Shoulder arthritis is an arthritic condition that affects your shoulder joint and surrounding structures, such as your rotator cuff. This condition is most commonly seen in the elderly (it is seen in 32% of people over 60 years), but people of all ages can develop shoulder arthritis. There are three main types of shoulder arthritis: osteoarthritis, rheumatoid arthritis, and rotator cuff arthritis. The most common form of shoulder arthritis is osteoarthritis, which occurs when cartilage in the joint wears down and becomes replaced by bone and fluid.
If you’re experiencing joint stiffness, pain, or swelling, it’s a good idea to see a doctor. Your symptoms might indicate an injury, such as a fracture, dislocation, muscle tear, or ligament tear. But if you’ve been diagnosed with shoulder arthritis and want to know what it is about, this article is for you.
We will walk you through everything you need to know about shoulder arthritis, including types of shoulder arthritis, signs and symptoms, the diagnostic process, and treatment of this condition.
Types of shoulder arthritis
Most of us think that arthritis is the same thing for everyone, but it is not. There are different types and subtypes, and even people with the same type of arthritis can have various manifestations of the disease. In shoulder arthritis, we can recognize three main types as mentioned above, but in reality, there are five. They are as follows:
- Shoulder osteoarthritis: Osteoarthritis is a term to describe a type of inflammatory disease in the shoulders that feature chronic wear down of the articulations. Osteoarthritis can be due to other conditions or develop because you have a wear and tear problem in your shoulders you never treated, and it complicates with inflammation.
- Shoulder rheumatoid arthritis: This form of arthritis is perhaps the most severe because your own immune system is working against you and attacking your articulations. It can lead to severe pain with stiffness and deformation of the affected joint.
- Post-traumatic shoulder arthritis: It develops after an injury. The damage that results from the trauma makes it difficult for the affected area of the bone to heal correctly. The damage may also destroy the cushions between the joints and cause a type of osteoarthritis.
- Rotator cuff arthropathy: They are similar to a rotator cuff tear, where the tendons around the shoulder become damaged. Rotator cuffs are important because they allow you to turn your arm over. When these tissues are affected by arthritis, it will be very painful to move your shoulders, and sometimes the cause of rotator cuff arthropathies is difficult to determine.
- Avascular necrosis: This is a condition that leads to the death of blood vessels in the shoulder. When this happens, the tissue dies, which prevents the bone from healing. This causes progressive damage to the joint and a severe limitation of movement.
⇒ Now, let’s discuss causes of shoulder arthritis.
What Causes Shoulder Arthritis
Shoulder arthritis is a painful condition that can affect anyone, and there are different types, as laid down above. In some cases, there is a clear trigger for the disease. In others, it might be very difficult to know what is happening or why it all started.
Among the most likely causes of shoulder arthritis, we should include:
● Trauma and injuries: Most healthy people who develop shoulder arthritis do so after suffering from a fall. This means that the injury was severe enough to damage the cartilage in your joint. The damaged area becomes inflamed as time passes, and the inflammation leads to bone spurs. Eventually, these bony growths become the source of the discomfort that you’re feeling right now. In time, patients develop osteoarthritis because they didn’t find treatment for their condition. This progressive problem is triggered by trauma and made worse by not looking for medical attention.
● Autoimmune disease: Inflammation plays a significant role in rheumatoid arthritis of the shoulder. This is the classic form of inflammatory arthritis of the shoulder, but there are many others, including lupus, gout, pseudogout, and ankylosing spondylitis. What they all have in common is inflammation as one of the primary sources of arthritic damage. This is often triggered by autoimmune reactions against the normal tissue of the articulation.
● Infections: This is known as septic arthritis, and we could include this type as another form of arthritis. However, it is not the most common cause. Infections only happen to people who get surgery in or around this joint. It is not likely that you will ever need this type of surgery if you didn’t have shoulder problems in the first place.
● Neuropathic problems: The nerves do not only give muscle commands and sense pain. They also trigger different reflexes and automatic processes to guard your shoulders and other articulations from damage. When you have a neuropathic problem involving your shoulder, these protective effects of nerves can be lost, and you could experience something known as Charcot arthropathy, a nerve dysfunction that causes arthritis.
● Vascular problems: Similar to nerve tissue, blood vessels are also important to maintain your shoulders. Most people believe that the bone tissue is inert and it is only there to provide support. They would probably be surprised to find out that it has a very rich blood vessel irrigation and needs plenty of blood and nutrients to keep working. This tissue is alive, like the rest of the body, and when the blood flow is cut in this area, the tissue dies, and osteonecrosis is one of the consequences. It is more common in smokers, heavy alcohol users, and people who need to use steroids to control another disease.
● Obesity: This is probably not considered a direct cause of shoulder arthritis, but it is definitely a trigger of the symptoms of shoulder pain. Obesity features excess body weight in the form of fat, which triggers an inflammatory problem in your body because the fatty tissue synthesizes plenty of inflammatory cytokines. So, if you have risk factors to develop inflammatory arthritis of the shoulder, these risk factors will become activated by obesity as a baseline inflammatory problem.
In addition to the reasons mentioned above, other factors can contribute to your shoulder pain. For example, you may also experience problems lifting heavy objects frequently or spending a lot of time playing sports.
If you want to avoid further injuries, it’s essential that you take some precautions. You should always wear protective gear when you work out. And if you do experience any kind of injury, make sure that you get medical attention immediately. Remember that not resolving problems in your joints soon may result in severe issues in the future, and they can be irreversible, as with osteoarthritis.
Signs and Symptoms of Shoulder Arthritis
This joint disease can cause significant discomfort, mainly when you use your arms for daily activities. If you suffer from either of the conditions mentioned above, you might have some of the following signs and symptoms:
1. Pain in the shoulder area:
Pain in your shoulders is definitely one of the most important symptoms. It is usually what makes people come to the doctor’s office and sometimes the emergency room to find a solution. Shoulder arthritis usually features pain for long periods of time, and the only exception is septic arthritis (arthritis due to infectious disease in the shoulder), which starts soon after the infection ensues and can be relieved with antibiotic treatment and painkillers.
People with shoulder arthritis avoid activities that require using their arms and hands because they hurt so much. They probably cannot reach things on higher shelves and will have trouble performing everyday activities. This pain sometimes comes and goes, and they often experience flare-ups with excessive symptomatic involvement in periods of stress and tension. During outbreaks, the painful articulation can become red, tender to the touch, and swollen. This may mean that the shoulder joint is inflamed, and you’re probably also experiencing muscle pain around the shoulder.
2. Stiffness:
Shoulder stiffness can be a problem with the muscles, tendons, ligaments, or cartilage around your shoulders. All of these structures can be affected by inflammation. You can feel pain in your shoulder joints as you move them or feel the shoulders locked or difficult to move without significant pain. Shoulder stiffness can make it difficult to lift heavy items or perform other actions involving your arms, such as reaching overhead when you try to pick something up.
The stiffness usually gets worse when you sleep, especially in rheumatoid arthritis, where patients typically report waking up feeling stiff and sore. So, suppose you’re experiencing stiffness symptoms that worsen when you leave the articulation inactive. In that case, this is a sign of rheumatoid arthritis, and it is a good idea to visit your doctor for a diagnosis.
3. Swelling:
This is basically inflammation being manifested through the skin. It feels warm to the touch, and the articulation may increase in size slightly and become tender. This happens because inflammation increases the blood flow to the area, which causes redness. The increased blood flow is met by the same outflow of blood through the veins, and the excess liquid stays in the tissue and makes it swell.
The inflamed tissues stretch because they are filled with fluid, and this stretching of the tissue stimulates nerve terminals, which send the pain signal to the brain. That’s the main reason why inflammation hurts, and this symptom is more commonly found in arthritis triggered by systemic inflammation, such as rheumatoid arthritis.
4. Crepitus (a crunching sound):
Crepitus in the shoulders is a common problem in patients with shoulder arthritis. The disease affects the cartilage and bone in your shoulders, and they are there to cushion other structures from rubbing together. Crepitus is one of the primary symptoms when you start losing the cushions in your articulations. It’s usually a result of inflammation or degeneration of the cartilage that holds your shoulder joint together.
Crepitus sounds like a grinding noise when you move your shoulder, and it is often accompanied by a burning feeling and pain. It is sometimes very loud, but other times, it is only felt or heard by you and when others place their hands on your shoulder while you move your arms.
Crepitus does not always mean you have a joint problem in your shoulders. Many other structures around the joint can give you a similar snapping sound once in a while. Thus, if you constantly have this problem and it is associated with shoulder pain, you probably want to talk to your doctor to rule out shoulder arthritis and other chronic shoulder conditions.
5. Limited movement:
If you are suffering from shoulder joint pain, it is very likely that your range of motion will be affected. A limited range of movement can also be triggered by inadequate warming up and stretching before you do physical exercise.
However, if you see it becoming a problem and your range of motion is severely affected, you should seek medical advice to see what you can do to get rid of it.
Diagnosis of Shoulder Arthritis
So, what if you have the symptoms and risk factors mentioned above and you are now suspecting shoulder arthritis? If that’s the case, it is good to know what your doctor will do to diagnose this condition.
The first step in diagnosing shoulder arthritis is to have a complete medical history. This should include your symptoms and the possible risk factors, such as your past medical history. After your doctor takes your medical history, they will ask plenty of questions to determine what symptoms you have and characterize them as accurately as possible. This is an important step, and we need absolute honesty to get an accurate diagnosis.
After that, the doctor will perform a physical examination of your shoulder. You may need to remove your shirt for this part of the interview. One of the most important elements of the physical exam is checking your range of motion (ROM). Your doctor may also ask you to perform certain movements and see what you can do. If that happens, don’t work against the pain and inform the doctor when the pain starts.
In some cases, the diagnosis is not yet clear, and doctors need to run some tests. The most common imaging test is an X-ray of the shoulder to see the space between the bone ends and assess the separation of the bones. In some cases, doctors will also inject anesthetics inside the joint. If that relieves shoulder pain, the diagnosis is confirmed.
Treatment Options
Shoulder arthritis has different treatment options, including surgical and non-surgical solutions.
Non-surgical or conservative solutions include:
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- Changing the type of activity you do to avoid overuse injuries
- Physical therapy increases the range of motion and strengthens the muscles to protect the articulation.
- Over-the-counter painkillers, which help deal with acute pain, but we should be aware of their side effects when taking them for long periods.
- Corticosteroid injections, which also improve the symptoms and provide relief for a more extended period, but they still need to be administered periodically.
- Temperature therapy to reduce the swelling and inflammation
- Disease-modifying agents if you have rheumatoid arthritis.
- Chondroitin and glucosamine supplements
Surgical solutions involve fixing the problem through arthroscopy or arthroplasty. Arthroscopy refers to introducing a probe with a camera to your joint, and in the same exploration, doctors can do debridement procedures and solve minimal problems. Arthroplasty will be recommended if arthroscopy is not enough and is reserved for more severe cases of damage in the shoulder joint. It is a shoulder joint replacement procedure that replaces the damaged area of the shoulder with a prosthetic device.
» Conclusion
Shoulder arthritis is a painful condition in which the joint swells and becomes stiff and immobile. It can result from several conditions, including injury, disease, and inflammation.
After reading this guide, you should have a much better idea of what you are facing. Hopefully, you are now able to get an appointment with a rheumatologist and begin a treatment plan that will help relieve your pain, restore your range of motion, and keep you moving and feeling great. We also reviewed a variety of treatments that could help reduce your symptoms and help you feel better. If you have any further questions, please don’t hesitate to ask your doctor.