Arthritis of the shoulder may affect the joint at the end of the collarbone (clavicle), which is known as the AC (acromioclavicular) joint. This AC joint is the bony prominence you can feel at the top of your shoulder. Or it may affect the ball and socket joint, where your upper arm bone (humerus) attaches into your shoulder. This ball and socket joint, called the glenohumeral joint is made up of the humerus, clavicle, and the shoulder blade (scapula). AC joint arthritis is the most common form of shoulder arthritis. There are several causes of arthritis in the shoulder, these include:
- age related osteoarthritis
- disease related inflammatory/Rheumatoid arthritis
- Injury related post traumatic arthritis.
The shoulder joint requires smooth cartilage surfaces covering the ball and socket bones of the joint in order to function correctly. With osteoarthritis the cartilage becomes worn away, and the bones can begin to rub and grate against each other. This is caused by age and simple wear and tear on the joint. Osteoarthritis causes pain in the shoulder, often at the front of the shoulder, and this pain increases with movement. Joint stiffness, weakness, and reduced mobility are common symptoms of shoulder arthritis.
With disease related arthritis, such as rheumatoid arthritis, it is not the wearing away of the cartilage that causes the problem, but inflammation of the ligaments around the shoulder joint, and the fluid within the joint cavity that is the cause of the pain. In rheumatoid arthritis, the person’s immune system attacks healthy tissues of the body, most notably the soft tissue around the joints. Symptoms of rheumatoid arthritis include joint pain, swelling, redness around the joint area, and stiffness and loss of mobility. The joint pain is most notable in the morning upon waking, or after prolonged rest, and the pain is usually present for more than one hour. Unlike osteoarthritis, the pain in the joint is often eased with gentle use and exercise.
Injury related Arthritis
Post traumatic arthritis may occur within a joint that has been previously injured. This type of osteoarthritis is commonly seen in a person who has experienced a severe shoulder injury such as a dislocation, a rotator cuff injury, or an AC joint injury. Often the injured part of the joint can become uneven, enlarged, or slightly deformed. Although swelling reduces after an injury, sometimes this residual effect remains and over time causes disruption to the movement of the joint. Symptoms of post traumatic arthritis are the same as in osteoarthritis and include limited range of motion in the joint, pain, joint stiffness, and weakness.
Medical treatment for arthritis of the shoulder involves the use of cold compresses to help ease pain and reduce swelling. Anti-inflammatory drugs are also commonly used to reduce swelling and ease pain. Physical therapy is also important as the joint needs to remain as mobile as is possible. Once a joint has lost mobility, it is very difficult to regain this movement. Gentle non-strenuous regular exercise is important for shoulder arthritis. If pain is severe then steroid injections into the joint may be necessary. However these injections are not considered the best course of treatment long term, as they only last up to a few months, and are only effective in reducing pain, not dealing with the cause of the pain. If joint deterioration is severe enough surgery may be required.
Surgical treatment will usually involve arthroscopic removal of any loose cartilage or bone fragments that are causing irritation and pain in the joint. If the joint is severely damaged, then a joint replacement arthroplasty may be required. Shoulder replacements are not as common as other joint replacements such as knee and hip joints, and Mr. Durrant will only suggest a shoulder joint replacement if it is the only treatment option available. A shoulder joint replacement is where the damaged portion of the bone is removed and replaced with a metal, ceramic, or pyrocarbon joint. Through thorough physical examination, x-ray and MRI scanning, Mr. Durrant will be able to accurately diagnose arthritis of the shoulder, and suggest the most appropriate and effective course of treatment for you.
Please contact Mr. Adam Durrants office for more information on arthritis of the shoulder or for additional resources on other shoulder related injuries.