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Shoulder arthritis causes friction and pain

As shoulder cartilage thins – through degeneration, disease or trauma – the joint’s smooth ball-socket motion deteriorates, causing painful grinding and stiffness.

The condition often leads to pain when patients reach above their head or behind their back, said Dr. Adam Smith, a board-certified orthopedic surgeon at West Tennessee Bone & Joint Clinic, P.C. “Some patients have severe pain at night that wakes them up, or pain so severe that they can’t get to sleep.”

Arthritis of the shoulder is a condition that affects the ball (humeral head) and socket (glenoid) joint in the upper arm. These bones are normally covered with a thick durable cartilage called articular cartilage that is slick and minimizes the friction between bones, allowing for the normally smooth motion of the shoulder. Arthritis occurs as articular cartilage becomes thin.

The primary types of arthritis affecting the shoulder are post-traumatic arthritis, degenerative osteoarthritis and inflammatory arthritis.

“Post-traumatic arthritis is due to previous injury, such as shoulder dislocation or fracture,” Dr. Smith said. “Degenerative arthritis occurs over years as cartilage degenerates. Inflammatory arthritis is an auto-immune disease in which the body’s own cells attack the cartilage and ligaments.”

When the cartilage becomes too thin between the ball and socket of the joint, it can lead to bone-on-bone contact. Spurs may build up around the shoulder. Special X-rays will allow surgeons to clearly identify arthritis and develop a treatment plan.

Conservative regimens, including anti-inflammatory medications and injections of cortisone, can be extremely helpful, Dr. Smith said. Arthroscopy of the shoulder may be helpful in a limited number of patients to remove debris and spurs from the joint.

“For those who do not respond well to these options, replacement of the shoulder is helpful, allowing a return to a pain-free lifestyle,” he said.

During the shoulder-replacement procedure, an orthopedic surgeon makes an incision in the front of the shoulder and spreads the muscles to allow entry. Scar tissue and spurs that limit motion are removed. The arthritic ball and socket are then replaced with a smooth metal ball and plastic socket.

“Patients usually stay one or two nights in the hospital to allow for adequate recovery,” Dr. Smith said. “The shoulder remains in a sling for about four to six weeks and motion therapy begins. In general, most patients have maximum recovery and are allowed to return to activities like golf at around six months after surgery.”

Q and A with Adam Smith, M.D.

What is shoulder arthritis?

Arthritis of the shoulder is a condition that affects the ball (humeral head) and socket (glenoid) joint in the upper arm.

These bones are normally covered with a thick durable cartilage called articular cartilage that is very slick and minimizes the friction between bones allowing for the normally smooth motion of the shoulder. Arthritis occurs as articular cartilage becomes thin.

What types of shoulder arthritis exist?

The primary types of arthritis affecting the shoulder are post-traumatic arthritis, degenerative osteoarthritis and inflammatory arthritis. Post-traumatic arthritis is due to previous injury, such as shoulder dislocation or fracture. Degenerative arthritis occurs over years as cartilage degenerates. Inflammatory arthritis is an auto-immune disease in which the body’s own cells attack the cartilage and ligaments.

What types of changes happen on my X-rays?

The cartilage becomes thin between the ball and socket, sometimes leading to bone-on-bone contact. Special X-rays will allow your surgeon to clearly identify arthritis. Spurs may build up around the shoulder.

What problems do patients with shoulder arthritis have?

As shoulder cartilage becomes thin, the smooth ball-socket motion is lost. Painful grinding may be noticed with motion. The shoulder can become stiff, leading to pain when reaching above the shoulder level or problems with reaching into the back pocket or putting on a belt. Some patients have severe pain at night that wakes them up, or pain so severe that they can’t get to sleep.

What options do I have with shoulder arthritis?

Conservative regimens including anti-inflammatory medications and injections of cortisone can be extremely helpful. Arthroscopy of the shoulder may be helpful in a limited number of patients to remove debris and spurs from the joint. For those who do not respond well to these options, replacement of the shoulder is helpful, allowing a return to a pain-free lifestyle.

What is shoulder replacement?

Replacement of the shoulder is performed by an orthopedic surgeon for patients who have continued pain and failure of a trial of non-operative treatments. An incision is made in the front of the shoulder, and the muscles are spread, allowing entry to the shoulder. Scar tissue and spurs that limit motion are removed. The arthritic ball and socket are replaced with a smooth metal ball and plastic socket.

What is the recovery time for shoulder replacement?

Patients usually stay one or two nights in the hospital to allow for adequate recovery. The shoulder remains in a sling for about four to six weeks and motion therapy is begun. In general, most patients have maximum recovery and are allowed to return to activities like golf at around six months after surgery.