Shoulder Arthritis

An estimated 54.4 million adults have been diagnosed with some form of arthritis, according to the Center for Disease Control and Prevention. Arthritis is the inflammation of one or more of your joints. Inflammation can often cause shoulder pain and stiffness. Orthopedic Institute offers many treatment options for shoulder arthritis that can help patients manage their pain and stay active.

Shoulder Arthritis: What is it?

Shoulder arthritis is damage to the cartilage located inside the shoulder joint. Usually, shoulder arthritis results from a gradual wear and tear of the cartilage. Cartilage softens the contact between the bones. Over time, the cartilage can become soft and develop cracks in its surface. As the deterioration worsens, the shoulder develops arthritis.

Man experiencing pain from shoulder arthritis

Symptoms: What does Shoulder Arthritis feel like?

Pain that worsens and becomes aggravated by activity
Feeling a deep ache in the joint or pain that intensifies with weather changes
Frequent pain on the top of the shoulder that radiates to the side of the neck and pain throughout the shoulder
Experiencing a limited range of motion
Your shoulder grinds, clicks, or snaps as you move it
Your arm becomes difficult to lift
Sleeping becomes difficult and night pain is common

Causes

These are the five most common types of shoulder arthritis:

Osteoarthritis: Also known as “wear-and-tear” arthritis, osteoarthritis is a condition that destroys the smooth outer covering (articular cartilage) of bone. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. During movement, the bones of the joint rub against each other, causing pain. Osteoarthritis usually affects people over 50 years of age and is more common in the acromioclavicular joint than in the glenohumeral shoulder joint.

Rheumatoid Arthritis: Rheumatoid arthritis (RA) is a chronic disease that attacks multiple joints throughout the body. It is symmetrical, meaning that it usually affects the same joint on both sides of the body. The joints of your body are covered with a lining—called synovium—that lubricates the joint and makes it easier to move. Rheumatoid arthritis causes the lining to swell, which causes pain and stiffness in the joint. Rheumatoid arthritis is an autoimmune disease. This means that the immune system attacks its own tissues. In RA, the defenses that protect the body from infection instead damage normal tissue (such as cartilage and ligaments) and soften bone. Rheumatoid arthritis is equally common in both joints of the shoulder.

Post-Traumatic Arthritis: Post-traumatic arthritis is a form of osteoarthritis that develops after an injury, such as a fracture or dislocation of the shoulder.

Rotator Cuff Tear Arthropathy: Arthritis can also develop after a large, long-standing rotator cuff tendon tear. The torn rotator cuff can no longer hold the head of the humerus in the glenoid socket, and the humerus can move upward and rub against the acromion. This can damage the surface of the bones, causing arthritis to develop. The combination of a large rotator cuff tear and advanced arthritis can lead to severe pain and weakness, and the patient may not be able to lift the arm away from the side.

Avascular Necrosis: Avascular necrosis (AVN) of the shoulder is a painful condition that occurs when the blood supply to the head of the humerus is disrupted. Because bone cells die without a blood supply, AVN can ultimately lead to destruction of the shoulder joint and arthritis. AVN develops in stages. As it progresses, the dead bone gradually collapses, which damages the articular cartilage covering the bone and leads to arthritis. At first, AVN affects only the head of the humerus, but as AVN progresses, the collapsed head of the humerus can damage the glenoid socket. Causes of AVN include high-dose steroid use, heavy alcohol consumption, sickle cell disease, and traumatic injury, such as fractures of the shoulder. In some cases, no cause can be identified. This is referred to as idiopathic AVN.

Evaluation: How is Shoulder Arthritis diagnosed?

After discussing your symptoms and medical history, your doctor will examine your shoulder. During the physical examination, your doctor will look for muscle weakness, tenderness to touch, signs of previous injuries, and other indicators. Your doctor may also use an X-ray to help determine the type of arthritis. An X-ray of an arthritic shoulder shows a narrowing of the joint space, changes in the bone, and the formation of bone spurs (osteophytes). Your doctor may inject a local anesthetic into the joint to confirm the diagnosis. If the anesthetic temporarily relieves the pain, the diagnosis is supported.

Treatment

As with other arthritic conditions, initial treatment of shoulder arthritis is non-surgical. Your doctor may start by recommending rest, physical therapy, and anti-inflammatory medications. If your pain causes disability and is not relieved with non-surgical options, your doctor may consider surgery.

Arthroscopy: Cases of mild glenohumeral arthritis may be treated with arthroscopy. During arthroscopy, the surgeon inserts a small camera, called an arthroscope, into the shoulder joint. The camera displays pictures on a television screen, and the surgeon uses these images to guide miniature surgical instruments. Because the arthroscope and surgical instruments are thin, the surgeon can use very small incisions, rather than the larger incision needed for standard, open surgery. During the procedure, your surgeon can clean out the inside of the joint. Although the procedure provides pain relief, it will not eliminate the arthritis from the joint. If the arthritis progresses, further surgery may be needed in the future.

Shoulder Joint Replacement (Arthroplasty): Advanced arthritis of the glenohumeral joint can be treated with shoulder replacement surgery, in which the damaged parts of the shoulder are removed and replaced with artificial components, called a prosthesis. Replacement surgery options include:

Hemiarthroplasty replaces the head of the humerus with an artificial component.
Total shoulder arthroplasty replaces the head of the humerus and the glenoid. A plastic “cup” is fitted into the glenoid, and a metal “ball” is attached to the top of the humerus.
Reverse total shoulder arthroplasty switches the ball and socket sides of the shoulder joint. 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 cuff tear arthropathy because it relies on different muscles, rather than the rotator cuff, to move the arm.

Resection Arthroplasty: This procedure is most common for treating arthritis of the acromioclavicular joint. In this procedure, a small amount of bone from the end of the collarbone is removed, leaving a space that gradually fills in with scar tissue.

Recovery: What Can Be Expected?

Surgical treatment for shoulder arthritis is generally very effective in reducing pain and restoring motion. Recovery time and rehabilitation plans depend upon the type of surgery performed, though most shoulder replacement surgeries require a one or two night stay in the hospital. Physical therapy typically begins right after surgery. A physical therapist will move your arm with you to keep your shoulder loose as it begins to heal. The therapist can also show you simple exercises that you can perform at home. You should be able to return to daily activities within a few weeks after surgery, though total recovery will take several months.

Woman recovering from shoulder arthritis

Physicians

The following physicians specialize in the treatment of Shoulder Arthritis:

R. Blake Curd, MD

Evan N. Hermanson, MD

Erik D. Peterson, MD

Peter A. Looby, MD

Dustin P. Collins, MD

Jason L. Hurd, MD

Matthew J. McKenzie, MD

Joshua J. Meaike, MD

Keith M. Baumgarten, MD

Joshua J. Meaike, MD

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Testimonials

I have had a knee and two shoulder replacements plus a diagnosis on an injury to my leg that probably saved muscle loss. I feel that Dr. Zoellner is the best orthopedic doctor that I could possibly have.

Love OI and Dr. Curd. He’s helped me with a couple of issues and I couldn’t be more pleased. The PA Chad is wonderful as well. The surgery went well, treatment(s) for another issue are as easy as they can be and easily scheduled. Definitely recommend Dr. Curd to anyone with hand or shoulder issues!

What a great doctor. Dr. Looby has seen me through knee and shoulder surgeries, with great skill and care. He always makes sure I am doing ok and answers all my questions and listens to my concerns. It has been an awesome journey to being pain-free and able to function normally. I will be able to dance at my daughter’s wedding. I am so grateful. What a blessing!

Dr. Baumgartner’s kind and pleasant personality set me at ease for the complex shoulder replacement surgery. He’s an outstanding and highly skilled surgeon; I highly recommend him.

From my first consult, I liked Dr. Hermanson and felt very confident in his abilities to fix my shoulder. My surgery and hospital stay were so positive! I recommended him to a friend and he did her surgery as well. He and his staff are professional, kind and a pleasure to work with! I highly recommend him!

Liz Hansen

Shoulder Arthritis