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.