Conditions

Shoulder arthritis

What is shoulder arthritis?

Shoulder arthritis occurs when the cartilage inside the shoulder joint suffers damage due to wear and tear over time. Shoulder arthritis may develop as a result of ageing or an injury.

The shoulder has two joints, namely the acromioclavicular (A-C) joint and the glenohumeral (G-H) joint, commonly called the ball-and-socket joint. Shoulder arthritis affects these two joints and can cause pain and discomfort.

There are different types of shoulder arthritis, including:

• Osteoarthritis – This form of arthritis is related to wear and tear, which occurs due to past trauma to the shoulder. Osteoarthritis in the shoulder occurs when the smooth cartilage that covers the edge of the bones become worn out, which may cause rough bone ends to rub against each other.
• Inflammatory arthritis – This includes rheumatoid arthritis and occurs when an underlying medical condition affects the immune system, leading to inflammation of the joints and deterioration of the joint lining as well as cartilaginous surfaces.
• Cuff tear arthropathy – This is the end stage of large tears of the rotator cuff tendon. If left untreated, rotator cuff tears develop into cuff tear arthropathy.
• Osteonecrosis – This is a rare condition where the blood supply to the bone-forming the ball of the shoulder is interrupted, leading to the death and collapse of a portion of the bone. Due to the loss of bone support, the overlying cartilage may become damaged or worn.
• Post-traumatic arthritis – when the shoulder joints are fractured, the cartilage can also suffer damage and, over time, this may cause the cartilage to wear out and disappear.

What are shoulder arthritis symptoms?

Shoulder arthritis symptoms vary according to the amount of cartilage lost. Symptoms may include:

• Pain in the shoulder joint which may be present in the front, side or back of the shoulder. Some people may experience pain even when they are not using the arm, while some have pain when they are using the arm.
• Shoulder stiffness that may be caused by the loss of range of motion in the shoulder. As the motion decreases, activities may be limited due to pain.
• Grinding, clicking or cracking may be experienced due to irregularities in the cartilage. This may or may not be painful. Occasionally, due to the surfaces of the shoulder joint being smooth, patients may feel their shoulder slide in certain positions.

How is shoulder arthritis treated?

Depending on your condition, Dr Botha may recommend the following:

• Medication – These include non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, to help manage pain.
• Injection of corticosteroids – These help treat inflammation inside the shoulder joint.
• Arthroscopy – This is a minimally invasive procedure done to remove loose fragments of cartilage and bone in the shoulder joint.
• Shoulder joint replacement - This is a procedure that involves the orthopaedic surgeon removing and replacing the shoulder joint with a prosthetic joint.