Shoulder arthritis occurs when the smooth, protective articular cartilage covering the ends of the bones within the joint begins to wear away. This breakdown prevents the ball (humeral head) and socket (glenoid) from gliding smoothly against each other. The two primary forms are osteoarthritis, often called “wear-and-tear” arthritis, and rheumatoid arthritis, an autoimmune condition causing joint inflammation. As the cartilage deteriorates, the resulting friction leads to pain, stiffness, and a significant reduction in the shoulder’s range of motion. Managing the condition involves self-management, medical treatments, and potentially surgery to restore function.
Lifestyle and At-Home Management
Managing shoulder arthritis begins with consistent adjustments to daily routines to reduce joint stress. This involves pacing tasks and avoiding repetitive or heavy overhead motions that aggravate the shoulder. Keeping items close to the body, instead of lifting them with an outstretched arm, can significantly lessen the strain.
Applying thermal therapy provides targeted symptom relief at home. Heat, such as a heating pad, relaxes surrounding muscles and eases stiffness, especially before gentle exercises. Conversely, ice packs applied for 15 to 20 minutes reduce acute pain and inflammation following activity or during a flare-up.
Maintaining flexibility is important, and gentle range-of-motion exercises prevent the joint from becoming progressively stiffer. Non-strenuous movements, like the pendulum exercise where the arm hangs freely and swings in small circles, promote relaxation and mobility. Other basic stretches include raising the arms overhead with a light stick or using fingers to “walk” up a wall to a comfortable stretch.
Using assistive devices reduces the physical demands placed on the shoulder. Tools like long-handled grabbers or reaching aids allow access to items without requiring the arm to lift overhead or strain the joint. These modifications support joint mechanics and limit cumulative damage caused by everyday friction.
Medications and Targeted Injections
Pharmacological interventions focus on reducing pain and controlling inflammation. Over-the-counter options include acetaminophen for pain management and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, which address both pain and inflammation. Individuals should discuss chronic NSAID use with a healthcare provider, as these medications carry risks, including potential side effects on the stomach and kidneys.
For more severe cases, a doctor may prescribe stronger NSAIDs or, for rheumatoid arthritis, Disease-Modifying Antirheumatic Drugs (DMARDs). DMARDs work systemically to modify the underlying immune response that causes inflammatory joint damage. These prescription medicines are managed by a specialist to monitor effectiveness and potential side effects.
Targeted injections offer localized relief. Corticosteroid injections deliver potent anti-inflammatory medication directly into the shoulder joint. This procedure provides substantial, though temporary, pain reduction lasting weeks to months by calming inflammation within the joint capsule. However, frequency is limited to prevent potential weakening of local tissues.
Injections of hyaluronic acid, a substance naturally found in joint fluid, are sometimes used in the shoulder. This treatment, known as viscosupplementation, aims to improve joint lubrication and cushioning. While more commonly used in the knee, it may offer pain relief in the shoulder for weeks or months.
Surgical Intervention Options
When conservative treatments fail to provide adequate pain relief or joint function is severely compromised, surgery is considered. The least invasive procedure is arthroscopy, which uses small incisions to insert a camera and specialized tools. A surgeon can use arthroscopy to clean out loose fragments and bone spurs, a process called debridement, which may offer temporary relief in early-stage arthritis.
For more advanced joint damage, shoulder replacement surgery, or arthroplasty, is the definitive treatment. A hemiarthroplasty is a partial replacement where only the humeral head (the ball) is replaced with an artificial component. Most patients with severe arthritis benefit from a total shoulder arthroplasty, which replaces both the ball and the socket (glenoid) with metal and plastic components.
Reverse total shoulder arthroplasty is used when arthritis is combined with a severely damaged or non-functional rotator cuff. In this operation, the ball and socket components are switched, allowing the deltoid muscle to power the arm instead of the damaged rotator cuff. The choice of procedure depends on the extent of cartilage loss, the condition of surrounding soft tissues, and the patient’s functional goals.