Arthritis of the Shoulder – Smoothing it out

A quick recap, what makes the shoulder joint go round? Or so to speak. The shoulder joint requires mobility, strength, stability and last but not least smoothness in order to function optimally. In this piece, we’re going to explore a little bit into what smoothness is.

The shoulder is a rather complex machine. It does not consist of just one joint but rather, four different joints, all working in unisons to provide controlled and purposeful movement of the arm. These four articulations are the: stenoclavicular, acromioclavicular, scapulothoracic and glenohumeral joint. A pathology of any one of them can lead to dysfunction of the shoulder girdle as a whole.

To try and simply matters, I will only be speaking about the glenohumeral joint here, as it is the biggest and arguable the most essential contributor to movement. This structure is what we call a ball and socket type of joint, where the head of the humerus (the ball) turns or spins around almost, on the surface of the glenoid (the socket). Now, follow me, make a fist with one hand, and put it into the palm of your other hand held in a clasped position. Now move your fist against your palm, that is sort of how this joint work.

Imagine for a moment, if the surface of the skin of your fingers or your palms were rough, it wouldn’t be so easy to move right. In the glenohumeral joint, it is the cartilage of the humeral head and the cartilage of the glenoid that glides against each other. And when the cartilage gets damaged from whatever reason, the smoothness is too. This is what we call arthritis of the shoulder. Shoulder arthritis is a debilitating condition that causes pain, stiffness, and limited range of motion. While arthritis is commonly associated with the knees and hips, it can also impact the shoulder joint, leading to significant discomfort and decreased quality of life.

So what causes the arthritis? Shoulder arthritis refers to the inflammation and degeneration of the shoulder joint, where the cartilage that cushions the bones wears down over time. This can occur due to various factors, including:

Osteoarthritis: The most common type of arthritis, osteoarthritis, occurs when the protective cartilage in the shoulder joint gradually wears away.

Rotator Cuff Arthropathy: Loss of properly functioning rotator cuff tendons, leads to loss of force coupling of the joint and wears of the cartilage, leading to arthritis.

Rheumatoid Arthritis: An autoimmune disorder where the body's immune system attacks the lining of the joint, leading to inflammation, pain, and eventually, joint damage.

Post-Traumatic Arthritis: This type of arthritis develops after a severe shoulder injury, such as a fracture or dislocation, which damages the cartilage and accelerates joint degeneration.

The most common symptoms associated with shoulder arthritis are pain and limited motion of the shoulder. There may be other symptoms depending on the cause of the arthritis. The pain and loss of shoulder mobility would usually lead to deterioration in quality of life. Upon a visit to your healthcare provider, he/she will ask about your symptoms, conduct a thorough physical examination of your shoulder, and order diagnostic tests such as X-rays, MRI scans, or CT scans to assess the extent of joint damage and rule out other possible causes of shoulder pain.

There are several treatment options that can help manage symptoms and improve quality of life. This includes medication to help alleviate the pain. Furthermore,  a structured exercise program supervised by a physical therapist can help strengthen the muscles surrounding the shoulder joint, improve flexibility, and enhance joint stability. Lastly, making lifestyle changes such as maintaining a healthy weight, avoiding repetitive overhead activities, and practicing proper posture can help reduce strain on the shoulder joint and improve symptoms.

If all else fails, then there is the option of surgery. Shoulder joint replace surgery is the most common procedure done for advance shoulder arthritis. This could be a partial or total shoulder replacement (anatomical or reverse). The indication for which surgery works best for a particular patient needs to be discussed with your doctor in further detail.

Shoulder arthritis can significantly impact daily life, causing pain, stiffness, and limited mobility. However, with early diagnosis and appropriate treatment, individuals with shoulder arthritis can effectively manage their symptoms and maintain an active lifestyle. If you're experiencing persistent shoulder pain or stiffness, it's essential to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan tailored to your needs.