Rotator Cuff Tear Arthropathy
Rotator cuff tear arthropathy is a type of shoulder arthritis that can develop after a massive and prolonged rotator cuff tear. The four rotator cuff tendons in your shoulder wrap around the ball portion of the shoulder joint, holding it in place. If one or more of these tendons is heavily torn, this may cause the humeral head to rub against other bones and develop arthritis.
Medications For Osteoarthritis In The Shoulder
Doctors may recommend over-the-counter medications to treat your shoulder osteoarthritis. These include nonsteroidal anti-inflammatory drugs . Examples of NSAIDs include ibuprofen and naproxen sodium.
A doctor may also prescribe oral steroids , such as prednisone or methylprednisolone, to treat inflammation. But this is sometimes controversial, as research on oral and injection-based steroids has been mixed. If you have concerns about steroid use in your treatment plan, be sure to discuss that with a doctor.
When To Talk With Your Doctor
If youve been using a particular management strategy for your arthritis, but you feel like its not working as effectively as it once did, contact your doctor. Its possible that you will have more success with a different type of treatment.
If your symptoms are worsening or new symptoms develop, thats another opportunity to discuss other treatment options with your provider.
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Main Types Of Arthritis
There are several types of arthritis, each of which has similarities and differences from one other. Let us look into these types and their possible lines of treatment.
One thing which should be kept in mind is that treatment in arthritis is not for the joint itself but is for the root cause which triggers arthritis.
What Are The Symptoms Of Arthritis
Due to the wide range of arthritis types, there are a lot of symptoms that you may experience. The most common symptoms include:
- Swelling around the joints
As Arthritis progresses, you may experience a range of motion loss. Around your joints, you may notice skin reddening. Most people experience worse symptoms in the morning and symptoms that are less intense throughout the day.
On top of these symptoms, people who have RA may also experience additional symptoms that include:
- Loss of appetite
Its important to seek treatment options if youre diagnosed with RA because the condition can lead to joint deformity. The deformity is the worst-case scenario.
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Shoulder Outward Rotation Stretch
This exercise also requires a broom handle or walking stick. It improves the flexibility in the shoulder joints. Follow the steps below:
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Types Of Arthritis That Affect The Shoulder
Osteoarthritis
This condition is also known as wear-and-tear arthritis as it destroys the outer covering of the bone. As the cartilage wears away, it becomes frayed and rough causing the bones to rub against each other and resulting in a lot of pain. Osteoarthritis is most commonly found in people over the age of 50.
Rheumatoid Arthritis
Unlike osteoarthritis, which can occur in a single joint, rheumatoid arthritis usually affects the same joint on both sides of the body. RA causes the lining in your joints to swell that results in pain and stiffness in the joint. Known as an autoimmune disease, RA attacks its immune system causing damage to cartilage, ligaments, and softening bone.
Posttraumatic Arthritis
Posttraumatic Arthritis is a form of osteoarthritis caused by a traumatic injury such as a fracture or dislocation of the shoulder.
Rotator Cuff Tear Arthropathy
This can develop from a long-standing rotator cuff tendon tear. The torn rotator cuff can no longer hold the head of the humerus , causing unwanted friction and ultimately resulting in arthritis.
Avascular Necrosis
Avascular Necrosis occurs when a bones blood supply is disrupted. The bone cells die, and the dead bone weakens and may begin to fracture and collapse, leading to arthritis.
Should I See A Doctor
Its common to have aches and pains in your muscles and joints from time to time. This may especially be true if you take part in unusual or strenuous physical activities.
So, how can you tell the difference between the early signs of arthritis and normal pain and stiffness? And, how do you know when you should see a doctor about your symptoms?
If you have swelling or stiffness that you cant explain and that doesnât go away in a few days, or if it becomes painful to touch your joints, you should see a doctor. The earlier you get a diagnosis and start the right type of treatment, the better the outcome will be.
Here are some other things to think about that might help you decide whether you need to see a doctor:
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Exercises For Osteoarthritis In The Shoulder You Can Do At Home
Its a good idea to talk with a physical therapist or doctor before performing at-home shoulder exercises to ensure youre practicing good form and not putting extra stress on your joints. But examples of some exercises that can help you when you have shoulder osteoarthritis include:
- Pendulum swings. This exercise involves standing with your feet shoulder-width apart while holding onto a sturdy surface for balance on your unaffected side. Lean forward slightly, enough to let your arm dangle, while keeping your back straight. Shift your weight side to side, which will have your arm move in circles. Repeat 30 times in each direction.
- Shoulder elevation stretch. While lying on your back, hold a cane or exercise band in your hands, palms facing upward. In a slow, controlled movement, lift the cane or band toward your head until you feel a gentle stretch in your shoulder. Hold this position for 5 to 10 seconds, then slowly lower your arms. Repeat 10 times, rest, and perform two additional sets.
- Shoulder outward rotation stretch. Like the shoulder elevation stretch, this exercise is also performed lying on your back with a cane or elastic band. Keeping your elbows bent at your sides with your hands grasping the under portion of the cane , slowly rotate your hand downward to feel a stretch in your shoulder.
How Is Shoulder Osteoarthritis Diagnosed
To diagnose shoulder osteoarthritis, the doctor will take a medical history and do a physical exam to assess pain, tenderness, and loss of motion and to look for other signs in surrounding tissues. At this point, the doctor may be able to tell if the muscle near the joint has signs of atrophy, or weakness, from lack of use.
Tests that might be ordered to diagnose osteoarthritis of the shoulder include:
- Blood tests, mainly to look for rheumatoid arthritis, but also to exclude other diseases
- Removal of synovial fluid, the lubricating fluid in the lining of the joint, for analysis
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Total Shoulder Replacement Surgery
Your surgeon will recommend total shoulder replacement if you have bone-on-bone arthritis along with intact tendons. When you have this procedure, your surgeon will make an incision in the front of your shoulder.
Youll receive a metal ball consisting of surgical-grade steel to replace the head of the humerus. You may also need to have your glenoid replaced with a medical-grade plastic socket.
How Your Back Works
The spine, which is also called the backbone or spinal column, is one of the strongest parts of the body and gives us a great deal of flexibility and strength.
Its made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support. There are also the bones in the tailbone at the bottom of the back, which are fused together and have no discs in between.
On either side of the spine, running from top to bottom, are many small joints called the facet joints.
The spinal cord passes inside the vertebrae, which protect it.
The spinal cord connects to the brain through the base of the skull and to the rest of the body by nerves that pass through spaces between the bones of the spine. These nerves are also known as nerve roots.
As you grow older, the structures of your spine, such as the joints, discs and ligaments, age as well. The structures remain strong but its usual for your back to get stiffer as you get older.
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What Is Shoulder Arthritis
Shoulder arthritis is damage to the cartilage inside the shoulder joint. The shoulder has two joints. Shoulder arthritis commonly refers to the bigger ball-and-socket joint named the glenohumeral joint after the bones it connects . The cartilage covers both the ball and the socket .
When the cartilage in the shoulder begins to break down on the surface and eventually in the deeper layers, its called shoulder arthritis. The second joint in the shoulder, the acromioclavicular or AC joint, can also develop arthritis known as AC joint arthritis.
Will I Need Repeat Cortisone Injections For Shoulder Arthritis
Depending upon your particular medical condition and your response to a previous injection, Dr. Jurek may recommend that an injection be repeated after a safe amount of time has elapsed. Typically, she will wait 4 to 6 months before repeating injections to prevent damage or weakening to tissues over time.
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Injections For Shoulder Arthritis
There are currently two types of injections that can provide pain relief for shoulder arthritis. The first type is cortisone shots. Typically, cortisone is mixed with a numbing agent that provides immediate pain relief and helps your doctor know if the injection is in the right place. Once the numbing medicine wears off, the joint may be sore until the cortisone kicks in. Its important to ice the shoulder for a day or so after the shot.
Cortisone shots dont damage the shoulder, but most surgeons limit them to no more than a few a year in most cases of arthritis. Cortisone shots may increase the risk of infection if you undergo a total shoulder replacement soon after the shot. If you are considering the surgery, consider avoiding cortisone shots a few months prior.
The other medicine that can help with shoulder arthritis is synthetically manufactured hyaluronic acid. Its a naturally occurring lubricant in the human body. This liquid substance has been injected into arthritic knees for many years. This injection sometimes helps with the pain for up to two years, but it is unusual for it to take all the pain away for an extended period of time.
The current recommendation is not to have shoulder replacement surgery within three months of having a cortisone shot in the shoulder. If you are considering surgery, it is best to avoid cortisone shots until you have discussed it with your doctor.
Getting A Diagnosis For Osteoarthritis In The Shoulder
Diagnosing osteoarthritis in your shoulder can be tricky, often due to your shoulder joints complexity. As you read in your shoulder joint anatomy description, there are lots of tendons, muscles, bursae, and more that are a part of your shoulder joint. Doctors have to narrow down the source of your pain, and that can be challenging.
Some of the diagnostic methods include:
- Asking you questions about your medical history, as well as your familys.
- Examining your shoulder to see your range of motion.
- Discussing what triggers your pain and what at-home treatments relieve it.
- If a doctor suspects arthritis, theyll commonly request an x-ray of your shoulder to look for signs of wear and tear on your joint.
- Reviewing other imaging studies, such as an MRI or CT, which will usually show a narrow joint space or formation of extra bone areas called osteophytes from your bones rubbing together.
A doctor may also try to rule out other possible causes. For example, if your
A healthcare professional will usually recommend conservative treatments at first to address your shoulder osteoarthritis.
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Types Of Shoulder Arthritis
Five major types of arthritis typically affect the shoulder.
Also known as “wear-and-tear” arthritis, osteoarthritis is a condition that destroys the smooth outer covering of bone. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. During movement, the bones of the joint rub against each other, causing pain. Osteoarthritis usually affects people over 50 years of age and is more common in the acromioclavicular joint than in the glenohumeral shoulder joint.
An illustration of damaged cartilage in the glenohumeral joint. This x-ray of the shoulder shows osteoarthritis and decreased joint space .
Illustration on left reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
Posttraumatic arthritis is a form of osteoarthritis that develops after an injury, such as a fracture or dislocation of the shoulder.
What Are The Four Stages Of Osteoarthritis In The Shoulder
Like in some people, the osteoarthritis in your shoulder may follow an expected pattern. This includes:
- Your cartilage starts to soften.
- Irregularities start to develop in the surface of your cartilage.
- The surface of your cartilage starts to flake and wear off.
- Your cartilage wears off completely, exposing the bone underneath.
This process can happen at different paces. But the more you use your shoulder joint, the faster your cartilage is likely to wear away.
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Treatment Options For Shoulder Arthritis
There is no cure for arthritis, so beware of ‘miracle cures’. Your doctor may prescribe anti-inflammatory medicine. They may recommend occupational therapy or physiotherapy, which includes exercises and heat treatment. In severe cases, surgery may be suggested. The type of surgery will depend on your age and severity of the disease. In the elderly with severe arthritis, joint replacement can give good results. Common surgery for treatment of shoulder arthritis arthroplasty may be total shoulder arthroplasty or reverse shoulder replacement.
Causes Of Shoulder Arthritis
The most common form of shoulder arthritis is osteoarthritis, which is degenerative joint disease. Certain people are more at risk of developing osteoarthritis as they get older, but anyone can develop the disease.
You could have a higher risk if you:
- Work manual labor jobs involving repetitive motions
- Play sports requiring repetitive overarm motions
- Suffered from shoulder injuries in the past
While osteoarthritis is a common cause of shoulder pain, it isn’t the only form of the disease. Arthritis can develop from avascular necrosis, which causes cells in the shoulder to die when blood cant reach the humerus bone, and rheumatoid arthritis, which is an autoimmune disorder that causes joint pain in the shoulder.
Post-traumatic arthritis and rotator cuff tear arthropathy can also cause shoulder pain.
If you’re not sure what’s causing your shoulder arthritis, we can help diagnose what’s wrong with your joint. From there, you can begin building a pain management plan and treat the root issue.
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Surgery For Back Arthritis
Surgery is a last resort when it comes to arthritis in the back. Know that 95 percent of people with back pain will not need surgery, and 75 percent will fully recover within three months, says Dr. Tiso.
Doctors recommend that you try medications, physical therapy, and weight loss before considering surgery, says Dr. Kilian. The best surgical outcomes often occur in patients who are actively involved in physical therapy and have a healthy body weight, he says.
The type of surgery depends on the type of arthritis and region of the back that is affected. Depending on the procedure performed, surgery aims to decompress any pinched nerves and free up the nerve roots from bone spurs and other tissues that may be pressing on them.
Is Osteoarthritis In The Shoulder Considered A Disability
The Social Security Administration does consider shoulder osteoarthritis a disability in qualifying individuals. Youd have to experience significant functional challenges that keep you from performing your work to qualify.
Ask a doctor if they think youd be a likely candidate for disability due to the state of your shoulder arthritis.
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