Arthritis of the Shoulder
What is arthritis how does it occur?
Glenohumeral Arthritis refers to degeneration of the joint between the Humerus and the Glenoid bone. The end result of arthritis is wearing out of the cartilage that coats the ends of the bones. Cartilage does not have any nerve endings, but the bones have plenty of nerve endings. So when the cartilage has worn out and the bone is now exposed, this leads to pain and problems.
Arthritis most commonly occurs because of wear and tear, and as a result of the aging process. Arthritis can, however, occur in younger patients. In these cases, the patient may be suffering from an inflammatory disorder such a Rheumatoid Arthritis or have previously sustained a significant trauma (i.e. shoulder dislocation or fracture of the shoulder). Other causes of arthritis include previous infection or long-standing rotator cuff tear.
The inflammation associated with arthritis leads to destruction of the shoulder joint cartilage (smooth outer covering of bone) and narrowing of the joint space. This joint space narrowing eventually leads to painful bone-on-bone contact. Pain is often difficult to localize and described as deep within the shoulder. Early stage arthritic pain usually only occurs with strenuous activity. As arthritis worsens, however, pain occurs at rest and simple activities of daily living become difficult. Patients with arthritis may also 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, ice, and heat. Injection 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, all of which involve removing damaged parts of the shoulder and replacing them with artificial components called prostheses. 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. Learn more about scheduling surgery.
Learn more about post-operative care.
*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.