The term arthritis literally means inflammation of a joint but is generally used to describe any condition in which there is damage to the cartilage. Damage of the cartilage in the shoulder joint causes shoulder arthritis. The cartilage allows the bones to slide over each other without friction, enabling smooth movement. Articular cartilage reduces pressure and acts as a shock absorber during movement of the shoulder bones. The proportion of cartilage damage and synovial inflammation varies with the type and stage of arthritis. Usually, the initial pain is due to inflammation. In the later stages, when the cartilage is worn away, most of the pain comes from the mechanical friction of raw bones rubbing on each other.
What are the Types of Shoulder Arthritis?
There are many different types of arthritis. The most common are osteoarthritis and rheumatoid arthritis.
Osteoarthritis is also called a degenerative joint disease. This is the most common type of arthritis, and usually occurs in the elderly.
With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. As a response to the arthritis the shoulder often forms new bone which can stick out at the end of a joint and are called osteophytes or bone spurs.
Osteoarthritis causes pain and can limit the normal range of shoulder joint motion. When severe, the shoulder joint may lose all movement, making you increasingly disabled.
This is an autoimmune disease in which the body's immune system (the body's way of fighting infection) attacks healthy joints, tissues, and organs. Occurring most often in women of child-bearing age (15-44 years), this disease inflames the lining (or synovium) of joints. It can cause pain, stiffness, swelling, and loss of function in the joints. When severe, rheumatoid arthritis can deform or change a joint.
Rheumatoid arthritis mostly affects the joints of the hands and feet and tends to be symmetrical. This means the disease affects the same joints on both sides of the body (both hands or both feet) at the same time and with the same symptoms. No other form of arthritis is symmetrical. About two to three times as many women as men have this disease.
Other Causes of Shoulder Arthritis
Secondary osteoarthritis is generally the consequence of another disease or condition, such as repeated trauma (fracture or dislocation) or surgery to the affected joint, or abnormal joint structures that you may have had from birth.
Symptoms of Shoulder Arthritis
Symptoms may vary according to the form of arthritis. Arthritic symptoms generally include progressively increasing pain and stiffness of the joint, which when severe, can have a significant impact on quality of life.
Diagnosis of Shoulder Arthritis
In general arthritis of the shoulder can be diagnosed with a medical history, a physical exam and X-rays of the affected part. Computed tomography (CT) scans and/or magnetic resonance imaging (MRI) scans may also be required if more information about the affected shoulder is required.
Treatment Options for Shoulder Arthritis
You may be prescribed simple analgesia or anti-inflammatory medications, and occasionally a cortisone injection into the joint can provide good symptomatic relief. Occasionally physiotherapy can be useful, which includes exercises and heat treatment. In severe cases, surgery may be suggested. The type of surgery depends on the age of the patient and the severity of the condition.
In younger patients with less severe arthritis an arthroscopic (keyhole) procedure may be recommended. The aim of this procedure is to provide pain relief and perhaps increase the range of motion of the shoulder, and to “buy” the shoulder a few more years. In the elderly with severe arthritis, joint replacement is the best option. This is now a very common surgery for the treatment of shoulder arthritis of any type, and in general is extremely successful at eliminating pain and improving the shoulder range of motion.