What is Shoulder Arthritis?
- Shoulder arthritis, specifically osteoarthritis (OA), is caused by the wear and tear of the articular cartilage in the shoulder joint. This degenerative process leads to pain, stiffness, and functional impairment. The two primary joints within the shoulder that can be affected are the acromioclavicular (AC) joint, where the clavicle meets the acromion, and the glenohumeral (GH) joint, where the ball of the humerus meets the glenoid fossa of the scapula [Khazzam et al, 2020; Millett et al, 2008].
- Anatomical Description:
- Glenohumeral (GH) Joint: This ball-and-socket joint is formed by the head of the humerus (upper arm bone) and the glenoid fossa of the scapula (shoulder blade).
- Osteoarthritis in this joint is characterized by the loss of cartilage, formation of osteophytes, and changes in the subchondral bone, leading to pain and reduced range of motion [Michener et al, 2021; Khazzam et al, 2020; Khazzam et al, 2020].
- Causes:
- Primary Osteoarthritis: This occurs due to the natural aging process and the degenerative changes in the joint cartilage without any specific underlying cause [Michener et al, 2021; Khazzam et al, 2020].
- Secondary Osteoarthritis: This can result from prior injuries, such as fractures, shoulder instability, rotator cuff tears, or joint infections, which accelerate the degenerative process [Michener et al, 2021].
- Prevalence: Osteoarthritis of the shoulder affects approximately 20% of adults over the age of 65. The prevalence of glenohumeral osteoarthritis has been reported to be between 17% and 20% in adults over 65 years of age in various population studies [Michener et al, 2021].
What are the early symptoms of shoulder arthritis?
- The early symptoms of shoulder arthritis, specifically osteoarthritis
- Gradual onset of deep shoulder pain: This pain typically worsens with activity and may be more pronounced at night [Khazzam et al, 2020; Kibler et al, 2010].
- Decreased range of motion (ROM): Patients often experience a progressive loss of shoulder motion, particularly in external rotation and abduction [Michener et al, 2021].
- Crepitus: A sensation of grinding or popping within the joint during movement [Kibler et al, 2010].
- Stiffness: Morning stiffness or stiffness after periods of inactivity is common [Khazzam et al, 2020].
Treatment
- Traditional Conservative Treatment - The goal of treatment is to control the pain using medications and a cortisone injection.
- Viscosupplementation injections (Hyaluronic Acid)
- These injections for Shoulder Arthritis can help with the pain. Commonly used to treat knee pain, viscosupplementation injections were approved for the treatment of the ankle and should in Europe in 2007. Recently in January of 2024, CMS has approved the use of viscosupplementation injections for the treatment of shoulder impingement and glenohumeral arthritis. Learn more about viscosupplementation here.
- Surgery
- When all conservative treatments fail, glenohumeral arthritis can be treated surgically with a shoulder replacement surgery. To learn how you can delay a shoulder replacement, contact our office to schedule your consultation.
