What is Shoulder Osteoarthritis?
Osteoarthritis (OA) is a term used to describe the breakdown of the cartilage of joints. Cartilage is the smooth coating on the ends of bones found at a joint, which allows for smooth and pain free movement of that area of the body. While multiple causes are thought to contribute to the development of OA, in many cases the breakdown is due to a previous traumatic injury or gradual deterioration related to chronic overuse. This process may affect any of the joints in the body, and when it involves the shoulder proper (called the glenohumeral joint) this can be very debilitating for patients. The cartilage may wear away from the ball (humeral head), socket (glenoid), or both in the shoulder. This leaves exposed bony surfaces and causes stiffness, grinding, and pain with motion of the shoulder. This process may also affect the acromioclavicular (AC) or sternoclaviclular (SC) joints at either end of the collarbone (clavicle). Shoulder specialist Dr. Robert Boykin focuses on treating patients in Asheville, Arden, Fletcher and surrounding North Carolina communities who are suffering from shoulder arthritis symptoms.
After a previous injury (even with treatment) or chronic usage (as seen in athletes, overhead laborers, etc.) the shoulder may be susceptible to arthritis. Also patients who have a tear of the muscles around the shoulder (known as the rotator cuff) are predisposed to developing arthritis if the rotator cuff tear is left untreated. This is typically a progressive process starting with pain and limited range of motion and eventually worsening to difficulty in using the shoulder even for minor activities of daily living. In addition patients with Rheumatoid Arthritis, a type of autoimmune disease typically affecting multiple joints in the body, may have involvement of the shoulder and lead to similar symptoms.
What are Symptoms of Shoulder Arthritis
- Pain due to the lack of cartilage between the joints and exposed bone
- Grinding with motion
- Difficulty moving or lifting the arm
- Pain at night
How to Diagnose Shoulder Osteoarthritis
If Dr. Boykin suspects a patient may be suffering from arthritis he will perform an initial history and physical examination followed by an X-ray. In certain cases an MRI will be ordered to localize and properly diagnose the condition. In patients suspected of Rheumatoid Arthritis or an infection, lab tests may also be ordered.
When discussing the proper treatment of arthritis, the goal is to eliminate the pain and restore mobility. In most cases patients can cope with some amount of arthritis through non-surgical treatment methods that help them to alleviate pain. This may include:
- Rest and activity modification
- Icing the affected joint
- Physical therapy
- Anti-inflammatory medications (NSAIDs) which can be taken by mouth or applied to the skin
- Corticosteroid injections to the joint
Surgical Treatment for Shoulder Osteoarthritis
When a patient continues to have pain and difficulty with their activities after non-operative treatments, Dr. Boykin may decide to discuss surgical treatments. The surgical treatment is based upon the individual patient, the severity of the arthritis, and the specific joint(s) involved along with other issues that may be going on in the shoulder. A decision will be made with the patient based on which procedure Dr. Boykin believes will provide the best opportunity to recover from and allow the patient to remain active and pain-free. These options may include arthroscopically removing the diseased area (a procedure of small incisions using a camera and specialized instruments), which may be an option in the AC joint and some milder cases of glenohumeral (shoulder)arthritis.
In severe cases of arthritis, Dr. Boykin may recommend a replacement of the joint, or arthroplasty. This may include replacing part or all of the joint and will depend on the areas affected by the arthritis in addition to the status of the rotator cuff tendons. In this procedure Dr. Boykin will replace the diseased shoulder joint with a synthetic shoulder joint that is highly successful in relieving pain and restoring motion.
Recovery Following Shoulder Arthritis Treatment
Following a surgical procedure, Dr. Boykin will recommend a rehabilitation program which will assist the patient in learning to use the joint again during the transition between the operation and full recovery. In order for full recovery to be obtained, the rehabilitation protocol must be followed and completed as it is our opinion that proper rehabilitation is one of the most important aspects of the procedure.
For additional resources on arthritis of the shoulder, or to learn more about shoulder surgery, please contact Dr. Robert Boykin, orthopedic surgeon serving Asheville, Arden, Fletcher and surrounding North Carolina communities.