What is shoulder arthritis?

Arthritis is a condition that occurs in various joints in the body, especially in the knees, hips, and spine. It can affect any joint, but the shoulder is affected infrequently.

When arthritis occurs, the cartilage that covers the ends of the bones making up the joint breaks down and often flakes off into the joint. The joint becomes swollen and stiff, and the lining tissue of the joint (the synovium) becomes overgrown. Frequently, spurs will develop around the margins of the joint and can, sometimes, break off inside. The pain can vary from middle to very severe, depending many factors, including the severity of the disease, the type of arthritis (most are war and tear, but some are caused by rheumatoid disease) and the activity level.

Who usually gets arthritis?

Anyone can develop arthritis, but it most often occurs in middle-aged patients and senior citizens. The condition may occur spontaneously and as late result of pervious trauma, such as a fracture or dislocation. It may also occur as a result of an inflammatory disease such as rheumatoid arthritis.

How do you know if I have arthritis?

The shoulder joint becomes stiff, feels heavy, and fatigues easily when arthritis is present. The stiffness is rally worse in the morning, and can slowly improve over the course of the day as the shoulder "wars up." Also, grinding and catching in the should are common signs of arthritis.

What test can the doctor do to prove if arthritis is present?

Most advanced cases of arthritis can be diagnosed with an x-ray evaluation of the shoulder. Sometimes, with rheumatoid or other types of inflammatory arthritis, special blood tests or other evaluations are needed.

What is the best treatment for shoulder arthritis?

The treatment of shoulder arthritis depends on how disabling and painful the disease is. Often your doctor will refer you to a rheumatologist who specializes in treating arthritis with medications. There are many non-steroidal anti-inflammatory medicines available which help to control the symptoms of arthritis. Glucosamine and chondroitin are two medicines that can also be used to provide pain relief in patients with wear and tear arthritis. Physical therapy, particularly hydrotherapy (swimming pool), is very soothing, and helps maintain or regain shoulder motion. IF the arthritis is advanced, causing severe pain and disability, the your doctor may consider an operative procedure. Some early arthritis can be treated with arthroscopic techniques. With this operation the doctor will trim out the inflamed synovial lining tissue an remove debris and pieces of the degenerative cartilage. O course, this will not cure the arthritis, but often can relieve many of the symptoms for a while. In severe disease, the only surgical treatment is joint replacement. This is a very good operation for pain relief an often will restore some motion, but it has it's limitations. The joint surfaces are surgically replaced through five inch incision in the front of the shoulder, and a metal ball and plastic socket are inserted.

If total shoulder joint replacement is needed, what are some of the risks?

The risks of total shoulder replacement are those of any standard surgical procedure and include infection, anesthesia risks (including death), nerve and vascular injury about the shoulder, and failure of the operation. If the operation fails, it may result in stiffness or sometimes a loose joint. If the joint becomes loose, it may have to be redone at a later date, or reoperated to have the ligaments or muscles tightened. In the shoulder joint, this is a rare occurrence.

What is the postoperative treatment after shoulder replacement?

Patients usually receive a sling to support the arm after surgery. Exercises begin on the day after surgery with elbow, wrists, and hand exercises. Shortly thereafter, rotational pendulum exercises can be added. Strengthening exercises begin at about 3 weeks when the sling is removed. This delay is necessary to allow the tissues that were opened at the time of surgery to heal.

How long will it take my shoulder to improve to it's maximum?

The shoulder will generally continue to improve quite steadily up to 5 or 6 months after surgery. After that point, further improvement is very slow. It has been shown that even after a year or more, activity can be increase as muscles strength continues to improve. It is very important to continue an exercise program to regain and maintain excellent muscle strength around the new shoulder joint.

Who can I call for more information?

Please feel free to contact us and ask one of our physicians for a referral. We will be happy to answer your questions and evaluate your shoulder in the Clinic.

Don Buford, M.D. © 2010