What is shoulder arthritis?
The main joint in the shoulder is the glenohumeral joint. Arthritis is the thinning and loss of the cartilage lining of the joint. The most common causes of this are primary (age-related) osteoarthritis and secondary to rotator cuff tears. Other causes also include trauma, instability, avascular necrosis, inflammatory arthritis and infection.
What are the symptoms of shoulder arthritis?
Patients with shoulder arthritis describe significant pain, which can affect their sleep and they often report being unable to lie on that shoulder. They also develop progressive loss of range of movement, particularly when taking their shoulder outwards away from their body. The loss of movement and pain prevents patients from performing day to day activities and can significantly affect their quality of life.
How is it diagnosed?
It is diagnosed by taking careful his history and performing a detailed examination. This diagnosis can be confirmed by a shoulder X-ray, and further information for operative planning can be gained by performing a CT scan and MRI scan.
How is it treated?
Treatment can begin with symptomatic management with pain killers and physiotherapy to maintain movement and muscle strength.
Intra-articular steroid injections and trials of nerve blocks to the nerves supplying the shoulder can also be used. These can be very effective on patients in which surgical intervention may not be recommended.
When surgical intervention is required, shoulder replacements are effective at relieving the debilitating pain and improving the restriction in the range of movement. There are two main types of shoulder replacement – anatomic and reverse. The type of shoulder replacement recommended depends on the condition of the shoulder rotator cuff tendons. These operations can lead to a significant improvement in a patient’s quality of life.