When Your Aching Shoulder Leads to Joint Replacement

What’s the first thing they ask you to do in school?

Raise your hand. Right?

So, if it’s something you’ve practiced most of your life, why does it hurt so much now?

One possible answer: You may need a shoulder joint replacement, the third most common joint replacement after knees and hips.

“The shoulder is more complicated than some joints in the body,” says Dr. Pat Denton of McLeod Orthopaedics. “It’s actually several joints with muscles and tendons that enable a broad range of motion, enabling you to reach for your wallet, swing a golf club and hammer a nail.”

THE JOINT
Three bones comprise the shoulder joint. Your collarbone is also called the clavicle. Your shoulder blade is the scapula. And the upper part of your arm is the humerous. The arm fits into a socket in the shoulder blade, creating the ball-and-socket.

CAUSES
Wear and tear over a lifetime of raising your hand or throwing a ball can trigger osteoarthritis, the most common cause of shoulder joint deterioration.

Other reasons for shoulder joint failure include:

  • Rheumatoid arthritis – a chronic inflammation that can damage the cartilage in the joint.
  • Post-traumatic arthritis – following a fracture or serious shoulder injury.
  • Osteonecrosis (ah-stee-oh-neh-CROW-sis) – the bone dies when blood supply is interrupted.

SYMPTOMS
Generally a problem of middle age, shoulder damage from osteoarthritis appears slowly. Limitation of motion, swelling and pain are common symptoms.

NON-SURGICAL OPTIONS
Similar to early treatment for hip and knee problems, your Orthopedic Specialist will probably suggest over the-counter-medications – such as aspirin or ibuprofen — injections of steroids or gels, or physical therapy.

If these don’t provide long-term relief, joint replacement surgery – arthroplasty (ARH-thra-plas-tee)– is likely the next step.

SURGICAL OPTIONS

  • Hemi (or partial) Arthroplasty replaces just the head of the upper arm with a metal or ceramic component (ball and stem).
  • Total Arthroplasty replaces both the upper arm and the scapula with a cup to complete the ball-and-socket.
  • Reverse Total Arthroscopy is a less common procedure, where the stem-and-ball component is fitted in the shoulder and the cup on the top of the upper arm. People with a bad rotator cuff tear, severe arthritis or poor tendon function find this a better repair.

RECOVERY
Expect a hospital stay of only one night with physical therapy while you are there. Your arm will be immobilized in a sling for about a month. You will be given a physical therapy or exercise routine to follow when you get home.

Do not lift anything heavier than a glass of water for several weeks. And it will be 2 to 4 weeks before your doctor will allow you to drive.

FINAL THOUGHT
Don’t dismiss shoulder pain and limited range of motion as “just another part of aging.”If ibuprofen or aspirin do not stop the pain and return your regular range of motion, see an Orthopedic Specialist for tests, a diagnosis and treatment options.

Find an Orthopedic Specialist near you.

Sources include:  McLeod Health, American Academy of Orthopaedic Surgeons, Patient (UK), National Institutes of Health, Arthritis Research (UK), Arthritis Foundation