Glenohumeral arthritis – also called shoulder arthritis or shoulder osteoarthritis – is a degenerative condition that causes worsening pain and stiffness in the shoulder joint.
What causes glenohumeral osteoarthritis?
The condition is linked to ageing, as wear and tear of the shoulder joint over time can cause the cartilage lining the joint to become thin and less flexible. Glenohumeral arthritis occurs most frequently in people over the age of 50.
There are other risk factors that can increase your chances of developing glenohumeral arthritis. If you sustain serious trauma to your shoulder, such as a fracture or dislocation, you may be more susceptible to shoulder osteoarthritis later in life.
In most cases doctors now recognise that the condition is related to a particular shape of shoulder socket and shoulder blade which means more stress is put through the shoulder joint over the course of an individual’s life.
Rheumatoid arthritis is an autoimmune disease and, along with other forms of arthritis like gout, it can make you predisposed to osteoarthritis.
Symptoms of glenohumeral osteoarthritis
The most obvious symptom of glenohumeral arthritis is pain, which is normally felt deep in the shoulder, but is often also felt down the front or the side of the upper arm. It may be experienced as a dull ache or intermittent pain at night which can make it difficult to sleep. The shoulder may feel stiff and swollen and difficult to move, making everyday activities like brushing your hair difficult.
Some people feel as though the shoulder is catching as it moves and this may be accompanied by a popping sensation or crunching sound, which is referred to as crepitus. The pain of shoulder arthritis may lead you to start restricting normal movement, including lifting, and this can lead to muscle weakness. Inactivity makes the shoulder feel stiff and sore so it may be particularly painful when you first get out of bed in the morning.
However, intense activity like golf or tennis can also cause a flare-up of pain. In the early stages, the pain may come and go, however as arthritis worsens it may become more persistent and severe.
Diagnosing glenohumeral osteoarthritis
Your doctor will carry out a physical examination and ask about your symptoms. They will want to rule out other possible causes of shoulder pain – such as bursitis, rotator cuff tears or shoulder impingement – so they may suggest a range of diagnostic tests including an X-ray which can reveal fractures, bony spurs (which can occur when there is a loss of cartilage in the joint) and a narrowing of the space between the head of the humerus and the socket. MRI scans can provide detailed images of the soft tissue and may be used if a torn rotator cuff is suspected or the diagnosis of arthritis is not clear on an X-ray. If surgery is being considered, You may also be offered a CT scan which helps the surgeon assess the pattern of arthritis and plan surgery better. Laboratory testing may be used to rule out conditions like rheumatoid arthritis or infections, which can also cause shoulder pain.
Treating glenohumeral osteoarthritis
The recommended treatment plan will depend on a range of factors, including how advanced the osteoarthritis is, your age, lifestyle and general state of health. With mild glenohumeral arthritis it is possible to manage the symptoms by avoiding activities that exacerbate the pain, applying heat to loosen up a stiff joint and a cold compress after activity to reduce swelling. Taking painkillers can help to relieve pain and a physiotherapist can recommend strengthening and stretching exercises to relieve stiffness and increase flexibility. As the condition starts to worsen and your shoulder joint deteriorates you may want to consider injections of steroids into the affected area to relieve pain.
Surgery for glenohumeral osteoarthritis
Painful glenohumeral arthritis that has not responded to non-surgical treatment is normally treated surgically. For some people who do not have severe arthritis on X-ray an arthroscopic (keyhole) surgery may produce some improvement without curing the problem. The most effective surgery is usually a shoulder replacement, of which there are different types. A hemiarthroplasty entails replacing the humeral head and leaving the natural shoulder socket intact. This may be particularly beneficial for younger people in whom it would be advantageous to maintain as much bone in the socket as possible for the future. An anatomic total shoulder replacement, by contrast, involves replacing both the ball and the socket it with an artificial implant, however the socket component can wear out after around 10 years, depending on how much the arm is used. In some cases, you may be offered a reverse total shoulder replacement, which is where the ball and socket part of the joint are reversed. This may be especially helpful if you have a torn rotator cuff, very severe stiffness, or profound bone changes due to the arthritis.
Your orthopaedic surgeon will discuss your symptoms and recommend an approach that is best suited to you. If you would like more information about diagnosing and treating shoulder pain, including the options for managing glenohumeral arthritis, contact us.
Orthopaedic Consultant & Surgeon | London
Thames Shoulder & Elbow are able to provide advice and support to anyone experiencing symptoms affecting the upper limbs (shoulder, upper arm, elbow, forearm and wrist).
Telephone: 020 376 15987
Email: admin@thamesshoulderandelbow.co.uk
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