Arthritis is one of the most common health issues faced by people around the world. Often regarded as the “old people’s disease”, arthritis can occur to anyone at any age, including adolescents and children.
Arthritis comes from a combination of two words – the Greek word “arthron” which means joint and the Latin word “itis” which means inflammation. Literally, arthritis stands for an inflamed joint. It occurs when the smooth cartilage covering any moving surface of a joint is damaged, leading to an eventual loss of the cartilage. This leads to a “bone on bone” situation, causing severe pain to the patients.
Arthritis is a health complication that leads to the tenderness and inflammation of one or more joints in your body. Arthritis in the upper back and shoulder is fairly common in people all over the country for which patients seek suitable medical support. In this blog, we would limit our discussion to shoulder arthritis.
The shoulder is the most common joint to be affected by arthritis after the hip and knee. This is because, for most people, the shoulders are the areas that do not have weight-bearing joints like the ones present in the lower limbs. Just like in the case of knees and hips, shoulder arthritis involves the loss of cartilage that leads to severe pain, stiffness in joints, and limited function. It also affects day-to-day functionality and the quality of life of the patients.
There are several treatments, surgical as well as non-surgical, that reduce the symptoms and help the patients lead normal lives.
Anatomy Of A Normal Shoulder
To understand shoulder arthritis and its different types, it is important to understand the anatomy of a normal and healthy shoulder. Your shoulder is made up of a number of different bones. The upper end of your arm bone (humerus) ends in a ball-shaped structure called the “humeral head”. This structure rests against the glenoid, a socket that is a part of the scapula.
Unlike the hip (which is also a ball-socket joint having a deeper socket for stability), the shoulder is built for motion instead of stability. In fact, the shoulder is capable of the most amount of motion as compared to any other joint in the body. For movement, the ball-like portion of the shoulder joint moves against the socket. However, as the former rests against the latter instead of being contained within, the ball-like portion relies on the soft tissues between the two bones for movement and stability. The joint is stabilized by ligaments (cords attaching the ball and socket of the joint) as well as tendons (tissues attaching muscles to bones).
It is the tendons in your shoulder that help the ball rotate resting against the socket and are therefore called the rotator cuff tendons. Four of these rotator cuff tendons provide stability and movement to your shoulder and are often subject to injury, degeneration, and wear and tear.
Types Of Shoulder Arthritis
Now that we are aware of the anatomy of a normal shoulder, let us understand the different types of shoulder arthritis. Here, we will discuss the five major shoulder arthritis issues that affect numerous patients around the world:
- Rheumatoid arthritis
- Post-traumatic arthritis
- Avascular necrosis
- Rotator cuff tear arthropathy
Rheumatoid arthritis is a common type of shoulder arthritis. It is an autoimmune condition that affects both sides of the body, leading to the symptoms being experienced in both the shoulders. Even if one of your shoulders is affected by rheumatoid arthritis, it is very likely that it would show its effects on the other shoulder as well.
Rheumatoid arthritis causes warmth, tenderness, and swelling in your shoulders. In most cases, patients suffer from stiffness in their shoulders when they wake up in the morning. It leads to the formation of rheumatoid nodules, the bumps that form under your skin or a similar pressure surface such as elbows, shoulder joints, or finger joints.
Some other symptoms of rheumatoid arthritis also include fatigue, fever, and weight loss. The stiffness and pain in the shoulder are the results of swelling in your joint linings. If not treated, the issue can escalate, leading to erosion of your shoulder bones and deformity of your shoulder joints.
Osteoarthritis is the most common type of shoulder arthritis. It is caused due to cartilage breakdown at the ends of your bones, the areas where they meet to form joints. As these ends of bones meet and rub together, the cartilage loss leads to pain, stiffness, and a loss of mobility in joints.
Along with shoulders, osteoarthritis is likely to affect other joints present in your knees, hips, and hands. While everyone is susceptible to this health complication, osteoarthritis generally occurs in patients over the age of 50. The issue leads to any and every activity of the shoulder resulting in pain, making movement difficult.
If osteoarthritis is ignored and left untreated for a long time, it tends to worsen, leading to further loss of movement, joint instability, and muscle weakness.
Post-traumatic arthritis is shoulder arthritis that occurs after the patient goes through a bone fracture or shoulder dislocation. It is essentially a side-effect of the trauma (fracture or dislocation) an individual experiences and the effect it has on their bones.
While most post-traumatic arthritis cases are resolved on their own after a few months, the condition can become chronic if the symptoms do not reduce after six months. If you leave the health complication untreated even after the symptoms persist, it may lead to permanent issues such as the hardening of bones, change of bone shapes, bumpy bones, and more.
Avascular necrosis is a health complication that can lead to shoulder arthritis. It is caused due to a disruption in the supply of blood to the bones, resulting in the bones getting weaker. If not treated, it can lead to your bones slowly collapsing and damaging the cartilage that covers them.
Avascular necrosis is more common than post-traumatic arthritis in the shoulder and can lead to shoulder arthritis if the head of your humerus bone does not receive blood supply for a long period of time. There are several causes of avascular necrosis, including alcohol abuse, sickle cell disease, traumatic injuries, and more. It is also possible for a case to have no precise cause of avascular necrosis, an issue known as idiopathic avascular necrosis.
If avascular necrosis is not given proper attention, it can worsen from mild bone damage to severe pain and damage that may call for surgical intervention.
Rotator Cuff Tear Arthropathy
Your rotator cuff connects your shoulder blade to the topmost region of your arm with the help of a collection of tendons and ligaments. A serious injury to your rotator cuff may lead to a type of shoulder arthritis known as rotator cuff arthropathy. Rotator cuff arthropathy is more common in the shoulder as compared to avascular necrosis.
When you get your rotator cuff torn, it leads to a loss of movement, joint pressure, stability, and movement in the shoulder. If the damage is serious and the rotator cuff is not able to heal properly due to a tear that is too big, it causes bone and cartilage damage, leading to rotator cuff tear arthropathy.
This shoulder arthritis can cause severe pain and weakness in the patients. If it is not treated on time, rotator cuff arthropathy can even make it difficult for a patient to lift their arm above their head.
How Is Shoulder Arthritis Diagnosed?
It is important to get your shoulder arthritis diagnosed before the issue worsens and leads to further complications. In most cases, the first sign of shoulder arthritis is pain in the general area. The degree and consistency of the pain may vary for different patients. While some patients may feel severe pain in their shoulder joints, others may experience radiating pain around their necks.
Another major sign of shoulder arthritis is a limited scope of movement and increasing stiffness in the shoulder region. If you have had a shoulder injury and/or are experiencing stiffness in the region that is not going away, you should immediately consult a doctor and get the issue resolved. Doctors generally examine the affected region for muscle tenderness, weakness, a grating sensation in the joint when moved, and the range of movement.
If the initial diagnosis shows signs of shoulder arthritis, a doctor would recommend shoulder getting a shoulder X-ray report taken to see what the issue exactly is. Finally, a doctor would inject a local anaesthetic into the affected joint where you feel the radiating pain. If the pain is momentarily relieved, your chances of being diagnosed with arthritis are high.
The Final Word
While it is pretty difficult to live with shoulder arthritis with the condition causing pain and discomfort, the symptoms can be relieved by getting adequate treatment. The key to tackling shoulder arthritis is to prevent things from getting worse and seek medical attention as soon as you notice even the smallest signs of danger.