Treatment Options And Prevention For Shoulder Arthritis
Shoulder arthritis is a chronic condition that usually cannot be completely cured. Therefore, treatments focus on controlling symptoms and slowing the progression of the disease. Specific treatment options include pain medication, heat or cold, rest, certain stretches and exercises, steroid injections and surgery.
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Medication Options For Neck Arthritis
Analgesic and NSAID pain medication
Over-the-counter medications can be used to help address pain, inflammation, and swelling. NSAIDs like aspirin, naproxen, and ibuprofen can help relieve pain and reduce inflammation. Analgesics can help with mild to moderate pain. Your doctor can prescribe a stronger anti-inflammatory if OTC medications dont provide relief.
Even though many commonly used NSAIDs are available over the counter, its important to talk to your doctor about side effects and drug interactions. NSAIDs can have significant side effects, including gastrointestinal complications, and are associated with an increased risk of heart disease.
Disease-modifying arthritis medication
Neck pain due to inflammatory arthritis is typically treated with a disease-modifying antirheumatic drug , such as methotrexate for RA. Other conventional DMARDs include leflunomide, hydroxychloroquine, and sulfasalazine. Biologics are a newer type of DMARD that target specific immune system pathways. DMARDs help to reduce the immune system activity that is triggering inflammation and pain.
Steroid injections and nerve blocks
An epidural steroid injection is where doctors inject medicine directly into the epidural space of the spinal canal surrounding the nerve roots. The medicine is a combination of corticosteroids and a local anesthetic, which together reduce inflammation and relieve pain.
The anesthesia offers temporary pain relief and the corticosteroids reduce inflammation in the joint.
What Home Treatment Methods Are Available To Combat Shoulder Arthritis
In order to lessen the joint pain associated with your osteoarthritis, you can pursue various home treatment methods. From immediate relief options, such as icing your sore shoulder, to thinking about pain relief now and in the future, through exercises, there are many home treatment methods to choose from in your quest for pain-free living.
Here are some of the home treatment methods you should try when you suffer from shoulder osteoarthritis and want to alleviate joint discomfort and reduce inflammation:
- Apply ice to the shoulder joint
- Apply moist heat to the muscles surrounding the shoulder joint
- Engage in stretches targeting the shoulder and surrounding upper body region
- Perform arthritis exercise for shoulder discomfort
- Rest to lessen shoulder movement
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What Does Shoulder Arthritis Feel Like
If you have shoulder arthritis, youll feel mild-to-severe pain and stiffness in your shoulder. Over time, youll notice a loss in your range of motion in your shoulder joint, especially if the glenohumeral joint is involved.
You may feel pain when you reach overhead, lift heavy objects or play sports or join in activities that involve a range of arm movements. In late-stage disease, you may not be able to complete simple everyday tasks without pain. These tasks include such things as bathing, grooming and even writing or using your computer.
Rotator Cuff Muscle Injuries
Injuries to the rotator cuff muscles, such as a large tear, can also increase the risk of developing osteoarthritis of the shoulder joint. The rotator cuff muscles normally help keep the shoulder joint in place, so an injury to the rotator cuff muscles can cause the bones of the shoulder joint to become misaligned and damage each other as they rub against each other.
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Medications For Psa In The Shoulder
One of the main goals of treating PsA with medication is to control inflammation. Medication helps to reduce joint pain and prevent joint damage, and it might repair some of the previous damage to the joint.
There are several medications used to treat PsA and manage PsA pain.
Nonsteroidal Anti-Inflammatory Drugs
Nonsteroidal anti-inflammatory drugs can help relieve pain and reduce inflammation caused by PsA. These drugs include over-the-counter medications, like Ibuprofen, as well as other options only available by prescription.
These drugs may not be strong enough to work alone, however. As one MyPsoriasisTeam member wrote, Aleve and Ibuprofen arent helping my PsA shoulder pain. Your rheumatologist will work with you to determine whether NSAIDs are right for you and, if they are, which ones will be the most helpful.
Steroid Injections or Oral Steroid Treatments
Steroid injections are sometimes injected directly into the shoulder. They can quickly reduce inflammation and help ease painful joints caused by PsA. They can even keep pain and inflammation away for months at a time.
However, repeated injections into the same joint can cause damage, and the inflammation may be worse after the injection wears off. One MyPsoriasisTeam member explained, Im on day eight of the 10-day Prednisone taper. Yup, my stiff neck and shoulder pain are returning with a vengeance.
Disease-Modifying Antirheumatic Drugs
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.
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Types Of Arthritis That Affect The Shoulder
There are five main types of arthritis that can affect the shoulder. So far we discussed the most common type, which is osteoarthritis degeneration of the joint.
Another type of arthritis that affects the shoulder is rheumatoid arthritis . It is an autoimmune condition, meaning, the bodys own immune system mistakenly attacks itself. Along with shoulder pain, RA in the shoulder may also lead to tenderness, stiffness, rheumatoid nodules, fever, weight loss, and fatigue.
Post-traumatic arthritis is brought on by an injury to the shoulder. PA can also result in fluid buildup in the shoulder, pain, and swelling. It commonly occurs as a result of a sports injury or other type of accident.
Avascular necrosis destroys the shoulder joint tissue when the blood cannot reach the bones in the shoulder. As a result, bone cells begin to die. AVN can occur from joint dislocation or bone fracture and can also be a result of taking steroids or drinking high amounts of alcohol. AVN is a progressive disorder, which means it worsens over time.
Lastly, rotator cuff tear arthropathy occurs as a result of an injury to the rotator cuff, which is comprised of muscles and tendons connecting the shoulder blade to the top of your arm. This type of arthritis is usually caused by a rip in the rotator cuff which can lead to intense pain and weakness.
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:
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Causes Of Shoulder Oa
- Primary OA has no specific cause, but is related to age, genes and sex. Primary OA is usually seen in people over the age of 50, and women are affected more often than men.
- Secondary OA has a known cause or influencing factor, such as previous injury, history of shoulder dislocations, infection, or rotator cuff tears. Having certain occupations such as heavy construction or participating in sports can also put you at higher risk of developing shoulder OA.
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 Outcome Can I Expect If I Have Shoulder Arthritis
Your outcome depends on your age, your activity level and the types and range of movements you make with your arm and shoulder. Also, the location, size and the severity of your shoulder arthritis.
Because each person and shoulder situation is unique, ask your provider what outcome you can expect as you explore all treatment options.
Nonsurgical Treatments Can Provide Pain Relief
There is currently no cure for OA, but nonsurgical treatments can slow its progress and help with pain management in the shoulder. These options include: activity modification, periodic rest, cold compresses, physical therapy, anti-inflammatory medications, such as aspirin or ibuprofen, and steroid injections.
Some people never need to consult a surgeon, says Dr. Martin. We may start with injections, physical therapy, and anti-inflammatories. If their pain isnt effectively managed, we will do an MRI to assess the rotator cuff. If it looks like theyre developing more arthritis over time, then we would suggest that they be evaluated for surgery.
Dr. Martin reminds patients that the timing of surgery is important. The sooner a person is evaluated, the better we can guide them on their medical journey, she says.
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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.
Rotator Cuff Injuries And Irritations
Your rotator cuff is a group of muscles and tendons that help tether your shoulder into the socket and allow you to move it in a circular motion. Some two million people visit a doctor each year for rotator cuffrelated issues, according to the American Academy of Orthopedic Surgery . Most problems with the rotator cuff fall into two categories: tears or inflammation. Suspect a rotator cuff problem if you have pain or stiffness in your shoulder when you lift your arm above your head to brush your hair or when you reach behind your back. “You won’t be able to do a lot of things you want to do, such as put dishes in an upper cabinet, play tennis, or do garden pruning,” says Dr. Ramappa.
Rotator cuff impingement. A rotator cuff impingement happens when there is irritation, inflammation, or compression of the tendons or bursa in the shoulder. An impingement can be caused by an injury, but it can also just result from general wear and tear from daily life.
Rotator cuff tears. A tear in the rotator cuff will produce pain that is similar to an impingement but has one additional differentiating feature. “If the pain is associated with weakness, it is likely caused by a tear, and if you just have pain, it may only be a rotator cuff impingement,” says Dr. Ramappa.
Performing simple stretches two to three days a week can help keep your muscles flexible and reduce pain, provided your doctor approves.
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Surgery To Repair Or Replace The Shoulder Joint
For those with shoulder arthritis that does not respond to other treatments, a physician may recommend surgery to repair or replace the shoulder joint. There are a number of surgical options for treating shoulder arthritis.
- Arthroscopy: Milder cases can be treated with shoulder arthroscopy, in which the surgeon uses small instruments to clean out the inside of the joint.
- Arthroplasty: More severe cases may need to be treated with shoulder joint replacement, or arthroplasty. In arthroplasty, part or all of the shoulder joint bones are removed and replaced with a prosthetic joint. After surgery, your physician will usually recommend a period of physical therapy to help in the recovery of function.
How Is Osteoarthritis In The Shoulder Diagnosed And When
The shoulders three bones and many tendons and muscles make the shoulder the most mobile joint in the body. But this combination of structures also makes the shoulder vulnerable to problems.
Five major types of arthritis commonly affect the shoulder: osteoarthritis, post-traumatic arthritis , rheumatoid arthritis , avascular necrosis and rotator cuff tear arthropathy. Other common shoulder conditions include bursitis, tendonitis, frozen shoulder and rotator cuff injury.
All of these conditions can produce shoulder pain, but vary in their underlying causes. Because the conditions show similar symptoms, its difficult for a person to know what problem is causing their shoulder pain without a physicians help.
A physical exam and X-ray can help diagnose the problem.
- During the physical exam, a doctor examines the shoulder joint for range of motion, involvement of other joints and tenderness. The exam also includes questions about personal and family medical history.
- X-rays are used to look for a narrowing joint space and damage related to the bones in the shoulder joint, as well as for the formation of bone spurs, which indicate arthritis.
- Other diagnostic tests may be used to rule out causes of joint pain. Blood tests and analysis of joint fluid can rule out rheumatoid arthritis or infection.
- An MRI may also be needed to gauge the condition of the rotator cuff .
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Medical Treatment For Osteoarthritis Of The Shoulder
Many people with mild to moderate osteoarthritis of the shoulder find that they can manage pain and stiffness using pain relief medication and physical therapy. These treatments do not reverse the progression of arthritis or address its causeunlike treatment for rheumatoid arthritis, an inflammatory condition that doctors manage using specific medication.
Still, relieving osteoarthritis pain and restoring strength and range of motion in the shoulder can support your ability to participate in the activities that make life enjoyable.
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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Shoulder Exercise: Passive Internal Rotation
Stretches the front of your shoulder
- Get a lightweight stick, such as a yardstick, wooden dowel, or cane.
- Hold the stick behind your back with one hand, and lightly grasp the other end of the stick with your other hand.
- Pull the stick horizontally so that you feel a pull in the front of your shoulder without pain.
- Hold for 30 seconds, and then relax for 30 seconds. Repeat on the other side.
- Repeat the sequence three more times.
Tip: Dont lean over or twist to side while pulling the stick.
What Is Shoulder Osteoarthritis
Osteoarthritis, the most common type of arthritis, is caused primarily by age-related wear-and-tear that involves the deterioration of the smooth outer covering of bone, known as cartilage.
Shoulder osteoarthritis can occur when cartilage in the shoulder joint wears away, leaving less protection for the bones. When bones rub against one another, this can cause damage and result in pain around the shoulder joint.
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Precautions Before Exercising With Shoulder Arthritis
If youre new to exercise, its always smart to first talk to your doctor. Your doctor or physical therapist can make sure the exercises are safe and help you gain mobility and strength without exacerbating inflammation or aggravating joint pain. If youve had surgery on your shoulder, get guidance from your doctor or physical therapist on which shoulder exercises are safe for you. More tips to help protect your joints:
Start slowlyEase your joints into exercise if you havent been active for a while, say experts. Push too hard too fast, and you can overwork your muscles and worsen joint pain. Go easy at first, then increase the length and intensity of your workout as you progress.
Move gentlyAlways warm up or stretch at the start of every exercise activity and do it again at the end. Dont force any stretches. Dont have someone else push on your shoulder to help you stretch more because that can set off a flare up, advises Dr. Yen Shipley. Instead, keep your movements slow and easy. Push to the point of feeling a good stretch without pain. With strength training, begin with fewer reps , and build up gradually.
Stop if your shoulder hurtsListen to the pain, says Shroyer. Take a break when your joint starts to ache. If you feel any new joint pain, its time to stop. Talk to your doctor about what pain is normal and when its a sign of something more serious.