Shoulder Arthritis
Description
Arthritis is simply the loss of joint cartilage. The
shoulder joint is composed of a ball (the humeral head) and
a shallow socket (called the glenoid). Both the ball and
socket are covered by a ULTRA smooth surface called
cartilage. The cartilage allows the two bones to glide over
one another with very little friction.
Pathology
If you loose the cartilage covering over the ends of the
ball and/or socket...you have arthritis. This means that
now when you move your shoulder, much more friction is
created. It is similar to rubbing two pieces of sandpaper
over each other. You can imagine how much heat is
generated. In the shoulder this creates a tremendous amount
of inflammation (or irritation) of the surrounding tissues.
Symptoms
Symptoms of arthritis usually begin with pain. At first it
starts as pain with activities but as time progresses, the
pain can even be at rest. Often patients describe it as a
deep pain which sometimes aches and is sometimes very
sharp. The pain also often travels down the arm. Night pain
is also a frequent complaint. As symptoms worsen, patients
often develop 'crunching' or what doctors refer to as
crepitance. This is when the two rough surfaces are rubbing
against one another. This can cause catching and locking of
the shoulder. As the arthritis worsens patients begin to
loose motion. This is a bad step in the process and
patients should try to avoid losing a significant amount of
motion because once motion is lost...it is quite hard to
ever regain.
Treatment Options
Like most other shoulder conditions there are several
options in treating arthritis.
- Do nothing and live with the pain: This is not cancer and will not kill you but living with the discomfort can be quite difficult. Doing nothing is always an option.
- Anti-inflammatory medication / cortisone (steroid) injections: This can help you live with your shoulder. The goal is to reduce your pain. This will in no way cure the arthritis but can decrease the pain generating inflammation in the shoulder. While injections typically work for a period of time...the effect is usually short lived.
- Physical Therapy: PT can help maximize your strength. Once again this does not cure the arthritis but can help compensate for the problems going on.
- Arthroscopic surgery: This option is for a select group of patients with MILD arthritis of the shoulder. Arthroscopic surgery can NOT cure the arthritis but it can smooth the rough spots and remove any loose cartilage causing problems. It is definately NOT a cure for arthritis but can buy patients some time before they need the larger surgery.
- Shoulder replacement: This is the definitive treatment for shoulder arthritis. In this procedure the surgeon removes the arthritic bones and replaces them with surfaces of metal and plastic. Shoulder replacements come in many different types (partial replacement, full replacement, reverse replacement). Each of these types of shoulder replacements have their place and Dr. Brady will review all of the options with you so you can make your own informed decision.
Treatment Options: Arthroscopic Labral Repair
