Typically, arthritis of the shoulder occurs when the cartilage over the glenohumeral joint surfaces (the ball-and-socket joint) is lost. The degeneration of the cartilage is caused by three types of arthritis:
- Osteoarthritis is caused by gradual wear and tear that occurs with age and/or overuse.
- Rheumatoid arthritis is a disease in which the body’s immune system attacks its own cartilage and destroys it.
- Post-traumatic arthritis happens after significant trauma, like a car accident, or repeated injury.
Pain is a common presenting symptom of shoulder arthritis, usually coupled with stiffness. Some individuals find that they can no longer use the affected shoulder to do their normal activities, like combing their hair, because of a limited range of motion. Commonly, the patient reports that they can no longer sleep on the affected side without pain. Some even notice a grinding feeling, the direct contact of the two bony surfaces, when they move their shoulder. Among individuals, the symptoms and progression of arthritis can vary greatly, however, the disease usually gets worse with time.
Treatment of arthritis of the shoulder depends on the type of arthritis present. Osteoarthritis is most often treated with non-steroidal anti-inflammatory drugs (NSAIDS), such as aspirin or ibuprofen. Rheumatoid arthritis may require additional medicine, such as corticosteroids and/or disease-modifying drugs like methotrexate. However, in either case, initial treatment is conservative and should include:
- Rest or change of activities to lessen the pain.
- If exercises are not too painful, they may be helpful in maintaining the flexibility and strength of joints with arthritis.
- Ice the shoulder for 20-30 minutes two to three times a day to reduce inflammation and pain.
- Dietary supplements such as glucosamine or chondroitin sulfate may be helpful.
There are surgical options if conservative treatment fails to relieve symptoms including replacing the entire shoulder joint with a prosthesis (total shoulder arthroplasty) or by replacing the head of the upper arm bone (hemiarthroplasty).