Arthritis in the Shoulder
Arthritis is a common shoulder problem. It can cause pain, swelling, stiffness, and make it difficult to lift your arm to comb your hair or reach up to a shelf. The major types of arthritis that affect the shoulder are osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. Osteoarthritis is the most common and is caused by the cartilage of the glenohumeral joint gradually wearing away and becoming frayed. This can result in bone rubbing on bone. Arthritis may effect either the glenohumeral joint (ball-and-socket) or the acromioclavicular joint (where the shoulder blade and collarbone meet).
The diagnosis can be made by a physical examination. Other tests which may help your doctor confirm your diagnosis include X-rays, CT, and MRI.
As with other arthritic conditions, initial treatment of arthritis of the shoulder is nonsurgical. Your doctor may recommend making some lifestyle modifications to protect your shoulder and slow the progress of arthritis. Physical therapy may be recommended to help increase range of motion and flexibility as well as help strengthen the muscles.
There are several types of medications that are useful in treating arthritis of the shoulder. Because people respond differently to medications, your doctor will work closely with you to determine the medications and dosages that are safe and effective for you. Over-the-counter medications, cortisone injections as well as alternative therapies may be recommended.
Patients with advanced arthritis of the shoulder may be candidates for either total or partial shoulder replacement. Each of these procedures involves replacing a portion of the shoulder based on the anatomy affected.Your orthopedic surgeon will talk with you about the different procedures and which operation would be best for you.
Total Shoulder Arthroplasty
The typical total shoulder replacement involves replacing the arthritic joint surfaces with a plastic socket and a highly polished metal ball attached to a stem. Patients with bone-on-bone osteoarthritis and intact rotator cuff tendons are generally good candidates for conventional total shoulder replacement.
Learn more about total shoulder arthroplasty.
Reverse Total Shoulder Arthroplasty
In a reverse total shoulder replacement, the socket and metal ball are the opposite of a conventional total shoulder arthroplasty. The metal ball is fixed to the glenoid and the plastic cup is fixed to the upper end of the humerus. A reverse total shoulder replacement works better for people with rotator cuff arthropathy because it relies on other shoulder muscles (not the rotator cuff) to move the arm.
Learn more about reverse total shoulder arthroplasty.
This procedure involves replacing just the ball of the shoulder joint. This may be performed while setting a fracture or when the socket cartilage is in good condition.
Learn more about hemiarthroplasty.
The most common surgical procedure used to treat arthritis of the acromioclavicular joint is a resection arthroplasty. In this procedure, a small amount of bone from the end of the collarbone is removed (usually through a scope), leaving a space that gradually fills in with scar tissue.
Learn more about resection arthroplasty.
Your doctor may recommend physical therapy to help you regain strength in your shoulder and to restore range of motion.