Osteoarthritis can affect any joint in the body, including the shoulder. Osteoarthritis of the shoulder can affect the two joints in the shoulder area -- the acromioclavicular joint and the glenohumeral joint. Early diagnosis and treatment help people with osteoarthritis of the shoulder manage their symptoms.
Cause of Shoulder Osteoarthritis
The shoulder is considered the most movable joint in the body, but because of its range of motion the shoulder is more unstable than other joints. The shoulder is a common site of injury. The ball of the upper arm is actually larger than the shoulder socket that holds it. To remain stable, the shoulder is supported by muscles, tendons, and ligaments.
The degenerative process associated with osteoarthritis can affect the shoulder, though it is less common than in other joints. When osteoarthritis develops in the glenohumeral joint, it is usually the result of a previous injury. Osteoarthritis in the acromioclavicular joint can be painful and cause problems when using the joint for everyday tasks.
Diagnosis of Shoulder Osteoarthritis
In order to diagnose osteoarthritis of the shoulder, the patient's medical history, physical examination, and x-rays are considered. The doctor will look for certain signs and symptoms during the physical examination including:
- muscle weakness or atrophy
- tenderness to the touch and pain when pressure is applied to joint
- range of motion -- both assisted and self-directed
- signs of injury to muscles, tendons, ligaments around the shoulder
- evidence of previous injuries
- crepitus -- a grating sensation upon movement of the shoulder
- x-ray evidence that reveals narrowing of joint space, changes in bone, the presence of osteophytes
Symptoms of Shoulder Osteoarthritis
Pain is the most common symptom associated with shoulder osteoarthritis. The shoulder affected by osteoarthritis worsens with activity and the pain becomes progressively worse. It's interesting to note that:
- if glenohumeral shoulder joint affected, pain is centered in back of the shoulder, and weather changes can increase pain intensity
- if acromioclavicular joint affected, pain is concentrated in the front of the shoulder
Limited range of motion is another primary symptom of shoulder osteoarthritis. It may become difficult to reach a shelf or raise your arm to brush your hair as well as any other activity that requires you to move the shoulder. Crepitus is felt and heard during movement of the shoulder. As shoulder osteoarthritis progresses, pain is constant with any shoulder movement. Pain will occur at night too, making sleeping difficult.
Treatment of Shoulder Osteoarthritis
Nonsurgical treatments are tried before surgery is considered for shoulder osteoarthritis. Treatment options include:
- rest the shoulder
- change or adapt routine activities to lessen pain
- moist heat can provide pain relief
- medications including NSAIDs or steroid injections to reduce inflammation
- ice shoulder for 20 to 30 minutes, 2 or 3 times a day to reduce pain and inflammation
There are surgical options as a last resort, when all other treatments have failed. The glenohumeral joint can undergo a total shoulder arthroplasty. If the head of the upper arm bone is the only portion replaced, the procedure is called a hemiarthroplasty. For the acromioclavicular joint, the common surgical procedure is a resection arthroplasty (removing the last half inch of the clavicle).
An accurate diagnosis and early treatment help decrease pain and improve function for the shoulder osteoarthritis patient. Appropriate treatment changes can be made as shoulder osteoarthritis progresses.
Arthritis of the Shoulder. Your Orthopaedic Connection. American Academy of Orthopaedic Surgeons. July 2007. A Patient's Guide to Osteoarthritis of the Acromioclavicular Joint. eOrthopod. Osteoarthritis. ADAM Healthcare Center. Accessed 10/19/2007.
Arthritis of the Shoulder. Your Orthopaedic Connection. American Academy of Orthopaedic Surgeons. July 2007.
A Patient's Guide to Osteoarthritis of the Acromioclavicular Joint. eOrthopod.
Osteoarthritis. ADAM Healthcare Center. Accessed 10/19/2007.