We don’t walk on our shoulders like we do on our knees and hips. So, you typically don’t develop wear-and-tear osteoarthritis in a shoulder in the way you do in the knee and hip.
“Most of the time shoulder problems are related to other factors. Probably the most common injury is when people tear the shoulder’s rotator cuff,” says McLeod Orthopedic Surgeon Thomas DiStefano, MD. “Previous damage — falls and fractures — alter the anatomy, leading to arthritis. Rheumatoid arthritis, which is different from wear-and-tear arthritis works to destroy the joint. There can be a loss of blood supply to the head of the bone running from the should to the elbow or the ball of the shoulder. That condition can lead to the joint dying, causing severe arthritis.”
When you’re younger, the rotator cuff is very strong with injuries relatively uncommon. As we get older, the rotator cuff thins out. Over age 45, the rotator cuff injuries become more common with tendinitis, partial and, even, full tears.
People feel pain on the outside of their shoulder, radiating down to the elbow. A person may have difficulty doing things above their shoulder or sleeping on that side. Night pain, is probably the most common reason a person comes in with a shoulder problem.
We always look at surgery as a last resort. We try other approaches first, because you want to try to avoid surgery.
Nonsurgical treatments include modifying your activity. Try not to perform actions that require you lifting your arm above the shoulder. Keep your arm tight to your body. The combination heat and cold is very helpful. Warm compresses help to relax the muscles; ice helps to keep inflammation and swelling down.
Over-the-counter anti-inflammatory medicine, such as Ibuprofen and Tylenol, offer temporary relief. We often recommend, glucosamine and over-the-counter joint vitamins. They don’t have any side effects and can often help patients. When these simpler efforts don’t clear up the shoulder pain, it’s time to see an Orthopedic Specialist.
Physical therapy will be recommended to regain the range of motion and strength, a common problem. Next, we might try cortisone injections. If these efforts don’t clear up the problem, a patient might have X-rays or an MRI to look at the soft tissues or see if there’s any structural damage. Depending on what the images show, a patient can be schedule for surgery, even shoulder joint replacement.