Although most people think of the shoulder as a single joint, there are really two joints in the area of the shoulder.
One is located where the collarbone (clavicle) meets the tip of the shoulder bone (acromion) called the acromioclavicular or AC joint. The junction of the upper arm bone (humerus) with the shoulder blade (scapula) is called the glenohumeral joint. Both joints may be affected by arthritis.
To provide you with effective treatment, your physician will need to determine which joint is affected and what type of arthritis you have. While AC joint arthritis may commonly be seen on x-ray, its true contribution to shoulder pain is variable and is best determined on a patient by patient basis. Glenohumeral arthritis may take many forms, but most commonly presents as aching pain made worse with motion, and with limitation in range of motion.
Four major types of arthritis generally affect the shoulder:
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Osteoarthritis is a degenerative condition that destroys the smooth outer covering (articular cartilage) of bone. It usually affects people over 50 years of age.
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Rheumatoid arthritis is a systemic inflammatory condition of the joint lining. It can affect people of any age and usually affects multiple joints on both sides of the body.
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Posttraumatic arthritis is a form of osteoarthritis that develops after an injury such as a fracture or dislocation of the shoulder.
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Rotator cuff tear arthropathy is a result of long standing rotator cuff dysfunction and may be quite painful and disabling. The pattern of arthritis and way the shoulder functions differ significantly from other forms of arthritis, and requires a more complex management strategy.
Treatments
Marshfield Clinic orthopedic specialists provide surgical and non-surgical treatment for a variety of injuries and conditions affecting the shoulder, including relief from arthritis.
Non-surgical
- Rest or change activities to avoid provoking pain; you may need to modify the way you move your arm to do things.
- Take non-steroidal anti-inflammatory medications such as ibuprofen to reduce inflammation.
- Ice the joint for 20 to 30 minutes two or three times a day to reduce inflammation and ease pain.
- If you have rheumatoid arthritis, your doctor 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.
Surgery
If your arthritis does not respond to either non-surgical treatments or medication, a doctor may recommend that you have surgery. Surgical treatment of arthritis of the shoulder is generally very effective in reducing pain and restoring motion.
- Shoulder Replacement: Arthritis of the glenohumeral joint can be treated by replacing the entire shoulder joint with a prosthesis (total shoulder arthroplasty or reverse shoulder arthroplasty) or by replacing just the upper end arm bone (hemiarthroplasty or humeral resurfacing). Consultation with a surgeon familiar with shoulder replacement can determine which procedure would be best for you.
- Resection Arthroplasty: Resection Arthroplasty is the most common surgical procedure used to treat arthritis of the AC joint. In this procedure, a small piece of bone from the end of the collarbone is removed, leaving a space that later fills with scar tissue.
