Shoulder pain is one of the most common musculo-skeletal complaints that both primary care physicians and orthopaedic surgeons encounter.
Most of these conditions involve the soft tissue around the shoulder, including the ligaments, tendons and muscles, that all function to support the shoulder during physical activity, range of motion and even at rest. However, one frequent cause of shoulder pain that does not involve the soft tissues is shoulder arthritis.
Shoulder arthritis frequently is seen in patients older than 50 and can be a disabling condition. Common symptoms include pain and the progressive loss of range of motion, difficulty sleeping due to pain, and catching, locking or grinding with shoulder motion.
The condition itself involves the degeneration and loss of cartilage that covers the surfaces of the ball (humeral head) and socket (glenoid) that make up the shoulder joint.
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This cartilage allows for the ball and socket to smoothly articulate with one another during range of motion and activity. Loss of this cartilage over time can lead to increased stresses on the joint and the subsequent development of joint space narrowing and osteophytes, or bone spurs, that are typically seen on X-rays of arthritic joints throughout the body.
Unfortunately, once this degenerative process occurs and the joint surface is damaged, modern techniques are unable to replace the normal cartilage in the joints. As a result, initial treatments for shoulder arthritis primarily focus on managing pain.
Use of non-steroidal anti-inflammatory drugs like Motrin, ibuprofen, Aleve or Celebrex, in conjunction with activity modification allow a large percentage of patients to achieve acceptable levels of pain and function. If these methods are unsuccessful, use of steroid injections, or cortisone shots, in the shoulder can often help achieve temporary or sustained pain relief and improvement in function.
If surgery is required, shoulder replacement is a common option. During this procedure, the shoulder joint is opened and the arthritic joint surfaces are removed. These joint surfaces are then replaced with a metallic humeral head (ball) and most commonly a durable plastic glenoid (socket), which the head forms a joint with.
Following a total shoulder replacement, patients should experience pain-free range of motion and be able to return to work and recreational activities after the postoperative period. Typically, patients may return to all activities around three months after surgery.
If you are suffering from frequent shoulder pain, contact a physician to see if shoulder arthritis may be to blame. Your physician can recommend the best course of treatment to help ease your symptoms.
Dr. Ryan P. Donegan is the division chief, orthopaedics, Saint Joseph East; shoulder and elbow surgeon, Bluegrass Orthopaedics.