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Arthritis of the Shoulder - Options for pain relief

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Published on Saturday, 26 September 2009 21:12

Written by Vic Goradia, M.D.

The bone ends of a joint are covered with a smooth material called cartilage. The cartilage cushions the bone and allows the joint to move easily without pain. A fibrous envelope called the synovium, which produces a fluid that helps to reduce friction and wear in a joint, encloses the joint. Ligaments connect the bones and keep the joint stable. Muscles and tendons power the joint and enable it to move.

Three basic types of arthritis may affect the knee or shoulder joints:

Osteoarthritis (OA) is the most common form of arthritis. OA is usually a slowly progressive degenerative disease in which the joint cartilage gradually wears away. It most often affects middle-aged and older people.

Rheumatoid arthritis (RA) is an inflammatory type of arthritis that can destroy the joint cartilage. RA can occur at any age, and generally affects multiple joints.

Post-traumatic arthritis can develop after an injury. This type of arthritis is similar to osteoarthritis and may arise years after a fracture or ligament injury.

Symptoms and Diagnosis

Generally, the pain associated with arthritis develops gradually. The joint may become stiff and swollen, making it difficult to move the shoulder. With most forms of arthritis, pain may increase after activities such as lifting objects. The pain may often cause a feeling of weakness resulting in a feeling of 'catching'. Many people report that changes in the weather also affect the degree of pain from arthritis.

X-rays typically show a loss of joint space in the affected joint. Blood tests and special imaging tests may be needed to diagnose RA. RA is typically diagnosed and treated by your primary care physician or a rheumatologist.

Shoulder Treatment Options

Over the door tubing for shoulder exercises Exercise options to build strength and minimize joint pain for shoulders.

As with other arthritic conditions, initial treatment of arthritis of the shoulder is conservative. For example, change activities to avoid provoking pain. This may mean you need to modify the way you move your arm to complete daily tasks. Take nonsteroidal anti-inflammatory medications such as aspirin or ibuprofen to reduce inflammation. Ice the shoulder for 20 to 30 minutes two or three times a day to reduce inflammation and ease pain. If you have rheumatoid arthritis, your rheumatologist may prescribe a disease-modifying drug such as methotrexate or recommend a series of corticosteroid injections. Dietary supplements such as glucosamine and chondroitin sulfate may be helpful .

Injections that can provide relief for certain types of arthritis in the shoulder and prevention.

• Cortisone Injections- Local treatment of inflammation in small area such as a joint (arthritis), bursa (bursitis), tendon (tendinitis), and myofascial pain.
• Hyalgan Injection - Works for shoulder pain caused by osteoarthritis which is not relieved by anti-inflammatory or pain medications. Benefits about 75% of arthritis sufferers. Hyaluronate (hi-a-lou’-ron-ate) therapy consists of a series of injections designed to change the character of the joint fluid.

If conservative treatment does not reduce pain, there are surgical options.

As with all surgeries, there are some risks and possible complications. Your orthopaedic surgeon will do all that is possible to minimize these risks.

Arthritis of the glenohumeral joint can be treated by replacing the entire shoulder joint with a prosthesis, called a total shoulder arthroplasty, or by replacing the head of the upper arm bone in a procedure called a hemiarthroplasty. The most common surgical procedure used to treat arthritis of the acromioclavicular joint is a resection arthroplasty. In this procedure, a small piece of bone from the end of the collarbone is removed arthroscopically, leaving a space that later fills with scar tissue. Surgical treatment of arthritis of the shoulder is generally very effective in reducing pain and restoring motion.