Arthritis is a degenerative disease caused by either wear and tear of the cartilage (osteoarthritis) or an inflammation (rheumatoid arthritis) of one or more joints. Arthritis not only affects joints, it may also affect supporting structures such as muscles, tendons, and ligaments.
The usual signs of arthritis of the shoulder are pain, particularly over the AC joint, and a decrease in shoulder motion. A doctor may suspect the patient has arthritis when there is both pain and swelling in the joint. The diagnosis may be confirmed by a physical examination and x-rays. Blood tests may be helpful for diagnosing rheumatoid arthritis, but other tests may be needed as well. Analysis of synovial fluid from the shoulder joint may be helpful in diagnosing some kinds of arthritis. Although arthroscopy permits direct visualization of damage to cartilage, tendons, and ligaments, and may confirm a diagnosis, it is usually done only if a repair procedure is to be performed.
Most often osteoarthritis of the shoulder is treated with nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, or cox-2 inhibitors. (Rheumatoid arthritis of the shoulder may require physical therapy and additional medicine, such as corticosteroids.) When non-operative treatment of arthritis of the shoulder fails to relieve pain or improve function, or when there is severe wear and tear of the joint causing parts to loosen and move out of place, shoulder joint replacement (arthroplasty) may provide better results. In this operation, a surgeon replaces the shoulder joint with an artificial ball for the top of the humerus and a cap (glenoid) for the scapula. Passive shoulder exercises (where someone else moves the arm to rotate the shoulder joint) are started soon after surgery. Patients begin exercising on their own about 3 to 6 weeks after surgery. Eventually, stretching and strengthening exercises become a major part of the rehabilitation program. The success of the operation often depends on the condition of rotator cuff muscles prior to surgery and the degree to which the patient follows the exercise program.
If you receive a shoulder injury, here's what you can do:
- Rest, Ice, Compression, and Elevation
- Reduce or stop using the injured area for 48 hours.
- Put an ice pack on the injured area for 20 minutes at a time, 4 to 8 times per day. Use a cold pack, ice bag, or a plastic bag filled with crushed ice that has been wrapped in a towel.
- Compression may help reduce the swelling. Compress the area with bandages, such as an elastic wrap, to help stabilize the shoulder.
- Keep the injured area elevated above the level of the heart. Use a pillow to help elevate the injury.
If pain and stiffness persist, see a doctor.
Source: The National Institute of Arthritis, Musculoskeletal and Skin Diseases
Last reviewed: May 2001
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