Shoulder Arthritis: Symptoms and Treatments

Arthritis in the shoulder occurs when the cartilage that covers the ball (humeral head) and socket (glenoid) begins to break down. This damage to the cartilage in the shoulder joint can cause a wide range of symptoms for patients that can worsen over time, especially if left untreated. When damage is caused to the cartilage layer cover the glenohumeral joint, it is referred to as glenohumeral shoulder joint arthritis.

There are several different types of arthritis that can impact the shoulder, including:

Oseoarthritis
Osteonecrosis
Inflammatory arthritis
Rotator cuff tear arthropathy
Post-traumatic arthritis
Rheumatoid arthritis

At Boston Hand to Shoulder, our doctors can treat any type of arthritis in the shoulder.

Several factors can contribute to the development of shoulder arthritis:

Age and wear and tear: Osteoarthritis typically develops due to wear and tear on the joint over time, making age one of the primary risk factors. As we get older, the protective cartilage naturally deteriorates, leading to bone-on-bone contact that causes pain and stiffness.
Previous shoulder injuries: Fractures, dislocations, or severe sprains may damage the cartilage or alter the mechanics of the joint, accelerating post-traumatic arthritis development even years after the initial injury.
Rotator cuff tears: Large or longstanding rotator cuff tears can change how the shoulder functions and lead to rotator cuff tear arthropathy. When the rotator cuff is severely damaged, the humeral head may migrate upward and cause abnormal wear on the joint surfaces.
Inflammatory conditions: Rheumatoid arthritis causes the immune system to attack the joint lining, leading to inflammation and cartilage damage throughout the body, including the shoulder.
Osteonecrosis: This condition occurs when blood supply to the bone is disrupted, leading to bone death and joint deterioration.
Other risk factors: Genetic factors, repetitive overhead activities, and previous infections can also increase the risk of developing shoulder arthritis.

The symptoms of shoulder arthritis can vary depending on the severity and type of arthritis, but most patients experience similar warning signs. Pain is the most common symptom, often starting as a dull ache deep in the shoulder joint. This pain typically worsens with activity and may become constant as the condition progresses. Many patients notice the pain is worse at night, disrupting sleep.

Stiffness and limited range of motion are also hallmark symptoms. You may find it increasingly difficult to reach overhead, behind your back, or across your body. Simple tasks like combing your hair, putting on a coat, or reaching for items on high shelves may become challenging.
A grinding, clicking, or popping sensation, known as crepitus, may occur when moving the shoulder. This happens when the roughened cartilage surfaces rub together. Some patients also experience swelling around the joint, though this is typically less pronounced than in other arthritic joints.

As arthritis advances, weakness in the shoulder may develop, making it difficult to lift objects or perform daily activities. If you're experiencing any of these symptoms, it's important to consult with a shoulder specialist for proper diagnosis and treatment.

Treatment for shoulder arthritis depends on the severity of your symptoms and how much the condition affects your daily life. At Boston Hand to Shoulder, our specialists create personalized treatment plans that may include both conservative and surgical options.

Conservative treatments are typically tried first:

Rest and activity modification: Avoiding activities that aggravate symptoms while maintaining gentle movement to prevent stiffness.
Physical therapy: Strengthening the muscles around the shoulder and improving flexibility to better support the joint.
Medications: Non-steroidal anti-inflammatory medications can help reduce pain and inflammation.
Ice and heat therapy: Ice helps during flare-ups while heat eases stiffness.
Corticosteroid injections: Injections directly into the shoulder joint can provide significant pain relief for several months, allowing patients to participate more effectively in physical therapy.
Hyaluronic acid injections: These injections help lubricate the joint and may provide relief for some patients.

When conservative treatments no longer provide adequate relief, surgical options may be considered:

Arthroscopic debridement: A minimally invasive procedure to clean out loose cartilage and bone spurs.
Shoulder resurfacing: Replaces only the damaged cartilage surface while preserving more of the natural bone.
Total shoulder replacement: Replaces both the ball and socket with artificial components for more advanced arthritis.
Reverse shoulder replacement: May be recommended for patients with rotator cuff tear arthropathy, where the ball and socket positions are reversed to allow different muscles to move the arm.

Your Boston Hand to Shoulder specialist will work with you to determine the most appropriate treatment based on your specific condition, activity level, and treatment goals.

Exercise plays a crucial role in managing shoulder arthritis. A physical therapist can design a program specific to your needs, but gentle exercises focusing on range of motion and strengthening are beneficial. Pendulum exercises, where you lean forward and let your arm swing gently in circles, can help maintain mobility. Wall walks, where you "walk" your fingers up a wall to gradually increase overhead reach, improve flexibility without excessive strain.

Resistance band exercises can strengthen the rotator cuff and surrounding muscles, providing better support for the arthritic joint. Stretching exercises help maintain or improve range of motion. It's important to perform exercises consistently but stop if you experience sharp pain. Your doctor or physical therapist should guide you on appropriate exercises for your specific condition.

While diet alone cannot cure arthritis, certain foods may worsen inflammation. It's generally recommended to limit processed foods high in sugar and refined carbohydrates, as these can trigger inflammatory responses. Red meat and processed meats may also promote inflammation. Some people find that reducing fried foods, excessive salt, and foods containing trans fats helps manage symptoms. Alcohol should be consumed in moderation, as it can interfere with medications and increase inflammation. Focus instead on anti-inflammatory foods like fatty fish, leafy greens, nuts, and berries.

Several vitamins and supplements may help support joint health, though you should consult your doctor before starting any new supplement regimen. Vitamin D is important for bone health and may help reduce inflammation. Omega-3 fatty acids, found in fish oil supplements, have anti-inflammatory properties. Glucosamine and chondroitin are popular supplements that may help maintain cartilage health, though research on their effectiveness is mixed. Vitamin C supports collagen production, which is important for cartilage health. It’s best to consult with your doctor on what they recommend as appropriate supplements based on your individual needs and current medications.