Treatment Options For Shoulder Arthritis
Your doctor may prescribe anti-inflammatory medicine and may recommend occupational therapy or physiotherapy, which includes exercises and heat treatment. In severe cases, surgery may be suggested. The type of surgery depends on the age and severity of the condition. In the elderly with severe arthritis, joint replacement is a good option. A common surgery for the treatment of shoulder arthritis is arthroplasty , which may be total shoulder arthroplasty or hemiarthroplasty.
Shoulder Bone Spur: Causes Symptoms Treatment And Exercises
Written byBel Marra HealthPublished onFebruary 9, 2018
For the most part, shoulder bone spurs can be easily treated since they grow slowly and are usually stable. However, there are cases where the growth is quick and may require aggressive treatment.
A bone spur is an abnormal bone growth. It develops on the surface of bones. Bone spurs are most often found in the joints where one bone meets another bone. They also develop in areas where tendons and ligaments meet bone. They have the potential to be rather painful because they can rub up against nerves and surrounding tissue. While bone spurs are common in the feet, elbow, and spine, a bone spur in the shoulder can also occur.
A lot of people who have shoulder bone spurs do not experience any painful symptoms, while others do have discomfort in the shoulder area. Shoulder spurs are often referred to as osteophytes, which we will explain later. The spurs or shoulder osteophytes can impact range of motion in the shoulder for some individuals.
Different Types Of Shoulder Arthritis
Osteoarthritis In OA, the cartilage in the shoulder joint gradually wears down, and the protective space between the bones decreases. Bone on bone rubbing and friction in the joint leads to pain, stiffness, and limited range of motion. Everyday tasks like combing your hair or carrying a bag become more challenging and painful, says Lauren Shroyer, MS, director of product development at the American Council on Exercise. Loss of range of motion in the shoulder can also lead to muscle spasms throughout the shoulder and the neck, which can cause headaches, she adds.
Osteoarthritis usually affects people over 50 years of age and is more common in the AC joint than in the glenohumeral shoulder joint.
Rheumatoid arthritis With RA, the immune system mistakenly attacks a protective lining in your joint called the synovium, and destroys cartilage. Though RA tends to affect smaller joints first , symptoms can spread to both shoulders as the disease progresses.
Post-traumatic arthritis A shoulder injury like a fracture or dislocation can damage the cartilage or cause additional wear, which can result in arthritis.
Rotator cuff tear arthropathy The rotator cuff is comprised of tendons and muscles that wrap around the ball portion of your upper arm bone, keeping it centered in the shoulder socket. If one or more of these tendons is heavily torn, it may cause the head of the upper arm to rub against other bones, damaging the surfaces and leading to arthritis.
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Shoulder Arthritis Treatment At Summit Orthopaedics
If you are suffering from pain and swelling that is localized around the shoulder, seek advice and accurate diagnosis. Identifying shoulder arthritis in the early stages, when there is limited wear and tear, can improve treatment outcomes. Call Summit Orthopaedics at today to schedule a consultation.
How Is Shoulder Osteoarthritis Diagnosed
To diagnose shoulder osteoarthritis, the doctor will take a medical history and do a physical exam to assess pain, tenderness, and loss of motion and to look for other signs in surrounding tissues. At this point, the doctor may be able to tell if the muscle near the joint has signs of atrophy, or weakness, from lack of use.
Tests that might be ordered to diagnose osteoarthritis of the shoulder include:
- Blood tests, mainly to look for rheumatoid arthritis, but also to exclude other diseases
- Removal of synovial fluid, the lubricating fluid in the lining of the joint, for analysis
- MRI scans
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Rotator Cuff Tear Arthropathy
Rotator cuff tear arthropathy is a type of shoulder arthritis that can develop after a massive and prolonged rotator cuff tear. The four rotator cuff tendons in your shoulder wrap around the ball portion of the shoulder joint, holding it in place. If one or more of these tendons is heavily torn, this may cause the humeral head to rub against other bones and develop arthritis.
Shoulder Osteoarthritis: Diagnosis And Management
PETER J. MILLETT, MD, MSc, Steadman Hawkins Clinic, Vail, Colorado
REUBEN GOBEZIE, MD, Case Western Reserve University, Cleveland, Ohio
ROBERT E. BOYKIN, MD, Harvard Combined Orthopaedic Residency, Boston, Massachusetts
Am Fam Physician. 2008 Sep 1 78:605-611.
Patient information: See related handout on shoulder osteoarthritis, written by Uma Jayaraman, MD, AFP Editing Fellow.
Shoulder osteoarthritis, also known as degenerative joint disease of the shoulder, is a gradual, progressive, mechanical, and biochemical breakdown of the articular cartilage and other joint tissues, including bone and joint capsule. As the articular surface wears, friction within the joint increases, causing progressive loss of the normal load-bearing surfaces with pain and disability. There are many risk factors for shoulder osteoarthritis, including age, genetics, sex, weight, joint infection, history of shoulder dislocation, and previous injury. Certain occupations, such as heavy construction or overhead sports, are also risk factors. The prevalence of shoulder osteoarthritis is increasing as the population ages. Primary care physicians will be confronted with this disease at various levels of severity. This review highlights epidemiology, evaluation, current treatment options, and treatment results for osteoarthritis of the shoulder.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
SORT: KEY RECOMMENDATIONS FOR PRACTICE
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Ice And Heat Application
Ice packs are most often used to reduce the swelling and pain from an acute shoulder injury, but they can also be used to treat shoulder overuse injuries . In these cases, the ice is applied right after the overhead activity to minimize the onset of inflammation.
Heat pads are also used to treat chronic shoulder conditions, but generally before the overhead activity is performed. Heat can relax the muscles, ease stiffness, and reduce pain.
Before applying ice or heat, talk with your doctor or physical therapist. Developing a specific plan for the timing and duration of each treatment is important for optimizing your shoulder healing.
Complications Of Shoulder Bone Spurs
There can be some complications associated with bone spurs of the shoulder. Without proper treatment, bone spurs can cause severe pain. When it comes to surgery and removing bone spurs, infection at the site can occur as well as permanent damage to the nerves in the shoulder. There are even cases where the relief from surgery is only temporary and the bone spur grows back. It is important to note that many people who do go through bone spur surgery dont experience any problems afterward.
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The Normal Unaffected Shoulder
The shoulder is made up of a number or interconnected bones. The upper end of the humerus is a ball, called the humeral head, which rests against the socket, a part of the scapula called the glenoid. Unlike the hip, also a ball-socket joint but one with a deep socket made for stability, the shoulder is made not for stability but motion – and has the most motion of any joint in the body. The ball of the shoulder joint moves against the socket, but because it rests against the socket, rather than being well contained in it, it is reliant on the soft tissues for both its stability and motion. It is stabilized by both ligaments and tendons . The tendons of the shoulder rotate the ball in the socket, and are called the rotator cuff. The four rotator cuff tendons thus supply movement to the shoulder and stability, and can themselves be subject to injury, wear and tear, and degeneration .
Shoulder Bone Spurs Treated With Prolotherapy At Caring Medical
What are we seeing in this image?
In this x-ray, a large bone spur in the shoulder is revealed. This x-ray is of a patient who is only in their thirties. This patient has significant pain and limitations in their range of motion or ability to move their arm around. Of note in this x-ray is that the patient has a lot of cartilage in the shoulder. While Prolotherapy injections may help with pain, the presence of the bone spur may require a recommendation for arthroscopic surgery.
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What Are The Symptoms Of Shoulder Arthritis
As with other joints, the most common symptom of shoulder arthritis is pain during activity. In time, pain can occur at rest, and may even interrupt sleep. As the cartilage disappears, the joint becomes stiff, reducing range of motion, and limiting activity, often causing interference with even the most common tasks of everyday life, such as dressing, reaching for objects, and even personal hygiene. As joint motion is lost, tasks such as driving, athletic activity, housework, and even writing and computer work can be affected. The pain is frequently centered on the back of the shoulder, but commonly is felt all the way down the arm to the elbow.
Perhaps the most disabling symptom for most people is the loss of sleep, as it frequently becomes difficult to find a comfortable position either on the affected or unaffected side.
Motion is often severely affected, and may be accompanied by cracking, grinding, or catching as the ball/socket bones rub against one another.
Rotator Cuff Injuries And Irritations
Your rotator cuff is a group of muscles and tendons that help tether your shoulder into the socket and allow you to move it in a circular motion. Some two million people visit a doctor each year for rotator cuffrelated issues, according to the American Academy of Orthopedic Surgery . Most problems with the rotator cuff fall into two categories: tears or inflammation. Suspect a rotator cuff problem if you have pain or stiffness in your shoulder when you lift your arm above your head to brush your hair or when you reach behind your back. “You won’t be able to do a lot of things you want to do, such as put dishes in an upper cabinet, play tennis, or do garden pruning,” says Dr. Ramappa.
Rotator cuff impingement. A rotator cuff impingement happens when there is irritation, inflammation, or compression of the tendons or bursa in the shoulder. An impingement can be caused by an injury, but it can also just result from general wear and tear from daily life.
Rotator cuff tears. A tear in the rotator cuff will produce pain that is similar to an impingement but has one additional differentiating feature. “If the pain is associated with weakness, it is likely caused by a tear, and if you just have pain, it may only be a rotator cuff impingement,” says Dr. Ramappa.
Performing simple stretches two to three days a week can help keep your muscles flexible and reduce pain, provided your doctor approves.
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Bone Spurs And Shoulder Instability
A bone spur is an abnormal bony overgrowth that extends out from the normal bone.
The shoulder reacts in many ways to its own instability.
- First, the joint can swell in order to help keep everything in place.
- When that no longer works long-term, the body then recruits nearby muscles to help stabilize the joint. These muscles can be in a constant state of contraction as they try to stabilize the joint, but then also have to allow for regular movement. In the process, patients can develop painful muscle spasms from the extra load of work they are incurring.
The muscles may then start to degenerate and the body is left with one other option for stabilization: to start to overgrow bone tissue as a permanent way to stabilize the joint. This overgrowth of bone is the bone spur . If left untreated, bone spurs can become very large and very painful. They may cause pain with certain motions or significantly limit your range of motion due to pain.
What Causes Bone On Bone Knee Pain
Age is the main factor associated with Osteoarthritis of the knee. As people age, develop a certain level of bone-to-bone problem. That doesnt mean young people cannot suffer the same. Besides age, several other factors can contribute to early cartilage wear out. Some of these factors include
Bone on bone pain is that feeling of extreme tenderness, discomfort or the aching of a single or more bone. Its difference with joint pain is that you experience it whether moving or resting.
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Shoulder Arthritis Due To Avascular Necrosis
Avascular necrosis refers to the disrupted blood supply to an area of the body, which results in that area dying . In the shoulder, the humeral head may lose blood supply due to disease, traumatic injuries, and other causes. Without a blood supply, the bone will slowly collapse, becoming uneven and causing arthritis.
Left Shoulder Pain Diagnosis
Here’s a quick summary to help you work out what might be causing your left shoulder pain:
- Aching Pain: usually indicates a bone or soft tissue problem often described as a nagging toothache e.g.shoulder bursitis, impingement syndrome
- Aching After Activity: usually indicates a muscular problem e.g.rotator cuff tear
- Sharp/Stabbing Pain: structures catching on each other or getting squashed such as ligaments or tendons e.g. biceps tendonitis, supraspinatus tendonitis, bankart lesions, SLAP tear, impingement syndrome
- Shoulder Stiffness: arm movements limited by stiffness rather than pain typical indicates frozen shoulder
- Burning Pain and/or Altered Sensation: usually indicates a nerve problem e.g. nerve pain or brachial neuritis
- Obvious Deformity: most likely due to a broken bone e.g. fractured collarbone or shoulder fracture
- Constant Pain: 24/7 pain that doesn’t go away may indicate a heart attack,shoulder fracture or brachial neuritis
- Feeling Unwell: may indicate an underlying medical issue e.g. heart attack, stroke, pancreatitis
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How Is Shoulder Arthritis Diagnosed
Your orthopedic surgeon will perform a comprehensive clinical examination to determine whether or not you have shoulder arthritis. This may include other tests such as x-rays or an MRI.
Medical History. Your doctor will ask you questions about your medical and family history and about any medications you may be taking. This information will help guide further treatment options.
Patient Interview. Your doctor will ask you about your work and lifestyle activities, and whether or not you have had any previous shoulder injuries. You will also be asked to describe your painthe pattern, any limitations to range of motionall vital information to rule out other potential sources of pain such as shoulder bursitis, shoulder impingement, rotator cuff tears or other common shoulder problems.
X-Rays. Digital imaging is ordered to arrive at clinical diagnosisverifying whether or not there are significant signs of shoulder osteoarthritis.
MRI. Your doctor may order an MRI for you if x-rays of the shoulder are inconclusive or if it is suspected that your pain is due to damage to the shoulders labrum or rotator cuff. An MRI provides more detailed images of the soft tissue and bone.
Lab Tests. Lab tests may be ordered to rule out other causes of shoulder pain, such as infection or gout.
Who Is At Risk For Shoulder Arthritis
Anyone who has had shoulder joint trauma, a broken bone, dislocation , or other serious injury or surgery is at risk for developing shoulder osteoarthritis many years after the initial trauma. Trauma to the shoulder joint eventually leads to shoulder osteoarthritis.
Other persons who are at risk are those whose jobs or recreational activities have required a lot of time lifting objects overhead, throwing, or doing high-impact activities such as chopping wood or using an air hammer. These repetitive motions over time cause wear and tear of the shoulder joint, causing the cartilage to thin and become less flexible.
Other risk factors include:
- Advanced age
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Standing Cable External Rotation
If you work at a desk or computer, you will be able to relate to the tension many people experience in the shoulders. The activity of working at a desk day in and day out means shoulders are constantly internally rotated. This can lengthen and weaken the muscles. You can strengthen these muscles by performing cable external rotations.
Those who suffer rotator cuff tears, such as baseball players, are often prescribed this type of exercise.
On an adjustable cable machine, you move the cable until the handle sits between your belly button and the bottom of your chest. You grab the handle in your right or left hand while your elbow is close to your body with your forearm crossing your stomach. You pull the cable as far away from your body as you can while keeping the elbow close to your body. If you are comfortable enough, you can repeat three sets of 12 to 15 repetitions.
Total Shoulder Replacement Surgery
Your surgeon will recommend total shoulder replacement if you have bone-on-bone arthritis along with intact tendons. When you have this procedure, your surgeon will make an incision in the front of your shoulder.
Youll receive a metal ball consisting of surgical-grade steel to replace the head of the humerus. You may also need to have your glenoid replaced with a medical-grade plastic socket.
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Prevention And Prognosis Of Shoulder Bone Spurs
In some cases, bone spurs can be avoided. For example, maintaining a healthy body weight through a good diet and regular exercise can lower your risk of developing bone spurs or osteophytes. Taking frequent breaks while working on the computer can help lessen strain on the shoulders, and limiting activities that involve repetitive stress on the shoulders can be helpful. It is advisable to wear proper protective gear when taking part in high-impact sports.
In most situations, bone spurs in the shoulder are resolved quickly. Of course, sometimes people experience recurrent bone spurs. If you have suffered a bone spur and only required conservative treatment, keep in mind that the next bone spur may require a more aggressive approach. When you have pain in the shoulder that doesnt go away or limits your ability to carry out every day tasks, get a medical assessment.