Shoulder Arthritis Treatment
What is it?
Arthritis or degenerative joint disease of the shoulder is a painful condition where the cartilage of the shoulder joint has worn away over time. The joint develops spurs and the surface becomes irregular. Eventually, all the cartilage wears away and the two bones in the joint rub against each other, causing pain and restricting movement of the shoulder.
Why does it occur?
Primary arthritis
The risk of developing arthritis increases over time with general wear and tear, as the protective cartilage on the ends of your bones can be worn away. It is also more common in those who play sports or engage in activities where the shoulder is overused, for example painting or swimming.
Injury
Previous injury or trauma to the shoulder can leave the joint uneven, leading to development of arthritis.
Rheumatoid arthritis
This is an autoimmune condition where the immune system mistakenly attacks the healthy tissue surrounding your joints. This causes the layer of cells covering your joints to become sore and inflamed.
What are the symptoms?
The most common symptoms of shoulder arthritis are pain, stiffness and swelling. Some patients experience a creaking sensation in the shoulder when moving it, and others find their range of movement becomes restricted.
How is it diagnosed?
Your surgeon will ask you a series of questions to establish the source of the possible arthritis, and to determine the extent of the pain. They will also carry out a detailed examination of your relevant joints. In most cases the diagnosis is confirmed with an X-ray, but occasionally further tests or scans may be required.
How is it treated?
The best course of treatment depends on your general health, day-to-day activity levels and severity of symptoms. Less invasive treatments will almost always be offered before considering surgery. When the shoulder is badly worn, a shoulder replacement is effective at relieving the pain and will increase shoulder mobility.
Non-surgical treatment
Prior to consideration for surgery, all non-operative measures should be exhausted. Pain relief and modification of activities may alleviate symptoms initially. Physiotherapy in the early stages will delay the onset and extent of any stiffness.
If the pain continues, steroid injections may reduce the pain caused by inflammation in the joint. This can be very effective as the hydrocortisone acts as a powerful anti-inflammatory. Following an injection, the joint should be rested for 24 hours and the sticky plaster should remain on to prevent anything from entering the injection site.
Platelet-rich plasma (PRP) injections are also being increasingly used where conservative treatment is not effective. A solution is extracted from the patient’s own blood, which is rich in growth factors that aid tendon healing.
Surgical treatment
Joint replacement also known as arthroplasty, involves replacement with an artificial joint made of metal and plastic. Arthritis affects every patient differently and there are several different types of joint replacement. The correct choice of implant is essential for a good outcome and you should discuss this with your surgeon.
Treatment options
The One Orthopaedics team specialists
Anthony Hearnden
Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Shoulder, Elbow, Hand and Wrist