Treating Arthritis of the Shoulder
By Dr. Robert Lieurance
Published in the Neosho Daily News
Although many people think of the shoulder as several joints, there are really only two joints in the area of the shoulder. One is located where the collarbone, or clavicle, meets the tip of the shoulder bone, or acromion. This is called the acromioclavicular (AC) joint. The other joint, located at the junction of the upper arm bone, or humerus, and the shoulder blade, or scapula, is called the glenohumeral joint. Arthritis may affect either or both joints.
Shoulder arthritis occurs when the cartilage in the joint becomes damaged or worn. In a healthy shoulder, the ends of the bones are covered with hyaline articular cartilage. This cartilage creates a surface so smooth that the friction at the joint is said to be less than that of a skate on ice. With arthritis, this cartilage progressively disappears, exposing the bone and causing pain with activity, limited range of motion, stiffness, swelling, tenderness, weakness, and sometimes a grinding or catching within the joint.
Osteoarthritis, one of the three forms of shoulder arthritis, gradually wears down the joint cartilage. Osteoarthritis, generally found in elderly people, is sometimes referred to as the “wear and tear” form of arthritis and is most commonly found to affect the AC joint. Post-traumatic arthritis, another form of the disease, can result from significant or repeated joint trauma that ruins the cartilage, and can also develop with a rotator cuff tear. Finally, rheumatoid arthritis, a disease in which the body attacks its own cartilage and destroys it, is a systemic inflammatory condition of the joint lining, or synovium. This type of arthritis affects all ages and multiple joints on both sides of the body. In all forms, arthritis destroys the cartilage.
To provide you with effective treatment, your physician will need to determine which joint is affected and what type of arthritis you have. Shoulder arthritis can be diagnosed through a careful medical history and physical examination with properly done X-rays.
Treatment of shoulder arthritis aims at reducing or eliminating the pain. Recommendations for relief may include over-the-counter pain medicines or physical therapy. In the event of extreme pain, the doctor may give you a series of injections directly into the shoulder.
Should your shoulder pain continue after trying the over-the-counter medicines, physical therapy, and injections, your physician may recommend shoulder surgery. Depending on the condition of the shoulder and the specific expectations of the patient, surgical options range from partial replacement to total shoulder replacement or reverse shoulder replacement. The goal of shoulder replacement arthroplasty is to restore the best possible function to the joint by removing scar tissue, balancing muscles, and replacing the destroyed joint surfaces with artificial ones. Surgical treatment of arthritis of the shoulder is generally very effective in reducing pain.
About the author
Robert Lieurance, MD, board-certified in orthopaedic surgery, specializes in orthopaedics and sports medicine at Freeman Midwest Orthopaedic Surgery, 3105 McClelland Boulevard, Joplin, Missouri, 417.347.2807.