Shoulder arthritis of the main ball and socket joint, also known as the glenohumeral joint, results in pain and stiffness in the shoulder. This pain is provoked by a loss of cartilage which normally allows the bones to move smoothly over one another and prevents rubbing.
Can glenohumeral arthritis be treated?
Osteoarthritis – the most common form of arthritis – is a degenerative disease. This means that it will worsen over time if repeat x-rays or scans are taken. In most cases this also means that pain and stiffness will increase over time. There are effective treatments that can help, or even reverse, symptoms. However, it is possible for the disease to become ‘too far gone’ for treatments to be completely effective, and for this reason it is important to get a diagnosis as early as possible so your orthopaedic consultant can help you to make informed decisions about your treatment.
What is it?
Your shoulder is made up of three bones – the scapula or shoulder blade, the humerus or upper arm bone and the clavicle or collarbone. There are two joints in your shoulder that can be affected by arthritis – the acromioclavicular (AC) joint where the clavicle meets the top of the shoulder blade (acromion) and the glenohumeral joint where the head of the humerus fits into the socket (glenoid) formed from the scapula.
There are different types of arthritis. The most common is osteoarthritis which is associated with ageing. Also called wear and tear arthritis, it mostly affects people over 50 and occurs more frequently in the acromioclavicular joint than the glenohumeral joint. When you have osteoarthritis, the articular cartilage wears away, losing its smoothness and becoming rough. Without this cartilage to cushion the ends of the bones and protect them from impacting one another, they can rub against each other causing pain from small fractures and inflammation. Bone spurs normally develop and further affect your ability to move your shoulder.
Other types of shoulder arthritis include:
- Rheumatoid arthritis – this is an autoimmune condition which means the body’s own immune system attacks healthy tissue, including cartilage and ligaments, and softens the bones.
- Post-traumatic arthritis – this can occur after a serious shoulder injury such as a fracture or dislocation. It is a form of provoked osteoarthritis.
- Rotator cuff tear arthropathy – this can develop after a large rotator cuff tendon tear because a torn rotator cuff is unable to hold the head of the humerus (the ball) properly in the glenoid socket. As the humerus moves around, it can rub against the acromion and this can result in damage to the surface of the bones.
Symptoms of glenohumeral arthritis
Shoulder arthritis causes pain which is often made worse by movement and may make sleeping difficult. Pain levels tend to increase as the disease develops. If the glenohumeral joint is affected, the pain will be in the side or back of the shoulder and may feel like a deep ache inside the joint. AC joint arthritis causes pain at the top of the shoulder which may travel to the side of the neck. Rheumatoid arthritis can affect both the glenohumeral and the AC joint and may cause pain throughout the shoulder.
Other common symptoms include shoulder stiffness and loss of movement which may make it difficult to perform everyday tasks, such as brushing your hair or reaching above your head.
Causes of glenohumeral arthritis
As outlined above, different types of arthritis have different causes but the most common – osteoarthritis – is caused by wear and tear in the joint linked to ageing, but predisposed by the shape and interplay of the bones in you shoulder.
While it is not possible to prevent arthritis although there are measures you can take to alleviate symptoms of the disease.
Diagnosis of glenohumeral arthritis
When we diagnose shoulder arthritis, we carry out a thorough physical examination and take your medical history. We may perform tests – such as X-ray, CT scan or MRI – to rule out other possible causes of joint pain, such as rotator cuff disease. In some cases, we may use ultrasound-guided injections of local anaesthetic to pinpoint the exact location of pain.
Treatment of glenohumeral arthritis
Treatment will depend on the type of arthritis you have and how advanced your symptoms and the disease are. Among the treatments that may help are:
- Physiotherapy to stretch and strengthen your shoulder muscles and improve the range of motion in the joint.
- Medication including anti-inflammatories which can help you to cope with the pain and reduce inflammation in the joint.
- Therapeutic injections of corticosteroids which may help to reduce inflammation and relieve joint pain and stiffness. You may also be offered hyaluronic acid injections which help to lubricate the shoulder joint.
- Surgery may be offered for the most severe symptoms. Shoulder socket replacements tend to have a shorter lifespan than other more common types of joint replacement surgery (knee and hip) so younger patients may be encouraged to delay surgery as long as possible, or to only have the ball replaced, but it depends on the rate of deterioration in disease and symptoms. Keyhole surgery techniques can sometimes be helpful in patients with very early arthritis.
If you are experiencing symptoms of glenohumeral arthritis and would like to discuss a diagnosis, or if you would like to explore treatment options, contact us for more information.
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
Hospital of St John and St Elizabeth, St John’s Wood – Directions
BMI The Syon Clinic, Brentford – Directions
HCA Chiswick Health Centre, Chiswick – Directions
West Middlesex University Hospital, Chelsea and Westminster Foundation Trust, Isleworth – Directions