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Arthritis of the shoulder joint

What is Arthritis of the Shoulder Joint?

When there is wear and tear in the shoulder joint it is described as arthritis of the shoulder joint. The disease process can be mild to severe. They can lead on to pain and stiffness of the shoulder joint. Hence there is limitation of shoulder function and the quality of life can be affected.

In a normal shoulder, the rounded end of the upper arm bone (head of the humerus) glides against the small dish-like socket (glenoid) in the shoulder blade (scapula). The surface of the joint normally is smooth and shiny and this helps us to perform free movement without much resistance and very low friction. Shoulder is one of the joint in the body that has very high mobility. In arthritis there is loss of this glistening surface of the joint and hence the underlying bone gets exposed. This leads on to pain, clicking, creaking sensation during movement and also reduced range of motion of the shoulder joint.

What causes it?

The common mode people get arthritis in the shoulder joint is part of ageing. Hence this condition is seen in elderly population and this is generally related to the usage of the arm over the course of the life. Previous fracture around the shoulder joint also can predispose to arthritis of the shoulder joint. A group of muscle that surrounds the shoulder joint called rotator cuff muscles if not functioning then that can also predispose to a different type of arthritis called CUFF TEAR ARTHROPATHY.

Inflammatory conditions of the joint such as Rheumatoid arthritis, gout etc can also result in severe pain of the joint. Rarely sudden lack of blood supply to the humeral head can result in longstanding arthritis.

What are the symptoms/effects?

Patients with arthritis typically describe a deep ache within the shoulder joint. Initially, the pain feels worse with movement and activity, and eases with rest. As the arthritis progresses, the pain may occur even when the shoulder is at rest. Eventually, the pain worsens so that it can disturb the sleep in the night. The patient’s shoulder may make grinding or grating noises when moved. Over the time, shoulder becomes stiff and painful to move. Simple daily activities like reaching into a cupboard, dressing, toileting and washing the opposite arm pit may become increasingly difficult.

How is it diagnosed?

The diagnosis is done by physical examination and investigations such as X ray. Sometimes a CT scan may be needed if we are planning for a total shoulder replacement.

What are the treatment options?

Initial treatment starts with taking pain-killing tablets. Gentle exercises to the shoulder will improve the stiffness. This simple measure can be helpful in early stages. An injection into the shoulder joint with a corticosteroid and local anaesthetic can also give short-term pain relief. But if the pain continues and affects the quality of life, disturbs sleep in the night and limits the activities to a considerable extent, then a surgery to replace the shoulder joint.

Total shoulder replacement can dramatically improve the pain, get mobility of the shoulder joint and the quality of life would improve.