Arthritis or osteoarthritis is a condition where the articular cartilage of a joint is damaged and is progressively lost.
The shoulder is a joint commonly affected by arthritis. Because it is a major joint with a pivotal role in many activities, arthritis can have a significant impact on your life. Arthritis is a progressive disease that comes on over years and decades. When the cartilage is completely lost, the person may reach the stage of having “bone on bone”.
Many conditions lead to cartilage damage and osteoarthritis. However, many cases are idiopathic, which means that there is no specific cause. There is probably a genetic component to this idiopathic variety, and joints other than the shoulder are commonly involved (knees, hips and hands). A long-standing, massive rotator cuff tear can lead to a particular type of arthritis, so-called “cuff tear arthropathy”. Injuries, such as dislocations and fractures, can cause cartilage damage. Diseases that cause inflammation of a joint such as Rheumatoid Arthritis can lead to cartilage damage. Arthritis is more common as we age, but it is not an inevitable consequence of ageing.
The predominant symptom of arthritis is pain. However, a person can have significant arthritis but only mild symptoms.
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Symptoms of shoulder arthritis
The predominant symptom of arthritis is pain. However, a person can have significant arthritis but only mild symptoms. Often the pain from osteoarthritis is intermittent. Factors such as increased activity (e.g. going for a much longer walk than usual) or a minor injury may trigger an acute exacerbation. Typically these flares tend to resolve with time and appropriate nonsurgical treatment. As the arthritis progresses, the pain tends to worsen both in intensity and duration. In the later stages of the disease, the pain can be disabling. Night pain is commonplace and tends to cause sleep disturbance as the arthritis deteriorates. Many people seek definitive treatment when the night pain becomes severe.
Arthritis can cause other symptoms in the shoulder. Arthritis leads to loss of movement, especially the ability to raise the arm and place the hand behind the back. Other symptoms include swelling and weakness. Problems with day-to-day activities such as dressing and personal hygiene can also occur.
Shoulder arthritis diagnosis
The diagnosis of osteoarthritis of the shoulder can be made based on your age, symptoms and the findings when a doctor examines your shoulder. However, imaging of the joint is required to confirm the diagnosis. X-Rays show characteristic changes of a reduced gap between the two bones (indicative of the extent of cartilage damage) and the presence of bone spurs (osteophytes) that project out from the bones.
As yet, there is no specific treatment to restore the cartilage damage. The cartilage loss is slowly progressive worsening over years to decades. However, as mentioned above, the pain from the arthritis is intermittent.