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Shoulder arthritis: Osteoarthritis, Chondrolysis, Rheumatoid Arthritis, Degenerative joint disease, and arthritis after shoulder surgery.
Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Wednesday, October 28, 2009
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Management and treatmentTreatment All
treatment should be performed on the recommendation of a qualified physician.
The non-operative management of shoulder arthritis may consist of gentle range
of motion exercises, such as those shown at our "Home Exercises for the Rough Shoulder" article and mild non-steroidal anti-inflammatory medications if these are well
tolerated by the individual (click here for more about FAQ about Arthritis Medications).
Sometimes modification of the use of the shoulder, such as reducing impact and
load, may be helpful.
Injections
of cortisone or other medications have not proved to be durably effective.
If
non-operative means are not successful, surgical reconstruction can be considered. Types of surgical reconstruction include the
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News Coverage of UW Medical Center's Innovative Shoulder Surgery Ream and run is a new and innovative shoulder replacement surgery designed for adults living an active life. This procedure was pioneered by Dr. Matsen, Chair of Orthopedics and Sports Medicine at the UW Medical Center.
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Dr. Matsen and Sarah Jackins, physical therapist with the UW Bone and Joint Center, discuss shoulder surgery with an emphasis on patient involvement in this UWTV video.
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Dr. Matsen discusses a new and innovative shoulder replacement surgery designed for adults living an active life.
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Dr. Matsen discusses a new and innovative shoulder replacement surgery featuring a reverse ball/socket technique that can lessen pain and improve function in shoulders with failed surgery or combined arthritis, rotator cuff tears and instability issues.
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Self-management The
patient may be able to improve the comfort and function of the shoulder with
home exercises and mild medication. However, these should be
performed only under the direction of a qualified physician. There are many
common sense approaches to managing arthritis (click here for more about FAQ about living with arthritis).Health care team Most
cases of advanced shoulder arthritis are managed by orthopedic surgeons with
special training in shoulder reconstruction. Less severe shoulder arthritis can
be managed by rheumatologists, physiatrists, and primary care physicians.Pain and fatigue An
important part of the management of the person with shoulder arthritis is to
manage the entire health of the individual (i.e. managing arthritis pain).
If the pain is severe enough to require narcotics, specialists in pain
management are often needed. If fatigue is a major feature of the condition,
evaluation by an internist or primary care physician is needed to exclude
factors such as anemia or underlying illness.Diet
Exercise and therapy When
recommended by a qualified physician, gentle exercises, such as those described
at the "home exercises for the rough shoulder" article may help with the stiffness associate with shoulder arthritis.Medications In milder
cases of shoulder arthritis, physicians may recommend non-narcotic medications
such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs
(NSAIDs) such as naproxen sodium (Aleve). These medications are not expected to
cure the condition, but may lessen its symptoms (FAQ about Arthritis Medications).
Dietary supplements, such as glucosamine and chondroitin sulphate have not been
proven to be effective in shoulder arthritis.Surgery Severe
cases of shoulder arthritis may require surgical treatment by a surgeon
specializing in this field. The types of surgery used for the different forms
of this condition include
- a
replacement of the ball of the arm bone (humeral hemiarthroplasty) along with a
re-shaping of the socket (glenoid). This procedure is called a ‘ream and run’
procedure or humeral hemiarthroplasty with a non-prosthetic glenoid
arthroplasty,
- a total
shoulder arthroplasty in which the replacement of the ball of the arm bone
(humeral hemiarthroplasty) is combined with the insertion of a plastic socket
(glenoid).
If the
rotator cuff is seriously torn or degenerated, the shoulder arthritis may
require
- a special
humeral head prosthesis, known as a CTA (cuff tear arthropathy) prosthesis,
- a reverse
ball and socket (Delta) total shoulder replacement arthroplasty.
Shoulder
arthroscopy has not been proven to be effective in the management of shoulder
arthritis. Joint aspiration Joint
aspiration is the process of removing some fluid from the sore joint. This
procedure is usually not helpful in the treatment of shoulder arthritis, unless
there is a suspicion of infection or gout.
Injecting
the joint with cortisone, steroids or other agents has not provided durable
benefit to affected shoulders.Splints or braces Splints
and braces have not proven helpful in managing shoulder arthritis.Alternative remedies Relaxation
techniques, such as meditation, visual imagery, progressive muscle relaxation,
yoga, or biofeedback may be helpful for people with shoulder arthritis, but the
benefit of these approaches has not been proven (click here for more about unproven remedies for arthritis)Social impacts The
limitations on social interactions imposed by shoulder arthritis can usually be
lessened by successful management (click here for more about "families and arthritis")Long-term management Individuals
with shoulder arthritis may require help with activities of daily living, such
as personal hygiene, shopping and housekeeping (click here for more about FAQ about living with arthritis)Unproven remedies It
often is difficult to be patient when suffering from shoulder arthritis. People
with shoulder arthritis might be tempted to try unproven treatments, such as
copper bracelets or magnets. The sensational successes advertised are usually
not supported by documented results. They even may be harmful and often keep
people from getting the medical care they really need. New treatments should be
discussed with a doctor and get his or her advice (click here for more about "unproven remedies for arthritis").
Surgery for Shoulder arthritis at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-BONE (2663) to make an appointment. Our clinical center is located in Seattle Washington, USA
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