Shoulder Arthritis

Arthritis of the Shoulder

What Is Arthritis of the Shoulder?

Arthritis is a degenerative disease caused by either wear and tear (osteoarthritis) or an inflammation (rheumatoid arthritis) of one or more joints. Arthritis not only affects joints; it may secondarily affect supporting structures such as muscles, tendons, and ligaments.

What Are the Signs of Shoulder Arthritis and How Is It Diagnosed?

The usual signs of arthritis of the shoulder are pain, particularly over the AC joint, and a decrease in shoulder motion. A doctor may suspect the patient has arthritis when there is both pain and swelling in the joint. The diagnosis may be confirmed by a physical examination and x-ray evaluation. Blood tests may be helpful for diagnosing rheumatoid arthritis, but other tests may be needed as well. Analysis of synovial fluid from the shoulder joint may be helpful in diagnosing other types of arthritis. Arthroscopy of the shoulder joint allows direct visualization of the joint and can identify damage to cartilage, tendons, and ligaments. However, arthroscopy is generally not performed if a patient’s arthritis is severe and generally a reconstructive procedure or joint replacement is required for pain relief.

How Is Arthritis of the Shoulder Treated?

Most often osteoarthritis of the shoulder is treated with nonsteroidal anti- inflammatory drugs such as aspirin or ibuprofen. (Rheumatoid arthritis of the shoulder may require physical therapy and additional medicine, such as corticosteroids.) When conservative treatment of osteoarthritis of the shoulder fails to relieve pain or improve function, or when there is severe deterioration of the joint causing parts to loosen and move out of place, shoulder joint replacement (arthroplasty) may provide better results. In this operation, a surgeon replaces the shoulder joint with an artificial ball for the humerus and a cap (glenoid) for the scapula (See x-rays below). Passive shoulder exercises (where someone else moves the arm to rotate the shoulder joint) are started soon after surgery. Patients begin exercising on their own about 3 to 6 weeks after surgery. Eventually, stretching and strengthening exercises become a major part of the rehabilitation program. The success of the operation often depends on the condition of rotator cuff muscles prior to surgery and the degree to which the patient follows the exercise program.

(Insert Pre and postop shoulder xrays)