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Shoulder Arthritis Specialist
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What is Shoulder Arthritis?
Shoulder arthritis is characterised by inflammation and degeneration of the shoulder joint, a ball-and-socket structure enabling a wide range of motion. This condition comprises two primary bones, the upper arm bone and the shoulder blade, connected at the joint. In a healthy shoulder, cartilage surrounds and lubricates this joint, preventing bone-to-bone friction. In shoulder arthritis, this cartilage deteriorates, leading to pain, stiffness, and swelling. These changes can impact arm mobility and, consequently, a person’s quality of life.
Types of Shoulder Arthritis
There are five major types of arthritis affecting the shoulder:
Osteoarthritis
Osteoarthritis results from the natural wear and tear of cartilage. Factors contributing to this include ageing, overuse, prior injuries, and genetic predisposition. It commonly affects individuals over 50.
Rheumatoid Arthritis
An autoimmune disease where the immune system mistakenly attacks joint linings, causing inflammation, pain, and joint damage.
Post-traumatic Arthritis
Develops following severe shoulder injuries like fractures and dislocations.
Rotator Cuff Tear Arthropathy
This condition arises when tears in the rotator cuff tendons lead to misalignment of bones and increased friction within the shoulder joint.
Avascular Necrosis
Caused by disrupted blood supply to the joint, leading to bone tissue death and joint deterioration. Avascular necrosis may be caused by factors such as steroid use, alcohol abuse, trauma, or certain other medical conditions.
Causes of Shoulder Arthritis
Shoulder arthritis arises from a combination of factors, which may vary depending on the specific type:
- Age-Related Wear and Tear
As individuals age, their joint cartilage, which acts as a cushion between bones, naturally wears down. This degeneration is more pronounced in people over the age of 50. - Autoimmune Conditions
In rheumatoid arthritis, a person’s immune system erroneously targets the linings of their joints. This autoimmune response leads to inflammation and damage within the joint, causing pain and restricting mobility. - Injury and Trauma
The shoulder is particularly susceptible to arthritis following physical injuries. Fractures, dislocations, and other severe injuries can damage the joint’s surfaces, leading to post-traumatic arthritis. The impact of such trauma accelerates the degeneration of joint tissue. - Rotator Cuff Injuries
The rotator cuff plays a role in stabilising the shoulder joint. When the tendons in the rotator cuff are torn, it can lead to an imbalance in the joint. This imbalance often causes the bones in the shoulder joint to move out of their normal position and rub against each other, contributing to the development of arthritis. - Reduced Blood Supply
Avascular necrosis, another form of shoulder arthritis, results from a lack of adequate blood supply to the joint. This leads to the death of bone tissue and subsequent joint deterioration. Causes of reduced blood flow include steroid use, alcohol abuse, trauma, or certain medical conditions, leading to progressive damage in the shoulder joint.
Symptoms and Signs
Pain is a common symptom for those with shoulder arthritis. It is often exacerbated by activities that stress the shoulder. The intensity of pain may increase over time and, although it is typically localised around the shoulder, can vary in exact location based on the affected joint and arthritis type.
Other symptoms include:
- Stiff Shoulder: Limits the range of motion in the shoulder.
- Weakness in the Shoulder: Challenges in lifting or carrying objects due to decreased shoulder strength.
- Sounds During Movement: Clicking or snapping noises during shoulder movement.
- Swelling: Occurring around the joint, contributing to discomfort.
Diagnosis
Diagnosing shoulder arthritis involves several steps:
- Medical History: This includes details about the patient’s symptoms, such as the onset, duration, and progression of pain or stiffness. Information about previous shoulder injuries, other medical conditions, family history, activity levels, and current medications is also gathered.
- Physical Examination: The shoulder specialist assesses for muscle weakness, tenderness, symptoms of injury, pain upon touch or pressure, range of motion, and involvement of other joints. This physical evaluation helps in identifying signs consistent with arthritis.
- Imaging Tests: To confirm the diagnosis, imaging tests like X-rays, MRIs, and CT scans are employed. These tests provide detailed images of the joint, allowing the shoulder specialist to observe the extent of damage within the shoulder.
- Joint Fluid Analysis: In some cases, fluid from the joint may be extracted and analysed. This can provide additional information about the type of arthritis and the severity of the condition.
Non-Surgical Treatment Options
Various non-surgical treatments are available for shoulder arthritis. These focus on symptom management and slowing the progression of the disease.
Rest and Activity Modification |
Initially, the shoulder specialist may suggest rest and activity modification to allow the joint to recover. Patients should avoid or modify activities that exacerbate their symptoms. This helps alleviate symptoms and prevents further damage to the joint. |
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) |
These drugs are commonly prescribed to reduce pain and inflammation associated with arthritis. They can be effective in managing symptoms, especially during flare-ups. |
Physical Therapy |
Shoulder specialists may suggest tailored exercises and stretches to maintain and improve shoulder function. Physical therapy focuses on strengthening the muscles around the shoulder, enhancing flexibility, and expanding the range of motion. Heat or cold therapy may also be part of the treatment, providing additional relief. |
Assistive Devices |
Some patients may benefit from the use of braces, slings, or splints. These devices can offer support to the affected shoulder, helping to stabilise the joint, reducing pain, and facilitating movement during daily activities. |
Corticosteroid Injections |
Injecting corticosteroids directly into the shoulder joint can provide temporary relief from pain and inflammation. This treatment is typically considered when other non-surgical methods have not been effective and is not seen as a long-term solution. |
Surgical Treatment Options
When non-surgical treatments for shoulder arthritis are not effective, surgical intervention may be considered. Each option is tailored to the individual’s condition and needs, aiming to reduce pain and improve joint function.
Arthroscopy
This minimally invasive surgery involves small incisions and the use of a camera to debride (clean out) the joint. It’s often used for less severe cases.
Joint Resurfacing
A procedure where only the damaged surfaces of the joint are replaced, preserving more of the patient’s natural bone.
Shoulder Joint Replacement
In severe cases, the damaged parts of the shoulder joint can be replaced with artificial components. A total shoulder replacement or a partial replacement can be conducted, depending on the extent of the damage.
Prevention Strategies
Preventing shoulder arthritis involves several proactive measures:
- Regular Exercise to Strengthen Shoulder Muscles - Low-impact exercises can strengthen the muscles around the shoulder joint, enhancing joint stability and flexibility.
- Injury Prevention - Be cautious during physical activities to avoid shoulder injuries.
- Maintain a Good Posture to Reduce Shoulder Strain - Use ergonomic tools and maintain proper posture to reduce strain on the shoulder.
- Healthy Lifestyle Choices to Reduce Joint Stress - Maintain a healthy weight and diet to reduce joint stress.
- Avoiding Repetitive Stress - Minimise activities that put excessive strain on the shoulder joint.
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 20 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
Insurance
Shield Plans
Corporate Partners
Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
How Long Is Recovery After Conservative Treatment for Shoulder Arthritis?
Recovery time varies, depending on the severity and treatment approach. For mild arthritis treated with rest, activity modification, or anti-inflammatory drugs, recovery could be a few weeks. Physical therapy may lead to improved motion and reduced pain over several weeks to months. The duration also depends on each patient’s healing ability.
What Should I Avoid Doing With Shoulder Arthritis?
Avoid activities that exacerbate shoulder pain or strain the joint. This includes repetitive movements, lifting heavy objects, or any action causing discomfort. Consult with our shoulder specialist for personalised guidance on specific activities to avoid.
How Should I Sleep With Shoulder Arthritis?
Try to sleep in a position that minimises stress on the shoulder. Using a supportive pillow and avoiding sleeping on the affected side can reduce discomfort.
What Exercises Can Help Treat Shoulder Arthritis?
Exercises focusing on low-impact strengthening and flexibility of the shoulder muscles can be beneficial. These may include gentle stretching and range-of-motion exercises. Reach out to our shoulder specialist for a tailored exercise plan suited to your needs.