Shoulder Arthritis: Causes, Symptoms, and Treatment Options

Shoulder arthritis is a degenerative joint condition that causes pain, stiffness, and reduced range of motion. Unlike arthritis in weight-bearing joints like the hip or knee, shoulder arthritis affects a highly mobile joint, meaning it can impact many everyday tasks, from reaching to lifting. While commonly associated with age, shoulder arthritis can also affect athletes, manual laborers, and individuals with prior shoulder injuries.

This article covers the causes, symptoms, types, and treatment options for shoulder arthritis in a friendly, conversational manner, along with insights from recent research.

What is Shoulder Arthritis?

Shoulder arthritis refers to the wearing down of cartilage in the shoulder joint. Cartilage acts as a cushion between bones, enabling smooth, pain-free movement. When it deteriorates, bones rub against each other, causing pain, inflammation, and stiffness. The shoulder contains two primary joints susceptible to arthritis: the glenohumeral (ball and socket) joint, which connects the upper arm to the shoulder blade, and the acromioclavicular (AC) joint, which connects the top of the shoulder blade to the collarbone.

Arthritis in the shoulder is typically progressive, meaning it worsens over time. But with early diagnosis and effective treatment, symptoms can often be managed, and function preserved.

Types of Shoulder Arthritis

Shoulder arthritis falls into several categories, each with unique causes and treatment implications.

Osteoarthritis is the most common type and is generally age-related, as cartilage naturally breaks down over time. This wear-and-tear arthritis affects the glenohumeral joint more frequently than the AC joint. It’s often seen in people over 50 but can appear earlier in athletes or individuals with a history of shoulder injuries.

Rheumatoid arthritis is an autoimmune condition where the body’s immune system mistakenly attacks joint linings, leading to inflammation and joint destruction. Although it can affect any joint, including the shoulder, it commonly affects both shoulders simultaneously.

Post-traumatic arthritis develops after an injury to the shoulder, such as a dislocation or fracture. Trauma to the joint can accelerate cartilage breakdown, even if the injury was years prior. This type often affects younger adults and athletes who have experienced impact or injury to the shoulder.

Rotator cuff tear arthropathy is a form of arthritis that can develop after a significant rotator cuff tear. In these cases, the rotator cuff can no longer stabilize the shoulder joint, causing it to wear down faster. This form of arthritis is relatively rare but can be particularly debilitating, often impacting individuals over 60.

Symptoms of Shoulder Arthritis

Shoulder arthritis symptoms typically develop gradually and worsen over time. Pain is often the first noticeable symptom, occurring during activity and even at rest. Many individuals with shoulder arthritis experience pain at night, which can interrupt sleep and worsen overall discomfort.

Stiffness is also a common complaint, with affected individuals noticing a decreased ability to lift the arm, reach overhead, or perform tasks that require shoulder flexibility. This stiffness can make everyday activities challenging, from putting on a shirt to reaching for objects on a shelf.

A hallmark symptom is crepitus or a grating sensation, which some describe as a “crunching” or “popping” sound during movement. This is due to rough cartilage surfaces or bone-on-bone contact.

Weakness can occur as arthritis progresses, particularly if the joint pain prevents regular use of the shoulder. The resulting muscle atrophy can make tasks that require arm strength, like carrying groceries or lifting items, difficult.

Diagnosing Shoulder Arthritis

A healthcare provider typically diagnoses shoulder arthritis through a combination of physical exams, imaging tests, and a review of symptoms. X-rays are often the first line of imaging and can show joint space narrowing, bone spurs, or other signs of arthritis. In some cases, a CT scan or MRI might be ordered for a closer look at the joint structure and surrounding tissues.

A thorough physical exam helps assess range of motion, pain levels, and overall joint function. Diagnosis is critical in determining the appropriate treatment approach, as the severity of arthritis and specific joint involvement often dictate the best course of action.

Treatment Options for Shoulder Arthritis

Treatment for shoulder arthritis ranges from conservative management to surgical interventions, depending on the severity of symptoms and impact on daily life.

Rest, ice, and anti-inflammatory medications are often the first line of treatment, particularly for managing pain and inflammation. NSAIDs like ibuprofen or naproxen are commonly used to reduce inflammation, although long-term use can have side effects.

Physical therapy is valuable in shoulder arthritis management, as it helps maintain joint mobility, strengthen the muscles surrounding the shoulder, and reduce strain on the joint. Therapy exercises typically focus on range of motion, flexibility, and strength training for the rotator cuff and shoulder girdle muscles.

Steroid injections provide temporary relief by reducing inflammation directly within the joint. These injections can be effective in the short term but may lose efficacy if used repeatedly. Corticosteroids also come with risks, such as cartilage damage and tendon weakening, making them a less frequent choice for long-term management.

Platelet-rich plasma (PRP) injections are a newer, experimental treatment. PRP uses the patient’s own blood, which is processed to concentrate platelets and growth factors before being injected into the joint. PRP injections are thought to promote healing and reduce inflammation, but research on PRP for shoulder arthritis is still emerging, and results are mixed.

Arthroscopic debridement involves a minimally invasive surgery where damaged cartilage or bone spurs are removed to reduce pain and improve joint movement. While not a cure, debridement can provide temporary relief for those with milder arthritis. The procedure is less invasive than a full joint replacement and may delay the need for more extensive surgery.

Shoulder replacement surgery, or arthroplasty, is often reserved for severe cases. In total shoulder arthroplasty, both the ball (humeral head) and socket (glenoid) components are replaced with artificial implants. A reverse shoulder replacement is sometimes used for individuals with rotator cuff tear arthropathy, as it changes the mechanics of the joint to rely less on the rotator cuff. While shoulder replacement is highly effective at relieving pain and restoring function, it comes with a longer recovery time and is typically reserved for individuals who have not found relief through other treatments.

Lifestyle Modifications and Self-Management

In addition to medical treatments, lifestyle changes can help manage shoulder arthritis symptoms and improve quality of life. Exercise remains one of the best ways to maintain shoulder health and can help delay the progression of arthritis by keeping muscles strong and joints mobile. Low-impact activities like swimming, yoga, and light resistance training are particularly beneficial.

Weight management is also important, as excess weight can increase the load on joints. While the shoulder is not a weight-bearing joint, maintaining a healthy weight reduces strain on the body and can indirectly improve joint health.

Heat and cold therapy can provide temporary relief for shoulder arthritis symptoms. Ice is useful for reducing inflammation after activity, while heat can help relax muscles and reduce stiffness. Many individuals find that alternating between hot and cold applications offers the best relief.

Assistive devices like ergonomic tools, braces, or shoulder supports can also help, particularly during activities that exacerbate symptoms. Working with an occupational therapist can provide insight into strategies for modifying daily tasks to reduce strain on the shoulder.

Research Insights

Recent research has shed light on new treatments and management strategies for shoulder arthritis. Studies have shown that early intervention with physical therapy and anti-inflammatory treatments can slow progression and maintain function. A 2019 study published in the Journal of Shoulder and Elbow Surgery highlighted the effectiveness of reverse shoulder replacements in individuals with rotator cuff tear arthropathy, noting a high success rate in restoring function and reducing pain (Denard et al., 2019).

Studies on PRP and stem cell injections are ongoing, with some findings suggesting that these treatments may provide short-term relief in early arthritis cases. However, more research is needed to determine their long-term efficacy.

Researchers are also investigating gene therapy as a potential treatment for osteoarthritis, including shoulder arthritis. While still in experimental stages, early studies suggest that gene therapy may one day provide a way to regenerate cartilage and repair joint damage.

Final Thoughts

Shoulder arthritis can be challenging to manage, particularly as it progresses. However, with a variety of treatments available, from lifestyle changes and physical therapy to advanced surgical options, there is hope for relief and improved function. Early diagnosis and a tailored treatment approach are key to managing symptoms and maintaining an active lifestyle.

Whether through conservative management, injections, or surgical interventions, working closely with healthcare professionals can ensure the most effective plan for your unique needs. With ongoing research into new therapies, the future of shoulder arthritis treatment looks promising.

References

Denard, P. J., et al. (2019). "Reverse shoulder arthroplasty improves function in patients with rotator cuff arthropathy." Journal of Shoulder and Elbow Surgery
Uhthoff, H. K., & Loehr, J. W. (2008). "Calcific tendinitis: pathogenesis and etiology." American Journal of Sports Medicine