Shoulder arthritis involves the wearing away of the smooth cartilage that cushions the ends of bones within the shoulder joint, specifically the glenohumeral joint where the upper arm bone meets the shoulder blade. This degradation leads to bones rubbing against each other, causing pain, stiffness, and a reduced range of motion. Individuals may also experience grinding, clicking, or popping sounds with movement. Shoulder arthritis can significantly affect daily activities, making simple tasks like lifting an arm or getting dressed challenging.
Non-Surgical Approaches
Non-surgical strategies often begin by alleviating symptoms and improving joint function. Reducing strain is a primary step. This involves modifying activities that aggravate pain, such as avoiding heavy lifting or repetitive overhead movements. Pacing activities throughout the day can also help prevent flare-ups and allow the joint to recover.
Pain management starts with over-the-counter NSAIDs like ibuprofen or naproxen, which reduce pain and inflammation. If NSAIDs are not suitable, acetaminophen can be used. Topical NSAIDs, like diclofenac gel, can also provide localized pain relief.
Physical therapy and exercises improve joint flexibility and strengthen surrounding muscles. Gentle stretching, such as pendulum swings or wall crawls, helps maintain range of motion and reduce stiffness. Strengthening exercises, including shoulder blade squeezes or resisted rows, enhance joint stability. Applying heat or cold packs can also help soothe discomfort and reduce inflammation.
Lifestyle adjustments can also support shoulder health and manage arthritis symptoms. Maintaining a healthy weight reduces the load on joints, which can ease pain. Ergonomic considerations, such as adjusting posture, help minimize stress on the shoulder. A diet rich in anti-inflammatory foods like fruits, vegetables, and lean proteins can also contribute to overall joint health.
Injection Therapies
If non-surgical approaches do not provide sufficient relief, injection therapies may target inflammation and pain directly within the shoulder joint. Corticosteroid injections deliver a potent anti-inflammatory medication, similar to cortisone, into the joint. These injections reduce inflammation, alleviating pain and swelling, often for several months. While effective, relief is temporary, and injections are typically limited to two or three per joint annually to minimize potential side effects.
Hyaluronic acid injections, sometimes called “lubricating” injections, are another option. Hyaluronic acid is a natural component of synovial fluid, which cushions and lubricates healthy joints. In arthritic joints, this fluid may thin, becoming less effective. Injecting laboratory-produced hyaluronic acid aims to restore the fluid’s viscosity, improving joint gliding and potentially providing pain relief.
Platelet-rich plasma (PRP) injections use a patient’s own blood components to promote healing. Blood is drawn, processed to concentrate platelets (containing growth factors), and then injected into the affected area. The goal is to harness the body’s natural healing factors to reduce inflammation and potentially aid tissue repair. While showing promise, PRP injections for arthritis are still an active area of research, and their long-term effectiveness continues to be evaluated.
Surgical Interventions
For severe shoulder arthritis where non-surgical treatments have not provided adequate relief and daily activities are significantly impacted, surgery may be considered. Surgery is reserved for advanced cases causing constant pain, significant stiffness, and weakness, especially when sleep is disturbed. The decision for surgery is made after evaluating the patient’s condition and the failure of conservative management.
Arthroscopy is a minimally invasive procedure using small incisions and a tiny camera to visualize the joint’s interior. During arthroscopy, a surgeon can remove loose fragments of cartilage or bone, debride damaged cartilage, or address other issues causing mechanical symptoms. This procedure is less invasive than open surgery, leading to a quicker recovery.
Hemiarthroplasty is a partial shoulder replacement where only the “ball” component (humeral head) is replaced with a prosthetic implant. The natural “socket” component, the glenoid, remains intact. This procedure is considered when damage is primarily confined to the humeral head, preserving more native joint structures.
Total shoulder arthroplasty, or shoulder replacement, replaces both the ball and socket components of the shoulder joint with prosthetic parts. In a conventional total shoulder replacement, the humeral head is replaced with a metal ball, and the glenoid socket is resurfaced with a plastic component. A reverse total shoulder replacement reverses ball and socket positions: a metal ball is placed on the shoulder blade, and a plastic socket is attached to the upper arm bone. This reverse configuration changes shoulder mechanics, allowing different muscles to power arm movement, and is often used for severe rotator cuff damage with arthritis.
Resection arthroplasty is a less common surgical option, primarily for specific arthritis types or when other shoulder replacements have failed. This procedure removes a small section of bone from the end of the clavicle. This creates a space between the bones, reducing friction and pain, though it may result in some loss of strength and stability.
Rehabilitation and Long-Term Management
Following any shoulder arthritis treatment, rehabilitation optimizes recovery and long-term outcomes. Physical therapy helps regain strength, flexibility, and full range of motion. A structured rehabilitation program involves exercises that progressively increase in intensity, guided by a physical therapist. The commitment to these exercises is important for maximizing functional improvement and preventing stiffness.
Long-term management also involves strategies to maintain joint health and minimize symptom recurrence. Maintaining a balanced lifestyle, including diet and weight management, can reduce stress on the shoulder joint. Continued low-impact exercises, such as swimming or gentle stretching, help preserve joint mobility and muscle strength. Avoid activities that consistently exacerbate pain or involve excessive overhead movements.
Regular follow-up care monitors shoulder arthritis progression and adjusts treatment plans. These check-ups assess symptoms, joint function, and overall well-being. Developing strategies for coping with persistent discomfort is helpful. This can include relaxation techniques, such as mindfulness or deep breathing, which may help manage chronic pain. Joining support groups can also provide a valuable network for sharing experiences and coping mechanisms.