Arthritis Of The Shoulder
Of the four joints in the shoulder, two may be affected by arthritis: the acromioclavicular or AC joint, where the collarbone meets the tip of the shoulder bone , and the glenohumeral joint, where the upper arm bone meets the shoulder blade .
Both of these joints are susceptible to three types of arthritis. Degenerative osteoarthritis, or wear-and-tear arthritis, is the most common and occurs as you age. Rheumatoid arthritis is an autoimmune disorder that causes inflammation of the joint lining, or synovium, and can happen at any age. Post-traumatic arthritis develops as a result of an injury such as a fracture, dislocated shoulder, or rotator cuff tear, all of which can damage the cartilage that lines the joints.
How Does Ra Affect The Shoulder
RA is common in the 2 joints of the shoulder, though it tends to affect them mainly in the later stages of the disease. The joints include:3
- Acromioclavicular joint This is located where the collarbone meets the tip of the shoulder blade
- Glenohumeral joint This is located where the head of the upper arm bone fits into the scapula
In people with RA, the bodys immune system attacks the healthy tissues inside the joints. This causes an inflammatory response that results in swelling and pain, especially when the joint is used. Common symptoms of RA in the shoulder joints include:3-5
- Redness or warmth in or around the shoulder
- Tenderness
- Pain at night
- Limited range of motion
- Pain focused on the top of the shoulder that may radiate to the side of the neck if the AC joint is affected
- Pain centered in the back of the shoulder if the glenohumeral joint is affected
Swelling is also common, though it is often hard to detect during a physical exam. As the condition progresses, it may also cause a grinding, clicking, or snapping sound when you move your shoulder.3
RA sometimes symmetrical, which means it usually affects the same joints on both sides of the body. As the condition gets worse, ligaments, joints, and cartilage become more damaged. Glenohumeral joint damage often leads to severely limited movement that is sometimes called frozen shoulder syndrome.3-5
Coping With Low Mood And Sleep Problems
You might find that osteoarthritis makes you feel depressed or anxious. Speak to your doctor if youre feeling low. They may suggest cognitive behavioural therapy and a few stress-relieving techniques.
The NHS also offer counselling sessions if youre living with chronic pain or long-term health conditions.
Osteoarthritis can also affect your sleep pattern. This can lead to tiredness and could make your pain feel worse. You may even have fatigue, which is when you feel extremely tired, even after resting.
But there are things you can do for yourself that might help, such as:
- Avoid lying on the side of the affected arm. Instead lie on your back with a pillow supporting your arm.
- Keep a sleep diary to work out if there are any patterns to your sleep problems.
- Sleep at regular times to get your body into a routine.
- Avoid using mobile phones, laptops or computers in bed.
- Try to wind down before bed by having a warm bath or reading a book.
Your condition can affect your relationships and how you interact with people generally. It might be worth having conversations with people close to you to explain your condition and how it affects you.
If youre still having problems, speak to your doctor or an occupational therapist. They can give you some tips and techniques and may also refer you to a pain management clinic, where you can be shown how to live a more active life.
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What Can Be Done For Ra In The Shoulder
First and foremost, if you suspect you have shoulder pain that may stem from RA, contact your doctor immediately. Prompt treatment can prevent the most severe problems. After all, a joint suffering from RA may be more likely to develop other problems than healthy joints.
Once your doctor has diagnosed RA in your shoulder, he or she will usually recommend a combination of drug treatment and non-drug treatment. Non-drug management of RA to the shoulder may involve resting the joint, application of heat and cool and maintaining a healthy diet. Physical therapy may also be a useful tool. Physical therapy could include massage, controlled exercise or other forms of rehabilitation. PT can often relieve some symptoms of RA and also lead to a quicker healing time for any concurrent injuries too. Finally, as stated in an article published by NCBI, surgery may be an option as well to help control the pain and prevent further injury to the shoulder.
As always, taking care of your RA, whether it affects your shoulder or any other part of the body, is a team effort between you and your doctors. Any new, unexpected pain should be brought to the attention of your rheumatologist or your general practitioner as soon as possible. In doing so, you can get back to normal as quickly and easily as possible. After all, no one likes shoulder pain!
When Shoulder Pain May Mean Arthritis
Learn about the various causes of shoulder pain, including different kinds of arthritis.
If you are experiencing pain, swelling and stiffness in the shoulders, you may have one of the following types of arthritis or related conditions.
Osteoarthritis
The most common form of arthritis, osteoarthritis is caused by the breakdown of the cartilage that covers the ends of the bones where they meet to form joints. Bones rub against each other due to the cartilage loss, causing stiffness, pain and loss of movement in the joint. Bony projections can develop around the joint. In shoulder OA, pain often worsens with activity. It is estimated that nearly 1 in 3 people over the age of 60 have shoulder OA to some degree.
Rheumatoid Arthritis
Rheumatoid arthritis is a chronic inflammatory disease that occurs when the immune system over-reacts and attacks the joints. The result can be joint pain, swelling, inflammation and loss of function. RA usually affects joints on both sides of the body. That means if one shoulder is affected the other likely will be too.
Juvenile Arthritis
Juvenile arthritis is the term used to describe types of arthritis that affect children and teens 16 years old and younger. There are different types of juvenile arthritis that can cause pain, swelling and stiffness in the shoulders.
Bursitis
Lupus
Infectious Arthritis
Reactive Arthritis
Arthritis-Related Conditions
Myositis
Polymyalgia Rheumatica
Getting a Proper Diagnosis
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How To Know If Your Shoulder Pain Is From Arthritis Or Bursitis
Two common shoulder problems are arthritis and bursitis. Your shoulders are packed with bones, muscles, tendons, and ligaments. Shoulder pain can develop from a variety of conditions that affect one, if not many, of these structures. While this can make it difficult to pinpoint the exact source of your shoulder pain, an accurate diagnosis and proper treatment are the keys to recovery. Arthritis and bursitis are two of the most common causes of shoulder pain however, they can be difficult to differentiate. The following article will help you determine if your shoulder pain is caused by arthritis or bursitis
Surgery For Neck Arthritis
Surgery is usually a last resort for neck arthritis, says Dr. Milani. Your doctor may recommend it if you have severe pain that isnt relieved with nonsurgical treatment or if you have signs of neurologic injury. Surgery may be needed if the arthritis causes instability, or more importantly, impingement of nerves and/or the spinal cord, says Dr. Shah.
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Arthritis And Chest Pain Symptoms
Arthritis chest pain has usually associated some exacerbation, such as minor trauma or upper respiratory infection, or it may be related to inflammation from the underlying arthritis condition.
The pain is either dull or sharp but usually located towards the front of the chest wall. Sometimes, pain radiates to the back or abdomen. Pain can also be felt when coughing, sneezing and taking deep breathes.
Tenderness and pain are worsened when you press on the rib joints or the breastbone. Tenderness in the breastbone or rib cage is a usually a telltale sign of costochondritis and makes it easier to diagnose this condition.
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You will need immediate medical attention if you experience any of the following symptoms:
- High fever, sweating, or chills
- Breathing problems
- Signs of infection, including pus, swelling, and redness in the chest wall and rib joints
- Worsening pain despite taking medication
- Nausea
Symptoms Of Pain Behind The Ear And Down The Neck
Pain down the neck and behind the ear is not a condition in itself. Ear and neck pain are usually symptomatic of other health issues and will usually be accompanied by other symptoms. For example, an ear infection can cause neck pain behind the ear on one side of your head and could be accompanied by swelling or discharge from your right or left ear.
Associated symptoms of pain behind the ear and neck can include:
- Throbbing pain in the neck and on one side of your head
- Shock-like pains at the top of your neck and behind your ear
- Redness of the ear or behind the ear that is sore to touch
- Soreness when turning your head from side to side
- Intense pain from your jaw that extends behind one ear
- An aching toothache that radiates pain to your ear
- Increased sensitivity to light along with a thumping headache
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Diseases That Affect Shoulder Arthritis
Along with the five different types of arthritis affecting the shoulder, there are other conditions and diseases that can worsen shoulder arthritis and lead to complications. These include juvenile arthritis, gout, pseudogout, reactive arthritis, lupus, infectious arthritis, polymyositis, dermatomyositis, polymyalgia rheumatica, osteonecrosis, Lyme disease. Other conditions such as gallstones, liver abscess, angina or heart attack, or ectopic pregnancy can also result in greater pain and swelling experienced in the shoulder.
Rheumatoid Arthritis In The Neck
Rheumatoid arthritis is a chronic inflammatory disease where the bodys immune system mistakenly attacks the lining of the joints. It often starts in the smaller joints of your hands and feet and can spread to other parts of the body like the neck as the disease progresses. This typically doesnt happen until years after the onset of arthritis symptoms.
Neck pain is the primary symptom of rheumatoid arthritis in the neck, with the severity varying from person to person. You may feel a dull or throbbing ache in the back of your neck around the base of the skull. Joint swelling and stiffness can make it hard to move from side to side.
The difference between rheumatoid arthritis neck pain and a neck injury is that stiffness and pain from an injury can gradually improve over days or weeks. Rheumatoid arthritis in the neck may not get better it can worsen if left untreated. Even if symptoms improve, inflammation, swelling, and stiffness can return with rheumatoid arthritis in the neck.
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Take Your Time And Do What Works For You
One MyPsoriasisTeam member shared the importance of taking their time and using treatments that work for them when experiencing pain: I have arthritis in my shoulders, and some days, the pain upon waking and then doing my hair is horrible. I give myself extra time for the Ibuprofen to start working before I get ready for the day.
Hang in there, the member added, and know you are not alone. This site is great that way because most of us understand what you are going through.
Causes Of Gout In Your Shoulder
An excess of uric acid in your bloodstream is thought to trigger gout by forming needle-shaped crystals that build up in your tissues and joints. Excess uric acid is technically known as hyperuricemia.
Uric acid is a waste product produced by the breakdown of purines, chemical compounds naturally present in your body. Uric acid is also produced when you digest foods containing purines.
Normally your kidneys remove uric acid waste via your urine. If your kidneys arent functioning properly, uric acid levels can build up in your bloodstream.
The crystals that form from this excess uric acid are attacked by your immune system as foreign bodies. Infection-fighting cells go to the area of the crystals, causing inflammation.
A of gout reports that only 10 percent of cases are caused by your bodys increased production of uric acid. The other 90 percent are caused by the failure of the kidneys to eliminate enough uric acid.
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Spondyloarthritis In The Neck
Other types of neck arthritis include psoriatic arthritis and ankylosing spondylitis, which are both considered a type of arthritis called spondyloarthritis. Its an umbrella term for inflammatory diseases that involve both the joints and entheses, the places where ligaments and tendons attach to the bones.
Psoriatic arthritis is a form of arthritis often accompanied by psoriasis, an inflammatory skin disease. For some people who have psoriatic arthritis, the condition involves the spine, which impacts the neck. Pain happens when inflammation strikes the joints between the vertebrae. This pain can occur on just one side of the body, the neck, and the lower and upper back. Read more about psoriatic arthritis symptoms.
Ankylosing spondylitis is a form of arthritis that strikes the bones in your spine and pelvis as well as peripheral joints. Early signs and symptoms might include pain and stiffness in your lower back and hips, especially in the morning and after inactivity. Fatigue and neck pain are common. AS symptoms might worsen, improve, or stop at irregular intervals.
Exercise For Arthritis In The Neck
Physical therapy
If youre experiencing neck pain due to arthritis, your doctor may recommend physical therapy. Physical therapy for neck arthritis entails doing specific exercises to help strengthen and stretch weak or strained muscles. Physical therapy can improve range of motion. Sessions and programs vary in length and frequency and are tailored to your condition.
The foundation of what were trying to do in physical therapy for the neck is often to help improve posture and the way people move, says Dr. Milani. Exercises in physical therapy tend to be focused on strengthening muscles of the back and neck, which puts less strain on structures of the cervical spine.
Youll do exercises during physical therapy and get instructions on ones to do at home.
Regular Physical Activity at Home
You may feel like you dont want to move when your neck hurts. But being inactive may increase stiffness, which can cause you to lose even more mobility. Aches and pains tend to respond better to continued movement than rest, says Dr. Milani. Exercise is often the foundation of treatment.
Exercises that involve stretching, strengthening, and improving range of motion can help reduce pain and keep your neck limber. You want to move gently and smoothly when doing neck exercises, not jerk your neck or make sudden movements. You may feel discomfort at first. Stop if any exercise increases your neck pain.
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How Is Ra Shoulder Pain Treated
There is no cure for RA, so treatment focuses on ways to manage the inflammation, pain, and stiffness that affect the shoulders. Treatment methods depend on your symptoms and how severe they are. The goals of RA treatments include:1,6
- Stop or reduce inflammation
- Prevent joint and organ damage
- Improve function and well-being
Options include both nonsurgical and surgical treatments.
Treatment Options For Shoulder Arthritis
The initial treatment for shoulder arthritis includes rest, icing the shoulder, and taking nonsteroidal anti-inflammatory medication such as aspirin or ibuprofen to ease the swelling.
If you have rheumatoid arthritis, your doctor may recommend corticosteroid injections or dietary supplements such as glucosamine and chondroitin sulfate.
If these treatment methods fail to relieve your pain, you may need surgery. Your doctor may recommend a total shoulder replacement if you have arthritis of the glenohumeral joint. During this procedure, your orthopedic surgeon will replace the entire shoulder joint with an implant. If you have severe rotator cuff damage along with arthritis, he will perform a reverse shoulder replacement instead. This procedure reverses the placement of the implants to allow the deltoid muscles to lift your arm.
Another option is to replace only the head of the upper arm bone. Known as hemiarthroplasty, this technique is viable if the shoulder socket does not have cartilage damage.
If you have arthritis of the AC joint, your doctor may perform resection arthroplasty. During this procedure, the surgeon will remove a small piece of bone from the collarbone, leaving a space that will eventually be filled in with scar tissue.
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What Kind Of Physical Therapist Do I Need
All physical therapists are prepared through education and experience to treat patients who have shoulder OA. You may want to consider:
- A physical therapist who is experienced in treating people with musculoskeletal problems. Some physical therapists have a practice with an orthopedic, geriatric, or sports focus.
- A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedic, geriatric, or sports physical therapy. This therapist has advanced knowledge, experience, and skills that may apply to your condition.
You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.
General tips when you’re looking for a physical therapist :
- Get recommendations from family, friends, or other health care providers.
- When you contact a physical therapy clinic for an appointment, ask about the physical therapists’ experience in helping people with shoulder OA.
- Be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.