Arthritis is a degenerative disease caused by either wear and tear of the cartilage (osteoarthritis) or an inflammation (rheumatoid arthritis) of one or more joints. Arthritis not only affects joints, but may also affect supporting structures such as muscles, tendons, and ligaments.
Osteoarthritis, or degenerative joint disease, is the most common form of arthritis found in the shoulder. It is due to:
- The normal wear and tear that our joints undergo during our lifetime. The saying is true: "If you live long enough, you will develop osteoarthritis."
- Or, it may be due to a joint injury. This injury can be due to over-utilization of the joint, a fracture, or surgery on a joint.
Rheumatoid arthritis is believed to occur as a result of our immune system mistakenly identifying the soft tissue membranes within the joints (the synovial membranes or joint lining) as foreign bodies. This results in an inflammatory response by our body, as our immune system tries to defend the joints by destroying these protective synovial membranes. The synovial membranes are composed of connective tissue, so the immune system may turn against other connective tissue structures and organs, thus possibly affecting the entire body.
The most common symptom of arthritis of the shoulder is pain, which is aggravated by activity and becomes progressively worse with time.
If the glenohumeral shoulder joint is affected, the pain is centered in the back of the shoulder and may intensify with changes in the weather.
If the acromioclavicular joint is affected, the pain is focused on the front of the shoulder.
Limited motion is another symptom. It may become more difficult to lift your arm to comb your hair or reach up to a shelf. You may hear a clicking or snapping sound (crepitus) as you move your shoulder.
As the disease progresses, any movement of the shoulder causes pain, night pain is common and sleeping may be difficult.
A diagnosis of arthritis may be suspected when there is both pain and swelling in the shoulder joint. The signs and symptoms that usually lead to a diagnosis of arthritis of the shoulder include:
- Muscle weakness when moving the shoulder.
- Tenderness to touch
- Decreased range of motion
- Involvement of other joints (an indication of rheumatoid arthritis)
- Crepitus, or a grinding sound within the shoulder joint with movement
- Pain when pressure is placed on the joint
- X-rays of an arthritic shoulder show a narrowing of the joint space, changes in the bone and the formation of bone spurs (osteophytes).
As with other arthritic conditions, initial treatment of arthritis of the shoulder is conservative:
- Rest or change activities to avoid provoking pain; you may need to modify the way you move your arm to do things.
- Take nonsteroidal anti-inflammatory medications such as aspirin or ibuprofen to reduce inflammation. Before taking these medications, we suggest that you discuss their use with your family doctor. These medications may cause G.I. problems, or they may interfere with other medications you may be taking.
- Ice the shoulder for 20 to 30 minutes two or three times a day to reduce inflammation and ease pain.
- If you have rheumatoid arthritis, your doctor may prescribe a disease-modifying drug or recommend a series of corticosteroid injections.
- Dietary supplements such as glucosamine and chondroitin sulfate may be helpful.
If symptoms become worse, or do not respond to conservative care, discuss your pain immediately with your family doctor.
People with shoulder pain have also found these products to be effective: