Springfield, Pa. – When you hear the term “arthritis,” most people think of a condition that affects the hands, knees or hips. What many of us may not realize is that arthritis can occur in any joint in the body.
The shoulder is one of our most active and overused joints. If you think about it, most routine activities and tasks can only be completed if one or both of the shoulders are working properly. Throwing a ball, reaching up for an item on a shelf, even driving a car can be quite painful for those who suffer from shoulder arthritis.
“Shoulder arthritis is the wearing away of normal joint cartilage causing rough, irregular joint surfaces and the production of bone spurs,” says Dean Trevlyn, M.D., shoulder specialist and orthopaedic surgeon with the Crozer-Keystone Human Motion Institute at Delaware County Memorial Hospital. “It can be caused by trauma (such as fractures or shoulder dislocations) and by repetitive stresses on the shoulder (such as strenuous overhead lifting or repetitive pushing and pulling). Often, there is a family history of arthritis which can predispose a person to develop arthritis.”
“Although the most common type of shoulder arthritis is osteoarthritis or ‘wear and tear’ arthritis, other types such as rheumatoid arthritis, post-traumatic arthritis, or the arthritis which develops following severe rotator cuff tears are not uncommon,” says Ronald Rosenfeld, M.D., chief of the Division of Orthopaedics at Springfield Hospital.
“The most common symptoms are pain with shoulder movement, a limitation of motion and a cracking or popping sensation on movement,” Trevlyn says. “People at risk would include anyone that has had one or more dislocations of the shoulder, anyone that has had a severe shoulder fracture, those with a family history of arthritis, and anyone that does repetitive, strenuous lifting.”
“Although shoulder arthritis is not uncommon, the most common causes of shoulder pain — tendonitis, bursitis, or tears of the rotator cuff — are treated differently,” Rosenfeld says. “Other significant conditions, such as problems in the cervical spine (neck) area or in the chest can present as shoulder pain and must be considered. Early evaluation of your shoulder pain by an orthopaedic surgeon is recommended to obtain an accurate diagnosis so that the most effective treatments can be started early.”
Fortunately, Crozer-Keystone hospitals have renowned orthopaedic surgeons on staff who specialize in the treatment and surgical repair of shoulder injuries and arthritis.
“When you see an orthopaedic surgeon for a shoulder problem, the first thing he or she will do is get your medical history,” says Jack Kazanjian, D.O., shoulder specialist and orthopaedic surgeon with the Crozer-Keystone Human Motion Institute at Delaware County Memorial Hospital. “Your doctor will do a comprehensive examination of the shoulder — checking for weakness, pain and tenderness — and will most likely refer you for imaging studies (such as X-ray or MRI).”
First-line treatment can include medication and/or physical therapy. “Once a diagnosis of arthritis is made, patients may benefit from over-the-counter anti-inflammatory medications (such as ibuprofen or sodium naproxen) and an exercise program,” says James McGlynn, M.D., shoulder specialist and orthopaedic surgeon with the Crozer-Keystone Human Motion Institute at Crozer-Chester Medical Center. “This helps them regain or maintain an adequate range-of-motion and strength so that they are able to perform activities of daily living as well as recreational activities. Coupled with periodic corticosteroid injections, these conservative treatments can allow most people with shoulder arthritis to maintain an active lifestyle. It’s only when these options fail to work that I would recommend activity modification as well as other more aggressive options, such as a surgical procedure.”
Surgery has proven to be very effective at reducing pain and getting sufferers back to their activities of daily living. “Experience matters,” says Charles Hummer III, M.D., orthopaedic surgeon with the Crozer-Keystone Human Motion Institute at Crozer-Chester Medical Center. “Whatever the procedure, it’s important that every surgeon is able to rely on their experience to treat a patient in a manner that he or she determines to be the best.”
“Our orthopaedic surgeons have many years of experience doing the traditional as well as newer techniques to repair joints that have been damaged by arthritis,” adds Jeffrey Malumed, M.D., co-chief of the
Section of Orthopaedic Surgery at Taylor Hospital. “We can do total shoulder replacements, arthroscopy, and reverse shoulder replacements. Reverse shoulder replacements are for patients who have longstanding severe, complete rotator cuff tears with arthritis.”
After about six months of rehabilitation, most patients regain full use of their shoulder. You may need to modify activities and restrict others — for example, no more volleyball or basketball — but most people are able to perform their activities of daily living and can participate in sports such as golf and bowling.
For a referral to a Crozer-Keystone orthopaedic surgeon, call 1-877-CK-MOTION (1-877-256-6846) or visit http://ckhshmi.crozer.org.