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info@prestigehealthcare.co.uk
Conditions we treat
Arthritis of the Shoulder
Arthritis of the Shoulder
General Information
Each year, millions of people worldwide are diagnosed with some form of arthritis. Simply defined, arthritis is inflammation of one or more of your joints. In a diseased shoulder, this inflammation causes pain and stiffness that can make it difficult to lift your arm, brush your hair or reach up to a high shelf.
Although there is no cure for arthritis of the shoulder, there are many treatment options available. Using these, most people with arthritis are able to manage pain and stay active.
Anatomy
Your shoulder is made up of three bones:
- Upper arm bone (humerus)
- Shoulder blade (scapula)
- Collarbone (clavicle)
The head of your upper arm bone fits into a rounded socket in your shoulder blade. This socket is called the glenoid. A combination of muscles and tendons keeps your arm bone centered in your shoulder socket. These tissues are called the rotator cuff.
There are two joints in the shoulder, and both may be affected by arthritis. One joint is located where the clavicle meets the tip of the shoulder blade (acromion). This is called the acromioclavicular (AC) joint. The second is where the head of the humerus fits into the scapula and is called the glenohumeral joint.
To provide you with effective treatment, your doctor will need to determine which joint is affected and what type of arthritis you have.
Description
Four major types of arthritis typically affect the shoulder.
(1) Osteoarthritis
Also known as "wear-and-tear" arthritis, osteoarthritis a condition that destroys the smooth outer covering (articular cartilage) of bone. As the articular 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; this is often referred to as "bone on bone" arthritis.
Osteoarthritis usually affects people over the age of 50 and is more common in the acromioclavicular joint than in the glenohumeral shoulder joint.
(2) 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.
(3) Post traumatic Arthritis
Posttraumatic arthritis is a form of osteoarthritis that develops after an injury, such as a fracture or dislocation of the shoulder.
(4) 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.
Avascular necrosis 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.
Symptoms
Pain. The most common symptom of arthritis of the shoulder is pain. This pain is aggravated by activity and progressively gets worse over time. The location of the pain will vary, depending on which shoulder joint is affected:
- If the glenohumeral shoulder joint is affected, the pain is centered in the side or back of the shoulder and may intensify with changes in the weather. Patients complain of an ache deep in the joint.
- The pain of arthritis in the acromioclavicular (AC) joint is focused on the top of the shoulder. This pain can sometimes radiate or travel to the side of the neck.
- Someone with rheumatoid arthritis may have pain throughout the shoulder if both the glenohumeral and AC joints are affected.
As the disease progresses, any movement of the shoulder causes pain. Night pain is common, and sleeping may be difficult.
Other symptoms may include:
Limited range of motion. Limited motion is another common symptom. It may become more difficult to lift your arm to comb your hair or reach up to a shelf.
Crepitus. You may hear a grinding, clicking, or snapping sound (crepitus) as you move your shoulder. Crepitus is sometimes painful and can be loud enough for other people to hear.
A Physical Examination by our physiotherapists might include all or some of the following:
- Weakness (atrophy) in the muscles
- Tenderness to touch
- Extent of passive (assisted) and active (self-directed) range of motion
- Any signs of injury to the muscles, tendons, and ligaments surrounding the joint
- Signs of previous injuries or surgeries
- Involvement of other joints (an indication of rheumatoid arthritis)
- Crepitus (a grating sensation inside the joint) with movement
- Pain when pressure is placed on the joint
Treatment
Non Surgical Treatment
As with other arthritic conditions, initial treatment of arthritis of the shoulder is nonsurgical. Our physiotherapist may recommend the following:
- Rest or change in activities. You may need to change the way you move your arm to avoid provoking pain.
- Physical therapy exercises may improve the range of motion in your shoulder.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen, may reduce inflammation and pain. These medications can irritate the stomach lining and cause internal bleeding. They should be taken with food. Consult with your GP before taking over-the-counter NSAIDs if you have a history of ulcers or are taking blood thinning medication.
- Corticosteroid injections in the shoulder can dramatically reduce the inflammation and pain. However, the effect is often temporary.
- Moist heat may provide temporary relief.
- Icing your shoulder for 20 to 30 minutes two or three times a day to reduce inflammation and ease pain.
- If you have rheumatoid arthritis, your GP may prescribe disease-modifying drugs.
For more information about Arthritis of the Shoulder or to have an assessment or some treatment contact us by filling out the form below, emailing or calling us.
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