Shoulder Arthritis

Shoulder Arthritis

Arthritis in the shoulder joint itself is fairly similar to arthritis in other locations of the body, however it occurs far less frequently than hip or knee arthritis. This is because the shoulder is typically not a full weight bearing joint like the hip or knee and therefore typically is under less stress. However, when it occurs, the symptoms are fairly similar. These include diffuse achy pain, occasional sharp pain, limited mobility and the sensation of grinding or clicking that causes pain. It is caused by a loss of the protective cartilage on the ends of the bone which leads to "bone-on-bone" contact. This eventually leads to the development of bone spurs (osteophytes) which further limits motion and can cause significant pain.

The diagnosis of shoulder arthritis is relatively simple with the proper physical examination and a series of routine X-rays. The treatment options for arthritis are somewhat more controversial. The benefit of physical therapy is limited in the treatment of shoulder arthritis, especially as the disorder progresses and stiffness become more and more of a problem.  Injections into the shoulder joint of corticosteroids ("cortisone shots") can have some temporary benefit to relieve the pain from the inflammation that occurs, but will not treat the underlying condition.  Viscosupplementation injections have also been used with temporary benefit.

The surgical treatment for shoulder arthritis may include a shoulder arthroscopy (see section on shoulder arthroscopy for more details of the procedure) as a minimally invasive surgery to remove loose fragments of cartilage and potentially smooth the cartilage surfaces. This also should be considered a somewhat temporary benefit. However, many patients will have long lasting benefit from a limited debridement and removing some of the irritating or inflammed tissue. The primary surgical treatment for shoulder arthritis is some form of joint replacement procedure. This can include a hemiarthroplasty (replacement of part of the joint), a total shoulder arthroplasty (replacing the whole shoulder joint), or a reverse total shoulder joint (a specialized replacement for severe arthritis in addition to a significant rotator cuff tear). The decision on which type of replacement is most appropriate, is a careful decision that needs to be made in consultation with your surgeon. This type of surgery is best at providing pain relief, but carries with it a moderate amount of restriction on activities and is not designed typically to provide the function of a normal healthy shoulder.