Shoulder arthritis

What is shoulder arthritis?

Arthritis is the wearing away of the cartilage that cushions the friction of the bones in the joints, and can affect two distinct points in the shoulder.

The shoulder is the nexus that joins the humerus with the shoulder blade and the clavicle, and is made up of three bones and two joints between them, which can be affected by arthritis. Thus, this wear and tear of the cartilage can occur either at the junction of the clavicle with the scapula (acromioclavicular joint) or at the junction between the humerus and the scapula (glenohumeral joint).

There are different types of arthritis that can affect the shoulder:

  • Osteoarthritis: this is wear-and-tear arthritis, which is caused by normal friction in the joint, which wears down the cartilage and becomes rough, until the bones actually rub together. It usually affects patients over 50 years of age.
  • Rheumatoid arthritis: Rheumatoid arthritis is a chronic autoimmune disease that can affect joints throughout the body. It causes the synovial membrane lining the joints to become inflamed. It can occur symmetrically, affecting both sides of the body at the same time.
  • Rotator cuff tear arthritis: Arthritis can occur after a severe tear of the rotator cuff tendon. This type of arthritis develops severe pain and even loss of mobility.
  • Post-traumatic arthritis: this is arthritis that develops after an injury such as a shoulder dislocation or fracture.
  • Avascular necrosis: this type of arthritis occurs when there is an alteration of blood supply to the head of the humerus, as bone cells die and the cartilage is destroyed.

Prognosis of the disease

Arthritis is a chronic disease, which progressively decreases mobility in the joints. If left untreated, the wear and tear of the cartilage in the shoulder joints will lead to bone friction, with increasing pain and become disabling due to loss of mobility in the arm.

Shoulder arthritis is a cause of loss of mobility that can become disabling.

Symptoms of shoulder arthritis

The main symptoms of arthritis, in this case affecting the shoulder, are progressive and intense pain, accompanied by stiffness and loss of mobility in the joint. More specifically, the patient may feel to a greater or lesser extent some of these symptoms:

  • Pain on touching the shoulder
  • Crepitus of the joint
  • Weakness of the muscles
  • Very severe pain, especially when raising the arm
  • Pain when applying pressure or weight on the shoulders

Medical tests for shoulder arthritis

For the diagnosis of shoulder arthritis, first of all the medical specialist will collect the patient’s clinical history, as well as his or her symptomatology.

To confirm and specify the diagnosis, an X-ray may be performed, which will show a narrowing of the joint space due to cartilage wear, signs of inflammation or bone deformities, depending on the type of arthritis present. Another measure to confirm the diagnosis of arthritis is to apply local anesthesia to the shoulder. If the pain is relieved, the hypothesis of arthritis is reinforced.

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What are the causes of shoulder arthritis?

Depending on the type of arthritis present, the causes may be diverse. The most frequent is the wear and tear of the joint, typical of the friction movement. This arthritis tends to occur mainly in people over 50 years of age and in athletes who have subjected this joint to greater wear and tear.

On the other hand, arthritis can also appear due to a fracture, severe dislocation of the shoulder, or a tear of the rotator cuff tendon. Finally, rheumatoid arthritis is caused by an immune system response.

However, the risk factors, which cause one person to develop arthritis and not others, are not known.

Can it be prevented?

When arthritis is diagnosed, action can be taken to prevent its progression and evolution, as well as in the case of rheumatoid arthritis, work can be done to prevent its evolution to other joints.

Treatments for shoulder arthritis

Initial treatment for shoulder arthritis in the early stages will be non-surgical, and includes some of the following measures:

  • Change of daily habits to increase rest and avoid overloading the shoulder.
  • Physical therapy to improve mobility.
  • Injection of corticosteroids in the shoulder to reduce pain and inflammation.
  • Pharmacological treatment with anti-inflammatory drugs.
  • Application of ice on the joint for half an hour, twice a day, also to reduce the symptoms of pain and inflammation.

When the arthritis of the shoulder is very advanced affecting the mobility, or does not present improvement with the initial treatment, shoulder surgery will be resorted to. Depending on the case, different surgical techniques may be chosen:

  • Shoulder arthroscopy: during arthroscopy, the specialist may clean (debride) the joint, to relieve pain. It may require a repeat operation in the future.
  • Shoulder arthroplasty: consists of replacing the joint or damaged parts of the joint with shoulder prostheses. There are three different types of shoulder arthroplasty:
    • Total shoulder arthroplasty: in which the entire shoulder joint is replaced.
    • Reverse total arthroplasty: also involves the replacement of the entire joint, but by a reverse mechanism which is more advisable for arthritis due to rotator cuff tear, since it avoids supporting the prosthesis in this area.
    • Hemiarthroplasty: the head of the humerus is replaced.
  • Resection arthroplasty: in this type of arthroplasty a small part of the clavicle is removed, and it is used for arthritis affecting the acromioclavicular joint.

Which specialist treats it?

The specialist who treats shoulder arthritis is the traumatologist, although it is possible that for its treatment it requires the collaboration of the expert rheumatologist and the physiotherapist.