DEGENERATIVE CONDITIONS OF THE SHOULDER

WHAT DEGENERATIVE CONDITIONS CAN AFFECT THE SHOULDER?

There are several types of shoulder arthritis. These include:

• Osteoarthritis
  Osteoarthritis, also known as degenerative arthritis, causes the cartilage that surrounds the bone to wear away, decreasing the protective space between the bones. This causes stiffness, swelling and pain, and is most common in people over the age of 50.
• Rheumatoid arthritis
  Rheumatoid arthritis is a chronic inflammatory disease that affects joints in various parts of the body, including the hands, wrists, knees and shoulders. The disease causes the lining of the joints to swell, causing pain and shoulder stiffness.
• Post-traumatic arthritis
  Post-traumatic arthritis occurs after an injury, such as a dislocation or fracture.
• Rotator cuff tear arthropathy (arthritis)
  Arthritis can develop after a rotator cuff tear has occurred and is left untreated. When tendons tear, the rotator cuff is unable to hold the humerus in place. This can lead to excessive rubbing of the humerus against the acromion and damage the bone's surface, leading to arthritis and considerable pain.
• Avascular Necrosis (Osteonecrosis)
  This painful condition develops as a result of a disruption in blood supply to the humerus. Bone cells cannot survive without blood, and therefore, avascular necrosis can result in serious damage to the shoulder joint and arthritis. The condition is caused by traumatic shoulder injuries such as fractures, as well as excessive steroid and alcohol use, and sickle-cell disease.

WHAT ARE THE SYMPTOMS OF ARTHRITIS?

Arthritis symptoms include considerable shoulder pain, stiffness, aching joints, neck pain, difficulty moving the arm in certain positions, and a grinding sound when moving the shoulder. Shoulder pain generally worsens with physical activity.

WHAT ARE THE TREATMENT OPTIONS?

If you are experiencing shoulder joint pain, your orthopaedic doctor will examine you to check for the following:

• Signs of previous shoulder injuries (such as sports injuries)
• Tendon injury
• Ligament injuries
• Injury to the muscles
• Areas of weakness, tenderness and pain

Your doctor may use x-rays to confirm the diagnosis before recommending one of the following non-surgical treatments:

• Shoulder exercises.
• Anti-inflammatory medications
• Anti-inflammatory diet
• Cortisone injections.

If your shoulder pain is not resolved, your doctor may recommend shoulder surgery. Surgery options include:

• Arthroscopy
  Certain types of arthritis can be treated with arthroscopy, during which your orthopaedic surgeon will clean out the inside of your joint. This procedure will provide temporary pain relief.
• Total shoulder replacement
  A plastic cup is placed into the shoulder socket, and a metal ball is attached to the top of the arm bone. This surgery is useful for those who suffer from severe shoulder pain and those who have tried other treatments such as medication, physical therapy and rest without success.

Dr Pirjol works with patients to exhaust all non-operative treatments available for degenerative diseases before recommending surgery.