Osteoarthritis Of The Shoulder
Get information about the causes, symptoms and treatments for shoulder osteoarthritis, which is more common and debilitating than you may think.
In shoulder osteoarthritis also called degenerative joint disease your cartilage and other joint tissues gradually break down. Friction in the joint increases, pain increases and you slowly lose mobility and function. Shoulder OA is not as common as OA of the hip or knee, but it is estimated that nearly 1 in 3 people over the age of 60 have shoulder OA to some degree.
Use Hot And Cold Therapy
Heat and cold treatments can help relieve arthritis pain and inflammation.
- Heat treatments can include taking a long, warm shower or bath in the morning to help ease stiffness and using an electric blanket or moist heating pad to reduce discomfort overnight.
- Cold treatments can help relieve joint pain, swelling, and inflammation. Wrap a gel ice pack or a bag of frozen vegetables in a towel and apply it to painful joints for quick relief. Never apply ice directly to the skin.
- Capsaicin, which comes from chili peppers, is a component of some topical ointments and creams that you can buy over the counter. These products provide warmth that can soothe joint pain.
What Are The Symptoms
Shoulder pain is most commonly felt in the front of the shoulder or in the upper part of the arm. Pain is usually felt when moving the arm and you may notice it with only certain movements. Most shoulder problems do not cause pain when the arm is not moving. However many people find it painful when lying on the sore side in bed at night. Pain that travels right down to your hand, with tingling in your fingers, may be from a problem with your neck, rather than your shoulder.
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Causes Of Shoulder Arthrosis
In most cases, Shoulder Arthrosis has no known cause and is called Primary Arthrosis. This type of disease occurs mainly due to overuse of the joint and natural aging. It has an important genetic component. Repeated use of joints over time also causes cartilage damage.
Shoulder arthrosis can also be caused by a process of “bone death,” called Osteonecrosis. Osteonecrosis is caused by fractures or diseases that affect blood vessels, such as Lupus, Sickle Cell Anemia, or even Rheumatoid Arthritis.
There is also a type of Shoulder Arthrosis that arises from chronic, untreated injuries to the tendons of the rotator cuff, called Rotator Cuff Arthropathy. However, its treatment is different from that performed for Arthrosis.
Shoulder Exercises And Streches
Regular exercises and stretches can keep your shoulder flexible and strong. Few things to remember before going to start with exercise
Pendulum Stretch for range of motion
This exercise uses the weight and momentum of your arm to encourage moment at shoulder joint, while maintaining the inactivity of the repaired and injured muscles.
Overhead Shoulder Stretch
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Shoulder Exercise: Crossover Arm Stretch
Stretches the back of your shoulder
- Stand straight, with your shoulders relaxed.
- Gently pull one arm across your chest as far as comfortable, holding at your upper arm.
- Hold the stretch for 30 seconds, and then relax for 30 seconds. Repeat with the other arm.
- Repeat the sequence three more times.
Tip: Dont pull or put pressure on your elbow.
What Will Happen To Me
For most people shoulder pain settles down fairly quickly. This usually takes several weeks but can vary between people. At least one in two people with shoulder pain will have fully recovered within six months. Unfortunately shoulder pain can return, even in people who have fully recovered. It is not possible to predict which cases of shoulder pain will return.
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What Is The Best Treatment For Arthritis In The Shoulder
No two patients with shoulder arthritis are exactly alike. Therefore, the best shoulder arthritis treatment isnt the same for everyone. However, at-home treatments, injections, and surgery rank as some of the most effective pain relief techniques that can help you get back to living life normally.
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.
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What Can I Do
Talk to your healthcare team. It is normal to worry about the cause of your pain and how it will affect you. Talking to your doctor or other health professional about your worries can be helpful. You will usually find there is no serious cause and there are ways you can deal with it.
Learn ways to manage pain. Talk to your healthcare team about ways to relieve your pain. For example, there are medicines that can help with shoulder pain. Always talk to your doctor or pharmacist about your medicines, as even natural or over-the-counter medicines can have side effects.
Stay active. Your shoulder is designed for movement. The sooner you get your movement and strength back, the sooner your shoulder will feel better. You may need to rest or reduce some activities when the pain is bad. But resting for more than a day or two usually does not help and may do more harm than good. See a physiotherapist or other health professional for advice about exercises to keep your shoulder moving.
Acknowledge your feelings and seek support.It is natural to feel scared, frustrated, sad and sometimes angry when you have pain. Be aware of these feelings and get help if they start affecting your daily life. There are many other treatments for shoulder pain that have not been well proven. Some unproven treatments may still be useful, however further research is needed.
These treatments include:
When To See A Doctor
Unless youve had a serious injury or get a sudden, continuous pain, you can usually treat your shoulder pain without having to see your doctor.
If, after two weeks of treating yourself, you feel the pain isnt any better you should see your doctor or a physiotherapist.
You should also see your doctor as soon as possible if you:
- develop severe pain in both shoulders
- also have pain in your thighs
- feel feverish or unwell.
These can be signs of the condition called polymyalgia rheumatica, which needs prompt treatment.
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What Causes Shoulder Arthritis
The end of the humerus, or upper arm bone, is shaped like a ball, which normally fits within a socket on the scapula, called the glenoid. The shoulder joint is stabilized by a set of muscles and tendons called the rotator cuff. Symptoms of shoulder arthritis can be felt throughout or stem from issues in these areas. Specific causes include osteoarthritis, injuries, and rheumatoid arthritis.
Can This Injury Or Condition Be Prevented
There is no way to prevent shoulder OA. You may reduce your risk by staying moderately active, keeping the shoulder strong, and keeping the shoulder muscles the appropriate length with stretching. Your physical therapist can help you determine what exercises will keep your shoulder healthy. Eating healthy and exercising will help you manage a healthy weight and healthy joints. Avoiding injuries to the shoulder joint will help reduce your risk of OA as well.
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Most Common Reasons You Cannot Lift Your Shoulder
Here are the most common reasons why you may not be able to move your arm. While there can be neurological reasons, like Parsonage-Turner Syndrome, most of you cannot move the arm or shoulder because of pain. The most common causes of shoulder pain and loss of motion are:
- rotator cuff tendonitis
- calcific tendonitis
- adhesive capsulitis or a frozen shoulder
The cause of your shoulder pain and the reason why it hurts will vary by age. Some problems are more common in different age groups. In younger athletes, tendonitis, or inflammation of the rotator cuff is more common.
In middle age, rotator cuff tendinosis, calcific tendinitis, AC Joint arthritis, and a frozen shoulder are more common causes of pain.
Lets run through each of these individually.
Regular Breaks And Unwinding
The primary reason why so many people have shoulder pain at the office is that they lack movement and breaks. It is essential to give your body a small break every 30 minutes. You do not need to run in the park during this break. All you need is to shake your arms a little bit.
Furthermore, let your eyes, neck, and head relax for a while. Stand up and walk around the office with some conversations. After that, you not only reduce the risk of shoulder pain but also strengthen the relationship with other people.
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How Does The Shoulder Work
Your shoulders each have two joints, making them the most flexible parts of your body.
The main shoulder joint the glenohumeral is a ball-and-socket joint. Its called this because the top of the upper arm bone the humerus is shaped like a ball. This ball fits into the shoulder blade bone, which acts as the socket, giving your shoulder a wide range of movement.
But, the shoulder socket is very small, compared to other ball-and-socket joints, such as the hip. Its held together and controlled by a covering of muscles, which are secured to the bones by strong cords called tendons.
These muscles and tendons form a capsule around the joint and support its movements, but can make it more likely to dislocate than other joints.
Inside the capsule is the synovium, which produces fluid that lubricates the joint and keeps the cartilage healthy. The cartilage helps protect your bones from any impact and sits between the bones of your shoulder joints to stop them rubbing together.
Above the main shoulder joint theres a smaller joint where the top of the shoulder blade the acromion meets the collar bone.
This is known as the acromioclavicular joint. It helps the larger joint below to move through its full range, particularly when youre raising your arm, lifting or throwing.
When To See Your Doctor
If youve been experiencing joint pain for a few weeks or longer, visit your doctor. You should see a doctor right away if you become unable to move your joint, notice the joint is very swollen and the skin is overly red, experience severe symptoms that interfere with your ability to complete daily activities. You should also see your doctor if you have a fever or flu-like symptoms along with joint pain. A fever may be a sign of an infection. See your doctor for a proper diagnosis, as each condition is treated differently. Bursitis is usually a temporary form of joint pain, while OA is a longer-lasting form.
For persistent joint pain that is interfering with your daily activities, see a Tristate rheumatologist to make the correct diagnosis and begin the proper treatment.
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Cycle Through The Pain
Cycling is one of the most effective ways to exercise with arthritis shoulder pain. If you ride your bike outdoors or use a stationary bike inside, make sure the handlebars are at an appropriate level. If theyre too low, youll end up putting more strain on already-stiff shoulder joints.
Try a recumbent bike without handlebars for indoor cycling. This places more focus on your legs and core. Hybrid bicycles tend to be the best options for outdoors. Thats because of the higher handlebar placement and upright sitting position.
Very few people have the space or money to invest in elaborate gym equipment. A gym membership is the perfect alternative. At the gym, take advantage of the cardio machines. They can help you to:
- condition your body
- take pressure off your shoulder joints
Consider using the following machines:
- elliptical
What You Need To Know
- Arthritis is damage to the cartilage in joints. Shoulder arthritis occurs when the cartilage starts wearing down on the ball and/or socket sides of the shoulder joint.
- Symptoms of shoulder arthritis may include pain in the shoulder joint, stiffness and reduced range of motion.
- There are many nonoperative treatments for shoulder arthritis, including stretches, lifestyle modifications, application of ice or heat, and medication to control the pain.
- Surgical options, such as shoulder replacement, are available to treat shoulder arthritis if nonoperative treatments dont offer the desired relief.
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Shoulder Impingement Or Painful Arc Syndrome
The rotator cuff is a group of muscles and tendons that keep the upper arm bone held in the shoulder blade socket.
Pain from a problem with the rotator cuff is often called shoulder impingement. The condition causes swelling, pain or damage to the tendons of the rotator cuff. This can make it painful and difficult to move your arm properly.
You may find it painful and difficult to lift your arm away from your body, particularly if youre trying to lift your arm above your head. Your arm may feel weak or you may have a dull lingering pain in your upper arm.
Really, its nothing to do with your tendons being trapped by bones, as was previously thought. Instead, its caused by overuse or age-related problems with the tendons themselves but the name is still used. This condition can also be called painful arc syndrome.
Rest and physiotherapy are the main courses of treatment for a shoulder impingement. Your doctor may recommend an injection of steroids and a local anaesthetic, to help with the pain.
If the pain doesnt settle, or comes back within a few months of treatment, you may need keyhole surgery.
What Causes Shoulder Osteoarthritis
Shoulder OA is caused by both genetic and behavioral factors.
Genetics predisposes you to wear-and-tear, then its what you do with your life that makes osteoarthritis manifest, explains Dr. Tamara Martin, an orthopaedic surgeon in the Department of Orthopaedic Surgery at Brigham and Womens Hospital. Factors include:
The bones of the shoulder.
- Gender: Shoulder OA is more common in women than men.
- Genetics: Hereditary factors determine the toughness and durability of cartilage, as well as how it attaches to bone. A person with weaker cartilage is more likely to develop OA than another individual, even when participating in similar activities.
- Repetitive stresses: People whose jobs call for repeated lifting or pushing, such as activities performed during manual labor, subject their joints to minor stresses that can accelerate the development of OA.
- Athletic participation, particularly sports that require a lot of shoulder movement. Athletes engaging in repetitive activities are more susceptible to cartilage loss. They are also more likely to injure their shoulder, which can lead to post-traumatic arthritis .
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Symptoms Of Shoulder Arthritis
Your shoulder joint is a ball-and-socket joint where your arm and the thorax meet. Your shoulder socket is formed by part of your shoulder blade, and your arm bone forms the ball of your shoulder joint. This joint has more movement than any other joint in your body, and when your shoulder becomes arthritic it can be a source of pain and disability.
Shoulder arthritis symptoms tend to progress as the condition worsens, but they might not progress steadily with time. You might have good months and bad months, or your symptoms may change with factors like the weather. Your arthritis symptoms on one particular day may not accurately represent the overall severity of your condition.
The most common symptoms of shoulder arthritis are:
- Pain with activities
- Tenderness around the joint
- A feeling of grinding or catching within the joint
Your evaluation will begin with a physical examination and X-rays. These can help with the diagnosis of your condition and can also serve as a baseline to monitor your disease and your response to treatment.