| > Site Map |
| Arthritis about the Shoulder & Elbow > Arthritis
of the Shoulder (Gleno-Humeral Arthritis) What is Arthritis of the Shoulder? (“Glenohumeral Arthritis”) The glenohumeral joint, commonly called the shoulder joint, is a ball-and-socket joint made up of the top, rounded portion of the humerus—the ball—and the dish-shaped part of the outer edge of the scapula, called the glenoid. Arthritis of the shoulder, or glenohumeral arthritis, affects the glenohumeral cartilage in the shoulder. Cartilage is a slick elastic connective tissue that allows movement in the joint and protects the bones. Very tough and malleable (such as the cartilage we can feel in our earlobes), this substance provides a smooth gliding surface enabling efficient joint motion. As we age, normal wear and tear (or degeneration) of the cartilage takes place in most joints. When cartilage degenerates the smooth surface roughens, later the bone becomes exposed, and the unprotected joint surfaces rub against each other. Besides causing pain to the sufferer, this rubbing of the bone can disable the joint or deform it in some way, sometimes making it appear larger. Over time bone overgrowth (spurs) occurs to make the joint larger and decrease the pressure per square centimeter. These symptoms are the result of conditions such as osteoarthritis, rheumatoid arthritis, posttraumatic arthritis, and cuff-tear arthropathy (arthritis that results from numerous rotator cuff tears). When any of these conditions affects the shoulder, there is usually pain and swelling that limit the motion of the arm. Glenohumeral arthritis is more common in patients older than 50, and should not be confused with arthritis of the acromioclavicular joint (AC arthritis) even though they are both in the shoulder and share common symptoms. Causes of Arthritis of the Shoulder? Destruction of the glenohumeral cartilage occurs as a result from:
People whose occupations require that they use their arms for extended periods of time are especially vulnerable to arthritis of the shoulder. Repetitive overhead lifting, such as that done by weightlifters or construction workers who reach overhead, can increase the incidence of the disease. Athletes who participate in contact sports, or people who experience a blunt force to the shoulder in the course of work, household activities, or an accident may over time develop osteoarthritis. Symptoms of Arthritis of the Shoulder? One of the first signs that a person may have glenohumeral arthritis is pain and tenderness in the shoulder area and upper arm. Sometimes patients will report pain in the forearm. There may be a decrease in shoulder motion. Compression of the joint, such as bringing the arm across the chest may result in increased pain. Pulling the affected arm underneath the chin as tight as possible usually causes pain at the shoulder if arthritis is present. Patients with arthritis of the shoulder will have trouble doing everyday activities, like reaching overhead, dressing or combing their hair. The pain may encircle the shoulder, the front of the chest, and the neck. There also may be some swelling at the site of the joint. If the shoulder had been injured some time in the past, there may be a snap or click as the shoulder is moved and a larger bump over the joint on the shoulder that is affected than is present on the other shoulder. Usually the diagnosis of glenohumeral arthritis is made during a physician’s physical examination. In the course of the examination, the physician will look for tenderness over the shoulder and the presence of pain with compression of the joint. An injection by the physician of a local anesthetic, such as lidocaine, will reduce the pain temporarily and confirm the diagnosis. X-rays may be used to reveal a narrowing of the joint and the presence of bone spurs around the joint. If a repair procedure is to be performed, the interior of the joint may be examined by the use of arthroscopy to determine the extent of damage to the cartilage, tendons, and ligaments, and to confirm the diagnosis. Treatment of Arthritis of the Shoulder? Treatment, initially, may be conservative, consisting of rest and non-steroidal anti-inflammatory medications (NSAIDs) such as aspirin, ibuprofen, and naprosyn, or prescription drugs such as Daypro. Ice may be applied for twenty to thirty minutes at a time, daily or several times daily, to decrease the pain and inflammation at the joint. Cortisone, a very strong anti-inflammatory steroidal medication, may be injected into the joint if the pain persists after the administration of non-steroidal medications. Usually one or two injections of cortisone are sufficient to permanently take care of persistent pain and swelling. In order to avoid further aggravation of the condition, there should be a lessening of activities that tend to put undue stress on the shoulder; once the cartilage is gone there is no way of replacing it at the present time. If the joint motion is restricted as a response to slowly increasing joint pain, a gentle program of daily range of motion exercises will usually decrease the pain. Your doctor will also want to see how well your shoulder responds to physical therapy. In some cases the doctor or therapist will use the gentle sound-wave vibrations of ultrasound to warm deep tissues and promote the flow of blood to the shoulder tissue. As pain subsides, you will be asked to try gentle stretching and strengthening exercises. These are often preceded and followed by use of therapeutic ice. Should rest, ice, medication, and modifying activities not work to reduce the pain and swelling, surgery may be the next step in treatment. The most common procedure for surgically treating glenohumeral arthritis is arthroplasty (shoulder replacement). When this is the case, prosthetic (or artificial) bones are used to rebuild the joint. The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician. © 2000 DynoMed.com, LLC, Indianapolis, IN |