Our hands, knees and hips are usually the first joints that come to mind when we think of arthritis.
Though less common, arthritis can also occur in our shoulders, spelling problems that begin with pain and end with a patient not even being able to lift an arm above the shoulder.
Shoulder expert Dr. Michael Codsi has information on how shoulder arthritis can effect you, and what you can do to keep it from getting worse.
What does it mean when someone has arthritis in their shoulder?
Dr. Michael Codsi: Arthritis, whether it’s in your hips, knees or shoulders, occurs when the cartilage designed to minimize friction in our joints breaks down.
This results in inflammation, swelling, and pain in the joint.
The shoulder has a range of motion greater than most other joints in the entire body, so it comes as no surprise that both of the joints in the shoulder may be affected by arthritis.
One joint is located where the clavicle meets the tip of the shoulder blade (acromion). This is called the acromioclavicular (AC) joint.
The second joint, where the head of the humerus fits into the scapula, is called the glenohumeral joint.
Arthritis in the shoulder most commonly results from general “wear and tear” as we get older, but can also occur due to autoimmune conditions like rheumatoid arthritis and with injury—those who play contact sports are more prone to developing arthritis.
How does shoulder arthritis affect a person’s day-to-day life?
Dr. Codsi: The first symptom most people will notice is pain.
Shoulder arthritis can feel like a constant ache that is smoldering all day and doesn’t go away.
The pain is generally worse in the morning and gradually gets better as the day goes on and the shoulder joint warms up.
Someone with shoulder arthritis will also notice a loss of motion and stiffness in their shoulder, especially when raising their arm overhead.
Repetitive motions, such as brushing your hair, putting on your shirt or reaching to get things out of an overhead cabinet can become difficult over time.
The pain is often “bearable,” so it’s often the case that a person will live with shoulder arthritis for many years before seeking any sort of medical treatment.
What can you do to keep shoulder arthritis from getting worse?
Dr. Codsi: It might seem counterintuitive, but the best thing a person with arthritis can do is to keep moving.
Our joints are designed to move and a reasonable amount of activity is good for them.
Over the counter pain medications, such as Tylenol and anti-inflammatory drugs (NSAIDs), can offer general pain relief.
Use these intermittently as they do have side effects. If you find yourself relying on OTC pain relievers on a daily basis, it’s time to get checked by a doctor.
Simple things like self-treating with a heating pad to soothe stiff shoulder joints or using one of the many products available to help accommodate your daily motions, such as mobility tools to assist you in reaching for items, can help you live with shoulder arthritis.
Ergonomic adjustments like placing items where they are easier to reach can also help.
When might you want to consider medical treatment for shoulder arthritis?
Dr. Codsi: Most people will want to see a doctor when arthritis starts limiting their normal activity.
Often people will complain of not being able to sleep at night when they first seek help.
Your primary care doctor can typically provide this first consultation, and help you explore other pain management options in addition to the one’s I mentioned earlier.
This may include steroid injections into the shoulder joint to relieve pain temporarily. The injections can serve as a bridge before surgery, making the pain tolerable to live with for a short period of time, but they are not a cure.
If you still have pain after all of the non-surgical options are exhausted, that is usually when we start talking about shoulder replacement surgery.
Shoulder replacement surgery removes the rough surfaces of the joint and replaces them with a smooth metal ball and smooth plastic cup.
What’s your advice to patients with shoulder arthritis considering surgery?
Dr. Codsi: For starters, you will know when it is time for surgery. Don’t let a surgeon tell you surgery is necessary. It is optional.
Also, do not make decisions based on your x-rays. Make them based on your pain and function.
And finally, learn about your options. There are a lot of different types of shoulder replacements available today and you want the best fit for your lifestyle.
I and 40 other shoulder specialists from across the U.S. have established the first national registry for shoulder replacements.
By collecting data on which shoulder replacements offer the best outcomes, we hope to help our patients make informed decisions about what option is best for them.
Dr. Michael Codsi is a fellowship-trained shoulder surgeon who practices at EvergreenHealth Orthopedic & Sports Care, part of the EvergreenHealth Neuroscience, Spine & Orthopedic Institute. He is a co-creator of the recently established ACESS national shoulder registry to collect information on all shoulder replacement operations and measure their effectiveness.