Shoulder Arthritis

Shoulder arthritis is a degenerative condition that affects the cartilage within the shoulder joint. The shoulder consists of two main joints: the glenohumeral joint (the ball-and-socket joint where the upper arm bone meets the shoulder blade) and the acromioclavicular (AC) joint (where the collarbone meets the top of the shoulder blade). Arthritis can affect either of these joints, leading to pain, stiffness, and reduced mobility. As the cartilage wears down over time, the bones begin to rub against each other, causing inflammation and discomfort.

There are several types of shoulder arthritis, each with different causes and characteristics:

Osteoarthritis – Often referred to as wear-and-tear arthritis, osteoarthritis erodes the smooth lining of the joint, eventually causing the bones to rub together. This type of arthritis is more common in people over 50 years of age.
Post-Traumatic Arthritis – This form of arthritis arises after a specific injury or trauma to the joint, such as a previous fracture or dislocation, which damages the cartilage and leads to long-term joint degeneration.
Rotator Cuff Tear Arthritis – This type of arthritis can develop after long-standing rotator cuff tendon tears. The loss of the tendon function and the resulting instability of the shoulder can accelerate arthritis in the joint.
Rheumatoid Arthritis – An inflammatory condition that affects the lining of the joint, rheumatoid arthritis causes pain, swelling, and damage to the cartilage. Unlike osteoarthritis, rheumatoid arthritis is an autoimmune disease where the body’s immune system attacks the joint lining.

What Causes Shoulder Arthritis?

Several factors contribute to the development of shoulder arthritis:

Age – The natural wear and tear on the joints increases over time.
Previous injuries – Shoulder fractures, tendon ruptures or dislocations can increase the risk.
Repetitive shoulder movements – Common in athletes and those with physically demanding jobs.
Genetic predisposition – Family history of arthritis may increase susceptibility.
Inflammatory conditions – Rheumatoid arthritis and other autoimmune diseases can accelerate joint damage.

What are the Signs and Symptoms of Shoulder Arthritis?

The symptoms of shoulder arthritis typically develop gradually and worsen over time. Pain is one of the most common signs, often increasing with movement and worsening at night. Many people also experience stiffness, making it difficult to perform everyday tasks such as reaching overhead or behind the back. Some may notice a grinding or popping sensation due to the loss of smooth cartilage. Swelling around the joint can also occur, further contributing to discomfort and reduced range of motion.

How is the Condition Diagnosed?

To diagnose shoulder arthritis, a specialist like Mr Soong Chua will first take a detailed medical history and perform a physical examination. This involves assessing pain levels, joint movement, and any visible swelling. Imaging tests, such as X-rays and ultrasounds, help confirm the diagnosis by revealing joint space narrowing, bone spurs, or other degenerative changes. In some cases, an MRI or CT scan may be used to evaluate soft tissue structures and assess the extent of cartilage damage.

Non-surgical Treatment Options

Managing shoulder arthritis without surgery focuses on reducing pain and improving mobility. Mr Soong Chua may initially suggest non-surgical approaches to shoulder arthritis to help alleviate symptoms and slow the progression of the condition such as:

Rest
Pain relief medications – NSAIDs help reduce pain and inflammation.
Physiotherapy – Strengthening surrounding muscles can improve joint support.
Lifestyle modifications – Avoiding high-impact activities can help minimise symptoms.

Surgery

If non-surgical methods are not effective, surgical intervention may be necessary. The type of surgery depends on the severity of arthritis and your specific needs:

Arthroscopic Procedures – Arthroscopy is a minimally invasive surgical technique where a small camera and specialised instruments are inserted into the joint through tiny incisions. This procedure allows the surgeon to view the joint in real-time and clean out any damaged tissue, remove bone spurs, or smooth out rough cartilage. While arthroscopy can sometimes help reduce pain and improve joint function, it is usually considered a temporary solution, and may not be suitable, particularly for advanced arthritis

Joint Replacement Surgery – In more severe cases of arthritis, when the damage is extensive and non-surgical treatments no longer provide relief, shoulder replacement surgery may be necessary. In shoulder replacement surgery, the ball (head of the humerus) and socket (glenoid) are replaced with artificial components. There are three main types of shoulder replacement surgeries:
- Hemiarthroplasty – In this procedure, the ball is replaced while the native socket remains. This option may be used in suitable patients who have limited arthritis but is less common.

Total Shoulder Replacement – In this procedure, both the ball (head of the humerus) and the socket (glenoid) of the shoulder joint are replaced with artificial components. This surgery is aimed at relieving pain and improving function.

Reverse Shoulder Replacement – This is a more complex procedure where the ball and socket are reversed (link to reverse page). It is often performed in cases where there is significant rotator cuff damage or arthritis that has caused severe loss of shoulder function. This procedure helps to improve stability and function, particularly for patients who have failed previous treatments.

When to see a specialist for shoulder arthritis?

It is important to consult a specialist if shoulder pain persists, if there is a significant loss of function, or if arthritis symptoms start interfering with daily life. Mr Soong Chua is an experienced orthopaedic surgeon who can assess the condition and recommend the most suitable treatment approach.

FAQs

Can shoulder arthritis be cured?
While there is no cure for arthritis, various treatments can help manage symptoms and improve quality of life.
Will exercise make arthritis worse?
Gentle, low-impact exercises can help maintain mobility and strengthen the joint. However, high-impact activities that cause pain should be avoided.
How long does recovery take after shoulder replacement surgery?
Recovery typically takes several months and includes physiotherapy to regain strength and movement.