Shoulder Arthritis
Cartilage breakdown in the shoulder joint causing pain and stiffness
Quick Facts
- Type: Joint (musculoskeletal) condition
- Main symptoms: Pain, stiffness, limited motion
- Common types: Osteoarthritis, rheumatoid arthritis
- Treatment: Therapy, medication, sometimes surgery
Overview
Shoulder arthritis is the gradual loss of the smooth cartilage that lines the shoulder joint, along with inflammation. Cartilage allows the bones to glide easily; as it wears away, the bones rub together, causing pain, stiffness, and loss of motion.
The shoulder has two joints that can be affected: the main ball-and-socket joint (glenohumeral) and the joint at the top where the collarbone meets the shoulder blade (acromioclavicular). Arthritis here is common with age but can also follow injury or result from inflammatory disease. While the damage cannot be reversed, treatment can ease symptoms and preserve function.
Symptoms
Symptoms usually develop slowly and worsen over time:
- Deep aching pain in the shoulder, often worse with activity and at the end of the day
- Stiffness and a reduced range of motion, making it hard to reach overhead or behind the back
- A grinding, clicking, or catching sensation with movement
- Pain that may disturb sleep, especially when lying on the affected side
- Weakness or a feeling that the shoulder is not as reliable as it was
With inflammatory types, such as rheumatoid arthritis, both shoulders may be involved and there may be warmth, swelling, and morning stiffness.
Causes
Several conditions can cause shoulder arthritis:
- Osteoarthritis: Age-related wear of the cartilage, the most common form.
- Rheumatoid arthritis: An autoimmune disease in which the immune system attacks the joint lining, often affecting both shoulders.
- Post-traumatic arthritis: Develops after a fracture or dislocation of the shoulder.
- Rotator cuff tear arthropathy: Long-standing rotator cuff tears can lead to a specific pattern of arthritis.
- Avascular necrosis: Loss of blood supply to the bone, which can damage the joint.
Risk Factors
- Older age
- Previous shoulder injury, fracture, or dislocation
- Repetitive overhead activity from work or sports
- A family history of arthritis
- Inflammatory or autoimmune conditions such as rheumatoid arthritis
- Long-standing rotator cuff problems
Diagnosis
Diagnosis is based on the history of symptoms and a physical exam to assess pain, range of motion, strength, and joint sounds. Tests may include:
- X-rays: Show narrowing of the joint space, bone spurs, and other signs of arthritis.
- MRI or CT: Provide more detail of the cartilage, bone, and rotator cuff when needed.
- Blood tests: Used when an inflammatory type such as rheumatoid arthritis is suspected.
Treatment
Treatment usually begins with non-surgical measures and progresses if symptoms continue.
- Activity changes: Modifying or pacing activities that aggravate the shoulder.
- Physical therapy: Exercises to maintain motion and strengthen surrounding muscles.
- Medications: Pain relievers and anti-inflammatory drugs; for inflammatory arthritis, disease-modifying medicines prescribed by a specialist.
- Injections: Corticosteroid injections can give temporary relief.
- Heat, ice, and rest: Simple measures that help manage flare-ups.
- Surgery: When pain is severe and limits daily life, joint replacement or other procedures may be considered.
Many people manage symptoms well for years with non-surgical care.
Prevention
Arthritis cannot always be prevented, but you can lower risk and slow progression:
- Treat shoulder injuries promptly and complete rehabilitation
- Use proper technique and avoid overloading the shoulder in sports and at work
- Keep the shoulder muscles strong and flexible
- Maintain a healthy weight and stay generally active
- Manage inflammatory conditions with your care team
When to See a Doctor
See a doctor if you have shoulder pain or stiffness that lasts more than a few weeks, limits your daily activities, or disturbs your sleep. Earlier evaluation is helpful if both shoulders are affected, if there is swelling, warmth, or redness, or if you have a known inflammatory condition. Seek prompt care if shoulder pain follows a significant injury or if the joint suddenly becomes very painful, swollen, and warm.
Frequently Asked Questions
What are the first signs of shoulder arthritis?
Early signs are usually a deep aching pain that worsens with activity, gradual stiffness, and difficulty reaching overhead or behind the back. Some people notice a grinding or clicking sensation and pain that disturbs sleep when lying on that side.
Can shoulder arthritis be cured?
The cartilage damage cannot be reversed, so there is no cure, but symptoms can often be controlled for years. Physical therapy, activity changes, medications, and injections help most people, and joint replacement can relieve severe, persistent pain.
Should I keep exercising with shoulder arthritis?
Yes, gentle, appropriate exercise usually helps by maintaining motion and strengthening the muscles that support the joint. A physical therapist can design a safe program. Avoid movements that sharply worsen pain, and balance activity with rest during flare-ups.
What is the difference between osteoarthritis and rheumatoid arthritis of the shoulder?
Osteoarthritis is age-related wear of the cartilage, usually affecting one shoulder. Rheumatoid arthritis is an autoimmune disease that attacks the joint lining, often involving both shoulders with warmth, swelling, and morning stiffness, and it requires specific medications.
When is shoulder replacement surgery considered?
Surgery is generally considered when pain is severe, limits daily activities and sleep, and has not improved with non-surgical treatments. The type of procedure depends on the kind of arthritis and the condition of the surrounding muscles, which your surgeon will assess.
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Arthritis of the Shoulder.
- Mayo Clinic. Osteoarthritis — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Osteoarthritis.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Arthritis.