As our population ages, more patients are developing osteoarthritis of the shoulder. Osteoarthritis is a degenerative condition of the smooth cartilage on the end of a bone. It is the most frequent cause of disability in the United States and currently affects about one in three people over the age of 60.
In the shoulder, we are talking about cartilage at the top of the humerus (upper arm bone) and on the glenoid (socket portion) of the scapula (shoulder blade). This cartilage allows the two bones to move together smoothly and prevents painful bone-on-bone contact.
Although more commonly seen in the hip and knee, arthritis of the shoulder can be equally debilitating and affect a patient’s ability to sleep and perform routine activities of daily living. Patients often have stiff and painful shoulders that worsen over time.
Who Gets Osteoarthritis of the Shoulder?
Shoulder osteoarthritis typically occurs in older people. It can occur as a result of wear-and-tear or can stem from a prior injury. These injuries can be fractures of the humerus, dislocations of the shoulder—when the head of the humerus partially or fully comes out of the glenoid socket—or the result of a direct blow to or fall onto the shoulder. Osteoarthritis, in general, is more likely to affect women than men.
Symptoms of Shoulder Osteoarthritis
Although more commonly seen in the hip and knee, osteoarthritis of the shoulder can be equally debilitating and affect a patient’s ability to sleep and perform routine activities of daily living. Pain is the most common symptom of shoulder osteoarthritis, and it is often felt as an ache deep within the shoulder joint. As the condition advances, you may have trouble sleeping due to the pain.
Stiffness and range of motion are other common symptoms. It may be difficult to lift your arm over your head. You might hear a crackling, grinding or clicking sound (known as crepitus) when you move your shoulder.
Treatment Options for Osteoarthritis of the Shoulder
Osteoarthritis of the shoulder is notoriously difficult to treat, especially without surgery. Cortisone injections may mitigate symptoms but do not reverse the course of the disease. Physical therapy is less helpful in treating shoulder osteoarthritis than it is in treating other shoulder problems, such as rotator cuff and biceps tendinitis.
Activity modification and anti-inflammatory drugs are the most effective nonsurgical treatments for shoulder osteoarthritis. Some activity modifications to consider can include:
- Keeping good posture by drawing your shoulder blades down the back
- Lifting objects close to the body
- Not lifting anything heavy or anything above the shoulder
- Not throwing anything overhand
- Sticking to a side stroke or breast stroke and avoid freestyle or backstroke when swimming
- Using caution when performing pushing exercises like pushups, a shoulder press or a bench press
Patients with a more advanced form of the disease may be considered for total shoulder replacement.
There are two types of total shoulder replacement, also known as shoulder arthroplasty.
In a traditional shoulder arthroplasty, the head of the humerus is replaced with a metal ball and glenoid is fitted with a plastic disc. This option is best for people who have osteoarthritis but their rotator cuffs remain undamaged.
In a reverse total shoulder arthroplasty, it is the glenoid that gets the metal ball, which fits into a plastic socket attached to the humerus. For people with damaged rotator cuffs or other severe shoulder conditions in addition to osteoarthritis, the reverse total shoulder arthroplasty may be a more effective procedure.
The number of shoulder replacements performed annually in the United States has increased significantly over the last 20 years. Instances of this procedure rose from approximately 8,000 in 1998 to more than 39,000 in 2010, according to a 2016 study published in Surgical Technology International.
There are now approximately 70,000 shoulder replacements (both partial and total) performed in the U.S. This is due in large part to our improved ability to restore function and provide pain relief through either anatomic or reverse replacement of the degenerative shoulder.
Shoulder replacement is now routinely performed safely and effectively at Summit Medical Group. If your shoulder pain is keeping you up at night or limits your daily activities, get checked out for osteoarthritis of the shoulder. Request an appointment with me or any of my colleagues in the Shoulder and Elbow specialty at Summit Medical Group Orthopedics.