shoulder osteoarthritis are pain, stiffness and loss of mobility, and treatment aims to alleviate these symptoms so you can maintain quality of life.
The first step is to look at your work or personal life and modify activities that may strain the shoulder joint. Ice or heat therapy, pain medication and physical therapy will also be advised.
Cortisone is a powerful anti-inflammatory medication that is injected directly into the joint. This can help alleviate the acute pain you are experiencing, so you can start physiotherapy to improve strength and range of movement.
WHEN IS SURGERY ADVISED FOR SHOULDER ARTHRITIS?
If non-surgical treatment options are not working, surgery may be advised. The type of surgery that your London Shoulder Specialist may recommend will depend on the severity of the wear and tear and other factors such as your age.
In a hemiarthroplasty procedure, the humeral head alone is replaced and is advised if there is no damage to the glenoid or for younger patients. For advanced shoulder osteoarthritis, a total shoulder replacement is advised. The ball at the top of the upper arm is replaced with a metal ball, and the shoulder blade is replaced with a plastic socket, both being fixed in place with bone cement. A reverse shoulder replacement is similar, but the position of the ball and socket is reversed to compensate for a weakened rotator cuff.
WHAT IS THE RECOVERY LIKE AFTER A TOTAL SHOULDER REPLACEMENT?
Immediately after total shoulder replacement, the focus will be on managing pain and reducing swelling. You’ll be advised to start physical therapy within a few days of surgery to strengthen the shoulder. You should be able to regain full shoulder movement six weeks after surgery. More vigorous activities and contact sports should be avoided for a year after surgery.
