Causes of Shoulder Osteoarthritis
Shoulder Osteoarthritis is more common in people over age 50. It is also more common in younger people with rheumatoid arthritis or after shoulder trauma, such as from broken shoulder bones, shoulder dislocation or infection.
The most common cause of shoulder osteoarthritis is attributed to “wear and tear,” an age-related type of joint disease. Cartilage gets soft, cracks, flakes or becomes frayed and eventually wears away. This exposes the bones beneath the cartilage, which begin to rub or grind against each other. Like the tires on your car, joint surfaces don’t wear down evenly or at the same rate. Other causes include:
- Rheumatoid arthritis: This is an autoimmune disease, which means your body’s defense system attacks its own healthy tissues. In rheumatoid arthritis of your shoulder, your immune system attacks the joint and joint lining, causing the lining to swell.
- Rotator cuff tear arthropathy: The rotator cuff is a group of four tendons that surround your shoulder joint and keep your shoulder stable as the “ball” of your upper arm rotates in your shoulder blade socket during movement. Tearing of these tendons (rotator cuff tears) usually happens as slow fraying and wearing over time.
- Trauma to your shoulder: Any type of injury to the bones of the shoulder — including dislocation, fracture or severe impact — can damage the cartilage surface.
- Avascular necrosis: This condition, also called osteonecrosis, is the death of part of the “ball” of your shoulder. Trauma or disease cut off blood flow to the bone.
Symptoms of Shoulder Osteoarthritis
The amount of cartilage loss varies from person to person and so do symptoms of shoulder arthritis. Symptoms of Shoulder Osteoarthritis include:
- Pain in the shoulder joint
- Stiffness of the joint is another sign of shoulder arthritis progression.
- Grinding, clicking or cracking (crepitus)
- Reduced Range of Motion
- Swelling
- Tenderness
Prognosis of Shoulder Osteoarthritis
Although there is no predictable way to regrow cartilage there are many treatment options available. Using these, most people with arthritis are able to manage pain and stay active.
Diagnosis of Shoulder Osteoarthritis
Your orthopedic surgeon will evaluate your medical history and may conduct a variety of tests to determine if you have osteoarthritis:
Physical examination: During the physical exam, your physician will examine your shoulder for swelling, range of motion, muscle strength, and tenderness. The exam also includes questions about personal and family medical history.
X-ray: X-rays are used to look for a narrowing joint space and damage related to the bones in the shoulder joint, as well as for the formation of bone spurs, which indicate arthritis.
MRI: An MRI may also be needed to gauge the condition of the rotator cuff. Other diagnostic tests may be used to rule out causes of joint pain. Blood tests and analysis of joint fluid can rule out rheumatoid arthritis or infection.
Treatment of Shoulder Osteoarthritis
Treatment options include:
Conservative Treatments: Non-surgical approaches include:
Medications: Such as nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants for pain management.
Physical Therapy: It often starts with range-of-motion exercises to keep the shoulder mobile. If your range of motion is not affected, then the goal is to prevent it from deteriorating.
RICE: Rest, Ice, Compression and Elevation
Lifestyle Changes: Generally, anything that causes pain should be avoided, especially if the pain interferes with your life. If shoulder pain lasts for several days and wakes you up at night, it may be reasonable to question how important that activity is to you.
Epidural Steroid Injections: Targeted injections to reduce inflammation and alleviate pain.
Acupuncture or Chiropractic Care: Some patients find relief through alternative therapies.
Surgical Intervention: When conservative measures are ineffective or symptoms worsen, surgery may be considered. Surgical options depend on your age and the degree of arthritis.:
Arthroscopic Shoulder Debridement: This minimally invasive procedure uses a small camera (an arthroscope) and surgical tools inserted through small incisions to “clean out” (debride) the shoulder joint. It is recommended for patients with lower grades of arthritis and is typically not recommended when there is bone-on-bone traction.
Osteotomy: Realigning bones of the arm to take pressure off the joint.
Joint fusion: Removing worn cartilage and fusing the bones on each side of the joint together.
Joint reconstruction: Removing the worn joint surface and replacing it with your own soft tissue or with an implant.
Shoulder Replacement: Shoulder replacement is the preferred procedure for bone-on-bone shoulder arthritis. It relieves the pain of arthritis, and it has been shown to last for many years.
- A standard total shoulder replacement procedure replaces the ball and the socket parts of the shoulder joint with artificial parts.
- In a reverse total shoulder replacement procedure, the ball and socket sides of the joint switch places. This procedure can be done for many conditions, but it’s mainly used when there is a rotator cuff tear in the shoulder with arthritis
Procedure Videos
Intra articular steroid joint injection
Axillary/supraclavicular nerve block
Radiofrequency Ablation
Peripheral Nerve Stimulation
References
- “Arthritis of the Shoulder.” OrthoInfo – AAOS, American Academy of Orthopaedic Surgeons, www.orthoinfo.aaos.org/en/diseases–conditions/arthritis-of-the-shoulder/#:~:text=Although%20there%20is%20no%20predictable,manage%20pain%20and%20stay%20active. Accessed 18 July 2024.
- Hampton, Lucinda, et al. “Shoulder Osteoarthritis.” Physio-Pedia, www.physio-pedia.com/Shoulder_Osteoarthritis. Accessed 18 July 2024.
- Osteoarthritis of the shoulder. Arthritis Foundation. https://www.arthritis.org/diseases/more-about/osteoarthritis-of-the-shoulder. Accessed June 27, 2024.
- Osteoarthritis of the shoulder. Brigham and Women’s Hospital. https://www.brighamandwomens.org/orthopaedic-surgery/osteoarthritis-of-the-shoulder. Accessed June 27, 2024.
- Shoulder arthritis. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22491-shoulder-arthritis. Accessed June 27, 2024.
- Shoulder arthritis. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/shoulder-arthritis. Accessed June 27, 2024.
- Shoulder pain: Causes, treatments, and prevention. Peninsula Orthopaedic Associates. https://posm.org/shoulder-pain-causes-treatments-and-prevention/. Accessed June 27, 2024.
