Dr Nitesh Bhagwan of Maritzburg Orthopaedic Centre explains shoulder arthritis – a common medical condition – which can be easily treated if detected early enough.
Shoulder arthritis is damage to the cartilage inside the shoulder joint. When the cartilage – which covers both the ball (the humeral head) and the socket (the glenoid) – begins to break down on the surface and eventually in the deeper layers, arthritis develops.
TYPES OF SHOULDER ARTHRITIS
There are several different forms of shoulder arthritis. Each may have different origins, and some causes of shoulder arthritis are still unknown.
Osteoarthritis of the shoulder is also known as degenerative joint disease, and is often associated with wear and tear related to ageing. It can also affect other joints and is the most common form of arthritis.
Rotator cuff tear arthritis can develop after a massive and prolonged rotator cuff tear. The four rotator cuff tendons in your shoulder wrap around the ball portion of the shoulder joint, and hold it in place. If one or more of these tendons is heavily torn, this may cause the humeral head to rub against other bones and develop arthritis.
The amount of cartilage loss varies from person to person and so do symptoms of shoulder arthritis. These are:
Pain in the shoulder joint is the major sign of arthritis.
Stiffness of the joint may be experienced as a loss of range of motion in the shoulder.
Grinding, clicking or cracking (crepitus) may be felt since the surface of the cartilage is irregular.
To diagnose shoulder arthritis, your orthopaedic surgeon will perform a physical exam and ask questions about your symptoms and medical history. The degree of arthritis and the amount of bone in the socket can be evaluated and confirmed with an X-ray or, if needed, with a CT scan.
The initial treatment for shoulder arthritis is non-operative. However, range-of-motion exercises are usually necessary to keep the shoulder mobile. Strengthening the shoulder that has arthritis is usually not recommended, as in some instances it could cause more pain. A physiotherapist may help with a home-based programme.
Lifestyle Modifications: The idea is to avoid, within reason, the things that make the shoulder painful. If shoulder pain lasts for several days and wakes you up at night, it may be reasonable to question how important that activity is to you.
Pain Control: Medication such as paracetamol and anti-inflammatories can be used (in consultation with your family doctor). Injections for shoulder arthritis include cortisone which has a potent anti-inflammatory effect, and hyaluronic acid which is a naturally-acting lubricant.
Shoulder Replacement Surgery: Shoulder replacement is the preferred procedure for the bone-on-bone shoulder arthritis. It relieves the pain of arthritis, and has been shown to last for many years.
A standard total shoulder replacement procedure replaces the ball and the socket parts of the shoulder joint with artificial parts. However, in a revers total shoulder replacement procedure, the ball and socket sides of the joint switch places. This procedure can be done for many conditions, but it’s mainly used when there is a rotator cuff tear in the shoulder with arthritis.
Shoulder joint arthritis can be disabling and have a significant impact on quality of life. Fortunately, there are both effective non-operative and operative treatments, depending on the severity and degree of impairment.
Early detection and treatment can go a long way to avoid pain and discomfort. It is worth consulting with a professional in the field at the first signs that something could be wrong.
Maritzburg Orthopaedic Centre has a tradition of excellence in orthopaedic care, and the fine reputation of its member physicians is known throughout KwaZulu-Natal. Each surgeon in the group is board certified and many have additional sub-specialty training.
Dr Nitesh Bhagwan is an Orthopaedic Surgeon with a special interest in shoulder replacements, arthroscopic rotator cuff repair, and shoulder reconstructions.
He was awarded the South African Shoulder Society Fellowship in 2007 and continues to maintain a strong interest in orthopaedic research and teaching.
He treats patients at both community level as well as high-performance athletes and has performed more than 3 500 shoulder arthroscopies and 600 shoulder replacements.
Dr Bhagwan combines clinical knowledge and experience with scientific evidence to provide the best advice and management possible to patients from Pietermaritzburg, the Midlands and the Upper Highway areas.
MEET THE TEAM:
- Dr Andre Morrish Hip and Knee Specialist
- Dr Nitesh Bhagwan Shoulder and Elbow Specialist
- Dr Ian Cochrane Spine and Arthroplasty Specialist
- Dr Greg Van Asch Hip, Knee and Trauma Specialist
- Dr Paul Hatfield Hand and Wrist Specialist
- Dr Ruvyn Frank Foot and Ankle Specialist
- Dr Jacques De Wet Tumour, Reconstruction and Deformity Specialist
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