Arthritis is defined as the pain that comes with the inflammation and stiffness of joints. This swelling can affect any joint in the body, but in this instance, the arthritis causes pain in the shoulder and arm of the patient. The shoulder is comprised of two major joints– the acromioclavicular, which is where the clavicle meets the shoulder bone, and the glenohumeral, which is where the arm bone meets the shoulder. There are a few different types of arthritis that can affect both of these joints within the shoulder.
There are three types of arthritis that commonly affect the shoulder:
Symptoms and Diagnosis
Pain is the most common indicator of shoulder arthritis. A limited range of motion may also accompany the pain, as well as difficulty sleeping due to extreme discomfort at night. During a physical examination, in addition to a review of your medical history, Dr. Urbanosky may look for any of the following symptoms:
An x-ray may also be taken, in which the physician would most likely see a narrowing of the space between the joint and an obvious change in the bone.
Once arthritis is diagnosed, there are a variety of nonsurgical treatments. Moist heat and ice will help prevent daily pain, as well as the use of anti-inflammatory medication. Physical therapy is also sometimes recommended. Simple daily accommodations in movement and activity level may help ease the pain.
The goal of many of physical therapy exercises is to stretch out and maintain mobility within the joint. One example of a stretch is an armpit stretch. In this case, the affected arm rests on a shelf or other raised level surface, and the patient bends at the knees to stretch out the armpit. After pain is controlling, the next level of therapy may aim to strengthen the shoulder muscles so the pain does not return. These are often performed using bungee cords or exercise tubes to add tension to the stretch.
If non-surgical options do not relieve symptoms, a physician such as Dr. Urbanosky may recommend surgery. Total shoulder replacement surgery is common for shoulder pain that persists for a long period of time and does not see improvement.
When shoulder replacement surgery is performed, both the ball and socket portions of the joint are replaced. Typically, the ball and stem are made of polished metal, and the socket is plastic. These implants act as a substitution for the damaged or diseased joint. The stem implant is inserted into the arm bone, and the rounded ball headpiece fits into the shoulder socket. These implants are usually held in place with cement, though there are recent developments in which the implant is made with material that encourages bone growth over time.
This surgery is mostly done under full anesthesia, though this depends on your overall health.
Depending on your condition, your physician may recommend a reverse total replacement. In this procedure, the portions of the joint are reversed, so the socket is attached to the arm bone and the ball is attached to the shoulder. This is most commonly seen in patients who have suffered rotator cuff injuries or severe arthritis. This procedure allows the patient to use the arm muscle, as opposed to the rotator cuff, to move the arm.
Post-surgery, a patient will be given pain medication for several days. After a two to three day hospitalization, a sling is worn to allow the shoulder to heal. Therapy, which typically begins the day after surgery, is also necessary to return to day-to-day functioning. Therapeutic exercises are prescribed multiple times a day and gradually get more difficult as the joint is able to handle more activity. Most patients improve dramatically within two weeks of surgery, but returning to activities such as driving and sports can take longer. Six weeks is the average recommended amount of time for modified activity.
To schedule a consultation with Dr. Urbanosky about your shoulder condition, please call: (815) 462-3474.
Labral Tears (including SLAP tear)
Total Shoulder Replacement
Total Shoulder Replacement Animations
Advantage TSR (shown top)
Global TRS (shown bottom)