Shoulder Arthritis

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is shoulder arthritis?

Shoulder arthritis is a degenerative joint disease that causes pain and stiffness in the shoulder joint. The shoulder joint is a ball and socket joint formed by the humerus (upper arm bone), scapular (shoulder blade), and the clavicle (collarbone). There are four joints that make up the shoulder joint all working together to make the shoulder joint the most flexible joint in your body. With shoulder arthritis, the cartilage of the joint breaks down and bony growths develop on the joint bone. There are two types of arthritis of the shoulder: osteoarthritis and inflammatory arthritis, such as rheumatoid arthritis. The pain from these conditions can make it difficult lifting the arm or doing everyday activities.

While the factors that trigger inflammatory arthritis aren’t completely understood, there are several known risk factors for shoulder osteoarthritis. People age 50 or older, especially women, and anyone who previously injured their shoulder are at higher risk of osteoarthritis in the shoulder. Heavy drinkers and people who use large doses of steroids also have a higher chance of eventually developing shoulder arthritis.

Pain in the shoulder joint is the most common symptom of an arthritic shoulder. Many people with arthritic shoulder also experience stiffness and loss of range of motion. Shoulder osteoarthritis symptoms typically begin slowly and gradually get worse. These symptoms are similar to other shoulder conditions, such as shoulder bursitis or shoulder tendinitis. See your doctor for a proper diagnosis and treatment plan.

There’s no cure for arthritis, but you have many options to help you manage the pain and improve your range of motion. Doctors often recommend treating both types of shoulder arthritis with physical therapy, nonsteroidal anti-inflammatory medications, and ice and heat. Shoulder surgery to repair the joint is an option if these treatments don’t provide relief. With inflammatory arthritis, treatment plans usually change as the disease progresses.

Left untreated, inflammatory shoulder arthritis can damage the joint, so it is important to see your doctor if you have symptoms of shoulder arthritis.

What are the symptoms of shoulder arthritis?

Both osteoarthritis of the shoulder and inflammatory arthritis cause similar pain and stiffness. Inflammatory shoulder arthritis can also cause body symptoms such as fatigue, fever, and decreased appetite. Osteoarthritis of the shoulder gradually progresses and worsens over time. Arthritis can affect one or both shoulders.

Common symptoms of post-traumatic and degenerative arthritis in the shoulder

  • Pain with movement and even at rest

  • Stiffness and reduced range of motion

  • Difficult lifting the arm

  • Grinding, clicking or snapping sound or sensation in the shoulder when you move it

  • Bone spurs

  • Swelling, more common for post-traumatic arthritis than osteoarthritis

Common symptoms of rheumatoid and psoriatic arthritis of the shoulder

Inflammatory arthritis of the shoulder also causes pain, stiffness, decreased flexibility, as well as:

  • Swelling

  • Redness around the shoulder

  • Heat coming from the shoulder

Arthritis can develop anywhere within the shoulder. When pain is mostly felt in the back of the shoulder, damaged cartilage or inflammation is likely where the upper arm bone and the shoulder blade connect, or glenohumeral joint. Pain at the top of the shoulder indicates arthritis is affecting the joint where the shoulder blade meets the collarbone, or acromioclavicular joint. Arthritis can also affect both shoulder joints at the same time.

If you notice these symptoms and they don’t go away, it’s important to talk to your doctor. Receiving a proper diagnosis and getting treatment in the early stages of shoulder arthritis can help slow the progression of the condition, and help you remain active without pain.

What causes shoulder arthritis?

Several different conditions can cause arthritis in the shoulder.

Osteoarthritis of the shoulder occurs from wear and tear of the cartilage over time. The cartilage loses its ability to cushion the shoulder bones during movement, and the joint no longer moves smoothly, slowly causing pain and stiffness that progresses. Post-traumatic arthritis is a type of osteoarthritis that develops after a fracture, a shoulder dislocation, or other traumatic shoulder injury.

Rheumatoid arthritis and psoriatic arthritis are chronic autoimmune diseases, when the body’s immune system attacks healthy tissues. This causes inflammation in the shoulder joint, damages cartilage, and causes pain and stiffness.

Rotator cuff tear arthropathy is a type of degenerative arthritis that develops when the rotator cuff is damaged. When the rotator cuff tendon is torn and not repaired, it no longer holds the arm bone tightly in the shoulder socket. Instead, the head of the arm bone rubs against the tip of the shoulder blade, causing wear and tear.

Avascular necrosis occurs when there’s interference in the blood supply to the top of the arm bone, causing the bone to die. As the bone collapses, it damages the cartilage and the socket, and it can eventually destroy the shoulder joint.

What are the risk factors for shoulder arthritis?

Rheumatoid arthritis isn’t fully understood and neither are the risk factors, but for other causes of shoulder arthritis, doctors know risks factors for developing shoulder arthritis:

  • Age 50 years or older

  • Women at a higher risk of osteoporosis

  • History of shoulder injury

  • History of using high doses of steroids

  • Heavy alcohol use

  • Sickle cell disease

  • Family history of shoulder arthritis

Reducing your risk of shoulder arthritis

You can’t change your age or gender, but you may be able to lower your risk of shoulder arthritis by:

  • Getting regular physical exercise to keep your shoulder muscles strong

  • Eating a healthy diet with enough calcium and vitamin D to maintain strong bones

  • Wearing appropriate protective gear and using proper techniques when exercising or playing sports

  • Drinking alcohol in moderation if you drink alcohol

If you know you are at a higher risk of developing shoulder arthritis, talk with your doctor about ways you may be able to prevent or slow the progress of the condition.

How is shoulder arthritis treated?

Medical treatments cannot cure should arthritis but treatment can help you manage your symptoms and slow down the disease’s progression. Doctors typically start by recommending nonsurgical shoulder arthritis treatment options. These may include a combination of:

  • Moist heat or ice

  • Physical therapy, such as stretches, to improve your range of motion

  • Lifestyle modifications, including rest and avoiding activities that aggravate shoulder pain

  • Nonsteroidal anti-inflammatory medication or corticosteroid injections to reduce inflammation

  • Over-the-counter or prescription pain relievers

If after nonsurgical treatments, the pain is still interfering with your everyday life, you might be a candidate for shoulder surgery. Several types of surgery can help shoulder arthritis:

  • Arthroscopy: This minimally invasive procedure involves a small camera and tiny surgical tools to clean out the inside of the shoulder joint. This surgery is designed to relieve pain, not get rid of the arthritis.

  • Fracture repair: A serious shoulder fracture might require surgical repositioning of the joint and hardware to secure the bones while they heal.

  • Shoulder joint replacement: Also called arthroplasty, this surgery uses metal and plastic components to replace the damaged part of the shoulder joint. Sometimes just one part of the joint is fitted with a prosthesis, and sometimes the entire joint is replaced.

  • Resection arthroplasty: During this procedure, the surgeon removes the tip of the collarbone. This surgery can sometimes be performed arthroscopically.

What are the potential complications of shoulder arthritis?

Shoulder arthritis can worsen over time and eventually cause loss of range of motion making it difficult to lift your arm. People with osteoarthritis or inflammatory shoulder arthritis may eventually find it difficult to manage their daily activities. It’s important to talk to a doctor about the best ways to treat the condition, slow its progression, and manage pain and stiffness.

Without treatment, inflammatory shoulder arthritis can damage the joint, so it is important to see your doctor if you have symptoms of shoulder arthritis. Most people with shoulder arthritis respond well to treatment.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 22
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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