Shoulder arthritis happens when the cartilage inside your shoulder joint is damaged. The shoulder consists of two joints. The larger ball-and-socket joint in the shoulder, known as the glenohumeral joint is the main part of your shoulder joint that suffers from this condition. The ball (the humeral head) and the socket are both covered in cartilage and damage to such cartilage occurs in shoulder arthritis.
The acromioclavicular joint and the glenohumeral joint are the two joints that make up the shoulder. The AC joint is the location where the tip of your shoulder blade (acromion of the scapula) joins the collarbone (clavicle). The AC joint is where osteoarthritis is found second to the glenohumeral joint. When the smooth cartilage wears away, the underlying rough bones start to rub against one another. This rubbing of bones develops bone spurs (osteophytes) which cause uneven mobility. These bony elevations develop as your bone tries to repair itself. Ultimately, severe inflammation develops in your shoulder joint that put you in trouble.
People over 50 are more likely to get osteoarthritis. Osteoarthritis can also develop in younger people if they suffer from trauma or injury of the upper arm bone (humerus), like a broken or dislocated shoulder. You are also at great risk of developing this condition if this is running in your family.
In this article, you will get complete information about shoulder arthritis and what you can do if you are suffering from this condition.
Causes of shoulder arthritis
Numerous factors may contribute to shoulder arthritis. They consist of:
- Osteoarthritis: This is the most prevalent form of all types of arthritis. In osteoarthritis of the shoulder, there is “wear and tear” and age-related joint pain. The cartilage in your joints damages over time, becoming weaker and more fragile. Your bones underneath the cartilage become visible, and they start to rub or grind against one another.
- Rheumatoid arthritis: This autoimmune disease called rheumatoid arthritis causes your body’s defense mechanisms to attack its own healthy tissues. When you have shoulder rheumatoid arthritis, your immune system attacks your own shoulder joint and the lining around it(1). Eventually, your shoulder is inflamed and gets swollen. As the condition progresses, the cartilage becomes damaged, and shoulder arthritis results.
- Rotator cuff tear arthropathy: Rotator cuff tendons is a group of four tendons that surround your shoulder joint and keep your shoulder joint stable. When these tendons wear over time, your bones dislocate partially and start to rub against each other. And you are now at great risk of developing shoulder arthritis in the future.
- Post-traumatic arthritis: You are more prone to develop shoulder arthritis if you suffered from any sort of shoulder injury previously. Perhaps your joint cartilage was damaged during injury which put you at a high risk of developing shoulder arthritis.
- Avascular necrosis: This happens after injury when your blood vessels rupture during trauma(2). This causes necrosis of your bone tissue and your bone tissue dies and inflammation develops in the area around it causing shoulder arthritis.
Signs and symptoms
Each person experiences shoulder arthritis differently. However, some warning signs and symptoms of shoulder arthritis are
The most typical sign of shoulder arthritis is a pain in the shoulder joint(3). Initially, only physical activity may cause shoulder pain. As your condition progresses, you could have severe pain at any time of day, whether you move your arms or not. Lifting heavy objects and heavy exercise can enhance your pain even more. If your condition is severe, the pain may travel down your arm and even to your elbow or wrist.
You also experience stiffness in your shoulder if you have shoulder arthritis. Even the daily chores become difficult to execute due to the stiffness of the shoulder. You may also notice a clicking or grinding sound as you try to move your shoulder. These noises are due to the cartilage loss and rubbing of your bones with each other.
If you have shoulder arthritis, you will find it difficult to find a comfortable sleeping position which results in sleep loss. Any shoulder motion could be painful. Place a pillow beneath the elbow of your affected side if you sleep on your back. Keep your shoulder in a more supportive position to avoid pain.
Care and treatment
Conservative therapy includes non-surgical treatments such as medications and physical therapy. Complete medical history and physical exam are necessary for the treatment of degenerative joint disease. Further treatment options include:
Taking proper rest is the most important in the treatment of shoulder arthritis. Avoid moving your shoulder and keep it braced. This will allow your shoulder to heal itself quickly. Try to sleep in a straight position to avoid any injury or impact on the affected shoulder.
Use anti-inflammatory medications like NSAIDs such as aspirin or ibuprofen. These medications are over-the-counter medications that lessen the pain and inflammation(4). However, do not take these medications by yourself as they have many side effects as well. To ensure that you can take these medications safely, consult your doctor.
Physical therapy is a great thing if you want pain relief and to boost the healing process of your shoulder arthritis. You need to consult your physiotherapist in this regard. The physical therapist will execute multiple exercises on your shoulder muscles that help your shoulder joint to get rid of the inflammation as fast as possible. This is a must-do thing if you are suffering from the condition.
Moderate exercise of the shoulder also assists in the healing process. Must do strengthening exercises of your shoulder that increase the flexibility of your joint. In addition, these exercises not only increase the range of motion at your shoulder joint but also strengthen your ligaments which help in recovery.
If your condition still persists and puts you in discomfort, try using additional drugs that your doctor prescribes. For instance, one of these could be steroid or corticosteroid (cortisone) injections. Also, take glucosamine and chondroitin sulfate as dietary supplements. Because the supplements could interact with other medications, you should consult your doctor before using them.
Surgical options are available if conservative therapy remains ineffective. Similar to any operation, there are certain possible risks and side effects, such as an infection or issues with the anesthesia. If the damage is severe, the surgeon gives an incision up to the joint space and executes a complete joint replacement(5). However, if the damage is not of that much extent, your surgeon replaces the cartilage (hemiarthroplasty) with arthroscopy instead of total shoulder replacement. You also need to undergo radiographic examination such as an x-ray before surgery.
Having surgery done doesn’t mean that you are now free to use your shoulder as a fully healthy person, you still need to take several preventive measures to avoid the onset of the disease again
Be physically active
One of the best methods to avoid arthritis is through physical activity. Keep your joints mobile and strengthen the muscles to support them. Exercise options include walking, household tasks, and playing with kids and pets. To become physically active is not the thing that you need to consult your doctor before carrying out.
Optimize your diet
Optimizing your diet is the first and foremost thing that you can do to prevent the onset of arthritis again. Several foods have anti-oxidants in them and they prevent the onset of inflammation in your body. Make whole grains, fish, fruit, and green vegetables an integral part of your dining table. Add such meals to your diet that are rich in such anti-oxidants. Avoid fatty meals which have a natural tendency to increase the inflammatory chemicals in your body.
Obesity is simply the accumulation of fat tissue in your body. Seems like nothing is going to happen with excess adipose tissue, isn’t it? However, studies(6) suggest that excess adipose tissue produces certain chemicals in the body that are pro-inflammatory substances. These chemicals cause widespread inflammation in your body. Your joints are one of the most vulnerable tissues to be affected by these chemicals thus developing the disease.
The prognosis for shoulder joint arthritis varies widely. Early on in the illness, symptoms are often minor and have little to no effect on the range of motion. People with severe arthritis may have less range of motion and intense discomfort in the shoulder joints. Regular physical activity will keep the shoulder joints active, which can significantly improve this region of the body’s range of motion and reduce pain. In order to prevent further harm to the joints or surrounding tissues, you should exercise carefully.
Frequently Asked Questions
What is end-stage shoulder arthritis?
At the end stage, the bones associated with the joint also start to degrade in addition to the cartilage. This reduces muscle strength and mobility throughout the body.
How should I sleep with shoulder arthritis?
Maintain a straight spine, neck, and head when you sleep. Avoid sleeping with your head too much forward or backward on the pillow or inclined too far to one side. Never sleep on your side or back, or on your stomach.
Why is arthritis pain worse at night?
At night, your body produces large amounts of melatonin and prolactin, both of which can raise inflammatory chemicals in your body. This is why your arthritis pain often gets worse at night.
How fast does shoulder arthritis progress?
It depends on the physiology of a person. In some circumstances, osteoarthritis can advance very quickly, causing the cartilage to completely degrade within a matter of months However, in other cases, the cartilage remains stable for a long period of time.
What triggers arthritis flare-ups?
Overactivity of your shoulder joint increases the damage and can flare up the condition. In addition, certain foods having lots of pro-inflammatory chemicals also flare up the underlying condition of shoulder arthritis.
Is heat or ice better for arthritis?
Utilizing heat, such as soaking in hot baths, putting heating pads, and soaking joints in warm wax can all temporarily lessen your pain. However, take preventive measures to avoid burning yourself. Spend no more than 20 minutes at a time using heating pads.
- Chen, A. L., Joseph, T. N., & Zuckerman, J. D. (2003). Rheumatoid Arthritis of the Shoulder. JAAOS – Journal of the American Academy of Orthopaedic Surgeons, 11(1), 12–24.https://journals.lww.com/jaaos/Abstract/2003/01000/Rheumatoid_Arthritis_of_the_Shoulder.4.aspx
- Ristow, J. J., Ellison, C. M., Mickschl, D. J., Berg, K. C., Haidet, K. C., Gray, J. R., & Grindel, S. I. (2019). Outcomes of shoulder replacement in humeral head avascular necrosis. Journal of Shoulder and Elbow Surgery, 28(1), 9–14. https://doi.org/10.1016/j.jse.2018.06.031
- Mitchell, C., Adebajo, A., Hay, E., & Carr, A. (2005). Shoulder pain: diagnosis and management in primary care. BMJ, 331(7525), 1124–1128. https://doi.org/10.1136/bmj.331.7525.1124
- Van Der Windt, D. (1995). The efficacy of non-steroidal anti-inflammatory drugs (NSAIDS) for shoulder complaints. A systematic review. Journal of Clinical Epidemiology, 48(5), 691–704. https://doi.org/10.1016/0895-4356(94)00170-u
- Hattrup, S. J., Sanchez-Sotelo, J., Sperling, J. W., & Cofield, R. H. (2012). Reverse Shoulder Replacement for Patients With Inflammatory Arthritis. The Journal of Hand Surgery, 37(9), 1888–1894. https://doi.org/10.1016/j.jhsa.2012.05.015
- Wang, T., He, C., & Yu, X. (2017). Pro-Inflammatory Cytokines: New Potential Therapeutic Targets for Obesity-Related Bone Disorders. Current Drug Targets, 18(14). https://doi.org/10.2174/1389450118666170104153512