Arthritis is damage to the cartilage in joints. Shoulder arthritis occurs when the cartilage starts wearing down on the ball and/or socket sides of the shoulder joint.

Shoulder arthritis is basically a degeneration of the joint.It could be potentially any cause from known causes of joint degeneration from use. It could be from trauma. It could be from even inflammatory type processes such as rheumatoid arthritis.

The primary cause of osteoarthritis is actually unknown, but it is probably some immunological cause. In the shoulder it’s not as prevalent as in the hip or the knee joint, only because humans walk and weight bear on their feet and their legs, and we don’t walk and weight bear on our arms.

Obviously over time though the shoulder can degenerate and can cause pain and subsequently stiffness. Most patients become systematic from shoulder arthritis at a later time in life, usually above 60s. We are seeing them in the younger patient population, partly because of the types of activities that we perform today – extreme sports and new injuries that occur are more severe and high velocity. But predominately more in the elderly population.

Obviously you can still have shoulder pain from other types of pathology like rotator cuff injuries. But other than that, there are other types of what we would call soft tissue, joint type injuries that you could tear and injure that result in pain. But again, the shoulder arthritis is, I would say, in a subset of elderly patients. It’s very high on our diagnosis list. As a result, if they present with pain and stiffness a baseline x-ray of the shoulder can help diagnose the problem.

Presenter: Dr. Patrick Chin, Orthopaedic Surgeon, Vancouver, BC

NOW Health Network Local Practitioners: Orthopaedic Surgeon

Shoulder arthritis is basically a degeneration of the joint. It can be caused from by known causes of joint degeneration from use, trauma and even inflammatory type processes such as rheumatoid arthritis. Arthritis in the shoulder is not as prevalent as it is in the hip or knee joint, only because humans walk and weight bear on their feet and their legs rather than their arms. It’s most common in people over the age of 60, although it’s found in younger patients who do extreme sports.

The five most common types of arthritis to affect the shoulder are:

• Osteoarthritis. Also referred to as “wear-and-tear” arthritis, it destroys the articular cartilage of bone.
• Rheumatoid arthritis. This common, chronic disease attacks multiple joints throughout the body.
• Avascular necrosis. This painful condition occurs when the blood supply to the head of the humerus is cut off.
• Rotator cuff tear arthropathy. This can occur if you have an ongoing rotator cuff tendon tear.
• Posttraumatic arthritis. Patients can develop this type of arthritis after an injury to the shoulder.

Both the acromioclavicular (AC) joint (where the clavicle meets the tip of the shoulder blade) and the glenohumeral joint (where the head of the humerus fits into the scapula) can be affected by arthritis. Symptoms of shoulder arthritis include pain, stiffness and reduced mobility. To make a diagnosis, your  Rheumatologist or orthopedic surgeon physician will probably recommend an x-ray. Often seeing a physiotherapist after surgery isa good optiuon. 

Shoulder arthritis can often be treated non-surgically. Non-surgical shoulder arthritis treatments include:

• Rest
• Nonsteroidal anti-inflammatory medications (NSAIDs)
• Physiotherapy to improve range of motion
• Corticosteroid injections
• Heat and cold therapy
• Disease-modifying drugs

If your arthritis pain doesn’t respond to non-surgical options, your physician or orthopedic surgeon may recommend surgery. Milder cases of shoulder arthritis may be treated with arthroscopy, which involves the surgeon inserting a small camera into the shoulder joint to display pictures on a TV screen. The surgeon is able to use tiny surgical instruments to repair the joint, making shoulder arthroscopy a minimally-invasive procedure. If your shoulder arthritis is more severe, you may require a shoulder joint replacement, during which the surgeon removes damaged parts of the shoulder and replaces them with an artificial prosthesis.Adherence:

Adhering to your medications, prescribed exercises or lifestyle changes (such as dietary changes, smoking cessation, reduced alcohol consumption, etc.) is essential to improving health outcomes successfully. Compliance to any prescribed treatment is the number one thing you can do to ensure positive changes and optimal treatment outcomes.

But again, the shoulder arthritis is, I would say, in a subset of elderly patients. It’s very high on our diagnosis list. As a result, if they present with pain and stiffness a baseline x-ray of the shoulder can help diagnose the problem.

Presenter: Dr. Patrick Chin, Orthopaedic Surgeon, Vancouver, BC

Now Health Network Local Practitioners: Orthopaedic Surgeon