How Doctors Diagnose Arthritis Shoulder Pain
To determine whether OA or an inflammatory arthritis like RA is responsible for your shoulder pain, your doctor will rely on your medical history, a physical exam, and blood and imaging tests. You can also expect your doctor to ask about your lifestyle.
If someone comes to me with shoulder pain who says hes a swimmer and has recently increased his activity level, for example, Im more inclined to think its OA, Dr. Rahmani says.
The location of your shoulder pain also provides clues, he adds: People with RA will have a more diffuse pain throughout the shoulder, while those with OA have tenderness in one area.
If your doctor suspects RA or another type of inflammatory arthritis, they will order blood tests to look for the presence of certain antibodies, such as rheumatoid factor and anti-CCP, which help identify these conditions.
If theres fluid in your joint, your doctor may take a sample and send it to a lab for analysis.
This gives your doctor a lot of information, Dr. Rahmani says. The white blood cell count can indicate whether you have OA or RA and how inflamed the shoulder is, and the fluid itself may reveal gout crystals.
When it comes to imaging tests, he says an MRI provides the most information.
Where In The Shoulder Is Pain Felt And What Might It Mean
The location of your shoulder pain may help tell which shoulder joint is affected.
- If your pain at the side of your shoulder and your ache feels like its deep in the joint, it likely involves your glenohumeral joint.
- If you feel pain at the top of your shoulder that sometimes travels to the side of your neck, it likely involves your acromioclavicular joint.
Symptoms Of Ra In The Shoulder
RA is an inflammatory disease that affects the joints of the body. People living with RA experience alternating periods of remission, during which the pain reduces, and flares, when the pain is intense.
Common areas of attack include joints in the hands, knees, and ankles. However, it can affect other tissues and organs in the body, including the heart, lungs, and eyes.
When RA affects the shoulders, the symptoms may include:
- pain and stiffness in the shoulder
- tenderness and swelling of the shoulder joints
- bilateral joint pain
- loss of appetite
The symptoms can be mild or severe, but it is best not to ignore them either way. Notifying a doctor of any early symptoms will help in treating and managing RA promptly.
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What Is Shoulder Osteoarthritis
The shoulder is made up of three bones: the scapula , the humerus and the clavicle . The part of the scapula that makes up the socket of the shoulder joint is called the glenoid. The ball and socket joint where the glenoid and the humerus is the shoulder joint. There is another small joint just above the shoulder called the acromioclavicular joint. This is where your collar bone meets the shoulder blade. Osteoarthritis can affect either of these joints.
When a joint develops osteoarthritis some of the cartilage covering the joint surfaces can gradually roughen and become thin. The bone underneath the cartilage then reacts by growing thicker and becoming broader, which can result in pain, swelling and restricted joint movement.
Most of the time there is no obvious reason for arthritis. It can develop as part of the natural ageing process, due to an injury, underlying inflammatory joint disease such as rheumatoid arthritis or a shoulder tendon problem . People with underlying neurological problems may also be affected.
Other Possible Causes Of Shoulder Pain
Not all shoulder pain is due to arthritis, of course. Visit our sister site PainSpot to take a personalized quiz to see what else could be causing your shoulder pain.
A condition called frozen shoulder shares several symptoms with osteoarthritis, Dr. Rahmani says, including pain, stiffness, and limited range of motion. Frozen shoulder occurs when the tissue that surrounds your shoulder joint becomes thick and tight. But unlike OA, which is progressive, frozen shoulder resolves over time, usually within one to three years.
Bursitis can resemble rheumatoid arthritis because it causes redness and swelling. However, bursitis is not an autoimmune disease like RA rather, it develops when the bursae become inflamed. Bursitis can often be blamed on overuse or injury of a joint.
Other medical conditions that dont directly affect the shoulder can cause referred pain in the shoulders. Some examples include shingles, cervical nerve impingement, and blood clots in the lungs, says Dr. Rahmani.
In addition, any condition that affects the diaphragm, such as an injured spleen or gallbladder problems, can cause referred pain in the shoulders because they irritate the nerves that run from the diaphragm to the shoulders, he explains.
Doctors may suspect these indirect causes of shoulder pain depending on what they see in your physical exam.
If someone reports pain but has good range of motion, thats when you have to think outside the box, Dr. Rahmani says.
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Is My Shoulder Pain From Arthritis Or Bursitis
Your shoulders are packed with bones, muscles, tendons, and ligaments. Shoulder pain can develop from a variety of conditions that affect oneâif not manyâof 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 key 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.
How Does A Doctor Know My Child Has Septic Arthritis
Prompt diagnosis of septic arthritis is necessary to prevent permanent damage to the joint.
In addition to a complete medical history and physical examination, diagnostic procedures for septic arthritis may include:
- removal of joint fluid: to examine for white blood cells and bacteria
- blood tests: to detect bacteria
- phlegm, spinal fluid, and urine tests: to detect bacteria and find the source of infection
- : a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film
- : a nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints to detect bone diseases and tumors to determine the cause of bone pain or inflammation
- : a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.
- radionuclide scans: nuclear scans of various organs to determine blood flow to the organs
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What Does Arthritis In The Shoulder Feel Like
Living with shoulder arthritis can cause pain that keeps you from using your affected arm. Pain may concentrate on the top or side of your shoulder. Sometimes it extends all the way down your arm. The pain may worsen after you exercise or lift a heavy object. You may also have trouble sleeping on the side of your body affected by arthritis.
Are Glucosamine Or Chondroitin Useful Supplements For Shoulder Arthritis
Some people who have arthritis say that glucosamine and chondroitin help relieve their joint pain. These personal reports are hard to evaluate. The Food and Drug Administration doesnt regulate supplements. Unlike medications, theres not a lot of scientific evidence to confirm that supplements help treat arthritis.
Always ask your healthcare if you are thinking about taking these or any other supplements, herbal products or other over-the-counter medications. Theyll share their knowledge as well as make sure these products arent interfering with your current medications.
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Which Joints Does Ra Affect First
RA is a progressive disease, meaning it may worsen over time. You typically experience symptom flares that come and go.
The smaller joints in your body are usually the first to experience symptoms such as pain and stiffness. These are the joints that connect your fingers to your hands and your toes to your feet.
As RA progresses, inflammation and the erosion of cartilage may spread farther inward to your:
- wrists and ankles
- knees and elbows
- hips, neck, and shoulders
Not everyone with RA will experience the same set of symptoms. But RA tends to affect the same joints on both the right and left sides of your body.
Let a healthcare professional know of any changes, either sudden or gradual, that affect your joints. These include:
- stiffness when you wake up
- areas of warmth
The early symptoms of RA can look like several other conditions, including osteoarthritis. Early diagnosis and targeted treatments can help you maintain mobility and reduce pain. Early diagnosis may also help you avoid the symptoms associated with later-stage RA disease.
Discuss your symptoms with a healthcare professional who can provide clarity about your diagnosis and what to expect.
Stretching And Shoulder Strengthening Exercises
After the acute episode of pain is controlled, your physician may recommend that you perform stretching and shoulder strengthening exercises. One example of a stretching exercise is called the “weighted pendulum stretch,” in which a small weight is held in the hand while the arm is allowed to swing back and forth. Other exercises can be used to strengthen the rotator cuff muscles, which increases the support for the shoulder joint.
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What Kinds Of Arthritis Affect The Shoulder
The most frequently occurring types of arthritis which affects the shoulder are , , rotator cuff tear arthropathy, and post-traumatic arthritis.
Osteoarthritis: Similar to the hip and knee, this is also called a wear and tear type of arthritis, and probably occurs as some combination of use, genetics, micro trauma, and increased forces across the joint. The cartilage loses its normal chemical makeup, becomes frayed and worn, and eventually disappears without this protective covering, the underlying bones grind against one another, causing pain.
Inflammatory arthritis: In conditions such as , multiple factors often having to do with the immune system, lead to inflammation of the joint and joint lining, ultimately wearing away the cartilage surfaces. Fortunately, the medical treatment of many types of inflammatory arthritis has made tremendous advances, and the need for surgical treatment has greatly diminished.
Rotator cuff tear arthropathy: This is the end stage of very large tears of the . A confluence of four muscles which stabilize and are the primary movers of the shoulder joint, which have been left untreated. While large tears of the rotator cuff tendon, are uncommon, an estimated 4% of patients with untreated rotator cuff tears develop cuff tear arthropathy. Treatment of shoulder arthritis caused by cuff tear arthropathy can be particularly difficult, since it results from damage to both soft tissue support of the joint as well as the joint surface.
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.
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What Are The Early Signs Of Arthritis In The Shoulder
The shoulder is a complex joint and has the greatest range of motion out of all the joints. Shoulder arthritis commonly refers to the bigger ball-and-socket joint out of the two joints. Here, the ball refers to the humeral head and the socket refers to the glenoid cavity of the shoulder blade .
The second joint in the shoulder, the acromioclavicular or AC joint, can also develop arthritis known as AC joint arthritis.
Early signs and symptoms of arthritis in the shoulder include
- Pain in the shoulder joint
- The pain is worse while lifting heavy objects.
- The pain can radiate to the arm and down to the elbow and wrist.
As arthritis in the shoulder progresses, you may experience stiffness due to loss of range of motion in the joint. Simple activities, such as combing the hair or opening the buttons of a shirt, become difficult.
What Are The Symptoms Of Shoulder Osteoarthritis
As with most types of osteoarthritis, pain is a key symptom. A person with shoulder arthritis is likely to have pain while moving the shoulder and after moving the shoulder. The person can even have pain while sleeping.
Another symptom may be a limited range of motion. This limitation can be seen when you are trying to move your arm. It can also be evident if someone is moving your arm to assess range of motion. Moving the shoulder might also produce a clicking or creaking noise.
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What Are The Symptoms
The main symptoms of osteoarthritis in the shoulder are pain and stiffness around the shoulder joint and upper arm.
- Pain may be worse when you move the joint or towards the end of the day.
- You may find your joints become stiff if you have been sitting for a while or in the morning after sleep. This often improves quickly when you get up and start moving.
- Having stiffness in the shoulder may lead to less movement which can affect your normal daily activities. You may notice some grating or crackling sounds when you move. This is known as crepitus.
These symptoms can vary depending on what activities/ tasks youve been doing and how long youve been doing them. Symptoms can also vary for no obvious reason and you may find you have phases of pain that last a few weeks or months and other periods of time where they is very little or no pain.
Living With Shoulder Arthritis
Shoulder arthritis can significantly affect your quality of life. Getting support from family, friends, and others who are also dealing with pain like yours can help. Some groups and organizations that can help you get the support you need include:
- Arthritis Foundation. The Arthritis Foundation offers support groups called Live Yes! Connect. Theyre available both online and via in-person support.
- ExtendaTouch. ExtendaTouch offers support for people with osteoarthritis and their caregivers.
- U.S. Pain Foundation. The U.S. Pain Foundation offers support groups for those living with chronic pain.
- Local hospitals. Your local hospital may also coordinate support groups for living with osteoarthritis or chronic pain.
The following are some frequently asked questions regarding shoulder osteoarthritis.
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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.
Taking Care Of Our Bodies Can Lead To Healthier Joints
Dr. Martin emphasizes the importance of taking care of our bodies.
Be thoughtful, she says. Be aware of how you use your shoulders. Keep your muscles strong and make sure youre using proper techniques, especially in sports training.
Tamara Martin, MD, is an orthopaedic surgeon in the Department of Orthopaedic Surgery at Brigham and Womens Hospital .
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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.
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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Experiencing Pain Or Limited Range Of Motion In Your Shoulder Heres What Could Be Causing The Problem
Shoulder aches are far from an unusual complaint. In fact, up to 70 percent of people will experience shoulder pain at some point in their life, with arthritis being one of the main causes, according to a study of shoulder complaints in a general population.
But determining which type of arthritis is responsible for your aching shoulders can sometimes be tricky, and doctors must rule out a number of other conditions that affect the shoulders to make a diagnosis.
Arthritis can affect either of the joints in your shoulder. The glenohumeral joint is the larger of the two this is where the top of the humerus meets the collarbone to form a ball-and-socket joint. The other the acromioclavicular joint is where the collarbone meets the shoulder blade.
If youre wondering if your shoulder pain could be due to arthritis, keep reading.