Arthritis of the Shoulder
What is arthritis how does it occur?
In general, arthritis refers to progressive wear of the cartilage that coats the ends of the bone. Because cartilage does not have any nerve endings, but bone does, loss of this cartilage exposing the bone eventually causes pain. Glenohumeral arthritis is degeneration or loss of cartilage of the joint between humerus bone and the portion of the shoulder blade known as the Glenoid. Arthritis most commonly occurs with wear and tear, usually affecting people over 50 years of age. Arthritis can, however, occur in younger patients. In these cases, the patient may be suffering from an inflammatory disorder such as Rheumatoid Arthritis or have previously sustained a significant trauma (i.e. shoulder dislocation). Other less common causes of arthritis include infection or long-standing rotator cuff tear.
Pain and eventually loss of motion are the two defining symptoms of arthritis. Early stage arthritic pain usually only occurs with strenuous activity. As arthritis worsens, however, pain occurs at rest and simple activities of daily living can become difficult. Patients with arthritis may also eventually experience decreased range of motion and abnormal popping or cracking sounds with shoulder motion.
An x-ray will likely be ordered and is the test of choice when diagnosing shoulder arthritis. A CT or MRI may be ordered to rule out other shoulder conditions and to plan for surgery, if indicated..
Non-operative treatment is 1st line treatment for shoulder arthritis. Treatment options consist of activity modification, physical therapy, anti-inflammatory medications (so long as not contraindicated), ice, and heat. Injections such as steroids, platelet-rich plasma, and hyaluronic acid are also options in select patients.
Surgery is usually considered for severe cases of arthritis in patients who continue to experience significant pain and disability despite non-operative treatment. There are numerous surgical options available. In earlier stages, shoulder arthroscopy may be beneficial in removing loose bodies, shaving off bone spurs, and performing procedures to try to regrow or replace specific portions of the damaged cartilage. Otherwise, in severe cases, shoulder replacement offers a reliable method to decrease or eliminate pain, and to increase overall function. Different versions of shoulder replacement exists, the ideal type of shoulder replacement surgery is patient-dependent. Important factors include age, status of the rotator cuff tendons, and degree of shoulder socket (i.e. glenoid) bone loss.
After arthroscopy, patients are typically in a sling for comfort purposes anywhere from a few days to a few weeks. After shoulder replacement, a sling is typically worn for up to four to six weeks. After this, physical therapy is required and may last for many months. Typically, by three months or so, patients are doing fairly well however recovery can improve for up to one year after surgery.
Immediate Post-Operative Instructions
Please refer to the following pages for more information:
*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables. It is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.
*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.