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Shoulder osteoarthritis

Shoulder Osteoarthritis

Shoulder osteoarthritis is a slow breakdown of cartilage in the joints. Cartilage is a firm, flexible connective tissue that protects the ends of the bones in the joints.

There are two main joints in the shoulder:

  • AC joint (acromioclavicular)
  • Glenohumeral joint.

The AC joint is the joint on the top of the shoulder where a chunk of the shoulder blade (the acromion) meets up with the collar bone (the clavicle). With ageing, this joint often becomes arthritic, with bone spur formation and loss of cartilage between the bones. This can cause pain in the top of the shoulder with overhead movement or reaching across the body. It can also cause tenderness or pain with pressure on it from a backpack strap, bra strap, or any other pressure.

The glenohumeral joint, though, has implausible motion. It is the junction of the glenoid (the cup or saucer) and the humeral head (the ball in the shoulder). This is the joint that let the shoulder to move over a higher range than any other joint in the body. Over time, this can also become arthritic. When the main shoulder joint (the glenohumeral joint) becomes arthritic, shoulder motion may reduce. This can be painful and may cause stiffness. When one or more of these joints are affected by arthritis, even simple activities can become difficult.

Symptoms

  • Swelling
  • Pain
  • Limited motion
  • Weakness are all common symptoms of arthritis

Other indicators may also occur, depending on the type and strictness of the disease, location in the body, and other factors.

Causes

  • Osteoarthritis—This progressive condition is caused by extreme use; wear and tear that occurs as part of the ageing process; or fissures, sprains, dislocations or other traumatic injuries that damage or destroy the smooth articular cartilage covering the ends of bones
  • Rheumatoid arthritis—This is a chronic, autoimmune disease that causes the immune system to attack and damage normal tissue, including many joints throughout the body

Diagnosis

To diagnose arthritis of the shoulder, and the category of disease, your physician may use a variety of diagnostic tools, including patient history, physical examination, blood tests, and X-rays. When X-rays appear normal, but arthritis is still suspected, an MRI can show more detail. Arthroscopy may also be used to allow direct inspection of the joint.

Non-surgical Treatment

There are several options for nonsurgical treatment of arthritis, depending upon how far the disease has progressed; how many joints are involved; your age, activity level and other medical conditions; whether the dominant hand is affected; your personal goals and home support structure; and your ability to understand your treatment and comply with a therapy program. Following a prescribed exercise program can also help improve strength and range of motion in the affected joint.

  • Medications—Although they offer relief for symptoms, medications cannot restore joint cartilage or reverse the damage. Anti-inflammatories are the most commonly used because they stop the body from producing chemicals that led to joint inflammation and pain. These include over-the-counter options such as aspirin and ibuprofen, as well as certain prescription medications. Acetaminophen is not an anti-inflammatory, but it can be used to help relieve the pain of arthritis.
  • Glucosamine and Chondroitin—Dietary supplements or nutraceuticals such as these are also widely advertised. These compounds are the “building blocks” of cartilage, they are not drugs. Originally used by veterinarians to treat arthritic hips in dogs, although in most studies of these nutraceuticals, no difference between placebo and the nutraceuticals have been found.
  • Injections—These may be used when anti-inflammatory medication is not appropriate. Typically containing an anaesthetic and a steroid, injections can offer pain relief for weeks or even months.
  • Physical therapy—Your physician or physical therapist may prescribe specific exercises to help you recover strength and flexibility, improve movement.

If the Nonsurgical Treatment is unsuccessful, surgery may be needed.

Surgery

When nonsurgical treatment does not provide the desired outcome, a variety of surgical options may be considered. For the AC joint, shoulder arthroscopy with a distal clavicle excision (removing the end of the collar bone to open space between the two bones) will usually provide permanent relief of pain. For glenohumeral arthritis (the main shoulder joint), shoulder resurfacing or replacement surgery can greatly improve symptoms.

Recovery

Following surgery, a trained therapist will help you maximize your recovery. The length of time needed for recovery varies, depending on the extent of the surgery and individual factors. Most people can return to most, if not all, of their daily activities about three months after major joint reconstruction.

Connect with Dr. Reetadyuti Mukhopadhyay, Consultant – Orthopaedics at the CK Birla Hospital for Women in Gurgaon, specialised in Shoulder, Arthroscopy & Sports Injury. Book an Appointment today!

 
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