Arthritis
of the Shoulder
What
Is Arthritis of the Shoulder?
Arthritis is a degenerative
disease caused by either wear and tear (osteoarthritis) or an
inflammation (rheumatoid arthritis) of one or more joints. Arthritis
not only affects joints; it may secondarily affect supporting
structures such as muscles, tendons, and ligaments.
What
Are the Signs of Shoulder Arthritis and How Is It Diagnosed?
The usual signs of
arthritis of the shoulder are pain, particularly over the AC
joint, and a decrease in shoulder motion. A doctor may suspect
the patient has arthritis when there is both pain and swelling
in the joint. The diagnosis may be confirmed by a physical examination
and x rays. Blood tests may be helpful for diagnosing rheumatoid
arthritis, but other tests may be needed as well. Analysis of
synovial fluid from the shoulder joint may be helpful in diagnosing
some kinds of arthritis. Although arthroscopy permits direct
visualization of damage to cartilage, tendons, and ligaments,
and may confirm a diagnosis, it is usually only done if a repair
procedure is to be performed.
How
Is Arthritis of the Shoulder Treated?
Most often osteoarthritis
of the shoulder is treated with nonsteroidal anti- inflammatory
drugs such as aspirin or ibuprofen. (Rheumatoid arthritis of
the shoulder may require physical therapy and additional medicine,
such as corticosteroids.) When conservative treatment of osteoarthritis
of the shoulder fails to relieve pain or improve function, or
when there is severe deterioration of the joint causing parts
to loosen and move out of place, shoulder joint replacement
(arthroplasty) may provide better results. In this operation,
a surgeon replaces the shoulder joint with an artificial ball
for the humerus and a cap (glenoid) for the scapula. Passive
shoulder exercises (where someone else moves the arm to rotate
the shoulder joint) are started soon after surgery. Patients
begin exercising on their own about 3 to 6 weeks after surgery.
Eventually, stretching and strengthening exercises become a
major part of the rehabilitation program. The success of the
operation often depends on the condition of rotator cuff muscles
prior to surgery and the degree to which the patient follows
the exercise program.
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