Inflammation of the shoulder joints is one of the most common causes of shoulder pain. Repeated or chronic joint inflammation caused by certain medical conditions can severely limit the shoulder’s range of motion.
Complications of arthritic diseases can largely disrupt an individual’s normal activities, which subsequently, decrease the quality of one’s life.
The shoulder is composed of three major joints. The acromioclavicular joint articulates the acromion, a part of the scapula, and the collarbone.
Connecting the shoulder girdle to the trunk is the sternoclavicular joint. The glenoid fossa, a shallow cavity in the scapula and the humerus join at the glenohumeral joint.
These joints are interconnected to assist the shoulder girdle to move as a single unit during arm and shoulder movements.
Causes
Arthritis of the shoulder is mainly caused by three major arthritic diseases: osteoarthritis, rheumatoid arthritis and posttraumatic arthritis.
- Osteoarthritis
Among all three, osteoarthritis is the most common type of arthritis that affects the shoulder joint. Osteoarthritis results from gradual and chronic degeneration of the joint’s cartilage caused by shoulder and upper arm overuse.
The cartilage serves as the smooth outer covering of the bone. Once it is worn out by overuse and aging, the joint is unable to initiate smooth movements.
Bare exposure of the bones results in shoulder pain and stiffness.
- Rheumatoid Arthritis
Rheumatoid arthritis is a genetically-linked systemic condition that mainly destroys the synovial membrane that lines the shoulder joints. The synovial membrane functions as the joints’ protective layer that prevents or minimizes friction during arm movements.
Unlike in osteoarthritis, where only one of the shoulders is affected, rheumatoid arthritis involves both shoulders.
- Posttraumatic Arthritis
Posttraumatic arthritis is a subtype of osteoarthritis, where inflammation of the shoulder joints occurs after an episode of injury. This condition is seen in individuals with histories of shoulder dislocation, fracture or rotator cuff tears.
Signs and Symptoms
Though there are different types of arthritis, shoulder pain is the common denominator of all arthritic diseases. The location of the pain varies, depending on the affected joint. In glenohumeral osteoarthritis, the pain is felt in the shoulder’s back. Acromioclavicular osteoarthritis results in pain in front of the shoulder girdle.
In rheumatoid arthritis, multiple joints are affected. Additionally, bilateral inflammation of the shoulder joints is frequently reported. Often, the severity of the pain and stiffness might also vary with the weather.
The pain and stiffness commonly worsen with cold temperatures.
With intense pains, the shoulder’s range of motion is severely compromised, and normal activities are more than difficult to complete. As the cartilage wears out, the joints rub on each other, resulting in audible clicking sounds on shoulder or arm movement.
Diagnosis
Diagnosis of shoulder arthritis is based on the results of the physical examination and on the data obtained from the medical history. An X-ray is usually ordered to assess the extent of the inflammation and the severity of the condition.
Arthritic shoulders reveal narrowing of the joint space, bone changes and formation and growth of bone spurs. If a rheumatoid arthritis is suspected, additional laboratory work ups, which include blood tests and Rheumatoid factor testing, are indicated.
Treatment
The treatment regimen for an arthritic shoulder depends on the type of arthritis and on the severity of the condition. Initially, conservative measures are utilized to control the inflammation and pain.
During shoulder pains, it is advised to rest the affected joint and to avoid movements that can aggravate the pain. The use of assistive devices might be necessary to reduce the discomforts during movements.
Moist heat on the involved area is applied alternately with an ice pack to reduce the swelling and the pain. Non-steroidal anti-inflammatory medications are usually prescribed to alleviate the pain.
Cortisone injections are administered in severe arthritic pains. Glucosamine intake has been proven by some clinical researchers to decrease the severity and episodes of pain and to slow down the progression of the degeneration. It has been used by more individuals with arthritis in the past few years.
It is essential to adhere to the prescribed exercise regimen as it can be of great benefit in maintaining the shoulder’s mobility and strength. Physical therapy sessions might be indicated to prevent further joint degeneration and stiffness caused by arm immobilization.
If the conservative or nonsurgical measures fail or if the shoulder’s range of motion is severely restricted, a surgical procedure is usually prescribed. A prosthetic joint replacement might be necessary.
