By Reaves M. Crabtree, MD
Shoulder pain can make everyday activities more difficult. One potential cause of persistent shoulder pain and stiffness is shoulder arthritis. The good news is that there are several treatment options available, and when surgery is necessary, modern shoulder replacement techniques can help many patients regain function and return to activities they enjoy.
What Is Shoulder Arthritis?
Shoulder arthritis occurs when the cartilage that normally covers the surfaces of the shoulder joint begins to wear down. The shoulder is a ball-and-socket joint. Healthy cartilage provides a smooth, protective surface between the bones, allowing the shoulder to move and rotate with minimal friction. As that cartilage deteriorates, the bones can begin to rub against one another.
This can lead to pain, inflammation, stiffness, and decreased range of motion.
What Are the Signs of Shoulder Arthritis?
Common symptoms may include:
- Shoulder pain, particularly with activity
- Stiffness or difficulty moving the arm
- Decreased range of motion
- Difficulty performing everyday activities
- A gradual decline in shoulder function
Shoulder arthritis can develop gradually, so some people may initially attribute their symptoms to normal aging, an old injury, or simply being more active than usual. If shoulder pain or stiffness is interfering with the activities you enjoy, an orthopedic evaluation can help determine the cause.
How Is Shoulder Arthritis Treated?
Treatment typically begins with non-operative options. The appropriate treatment depends on the severity of arthritis, your symptoms, your activity level, and your individual goals.
Non-operative treatments may include:
- Activity modification: Adjusting or temporarily avoiding activities that aggravate the shoulder.
- Physical therapy: Exercises designed to improve strength, flexibility, and shoulder function.
- Injections: In appropriate patients, injections may help reduce pain and inflammation.
For many patients, these treatments can provide meaningful relief. However, if symptoms continue despite non-operative treatment and significantly affect a patient’s quality of life, shoulder replacement may be an option.
Traditional vs. Reverse Shoulder Replacement
There are two primary types of shoulder replacement procedures: anatomic (traditional) shoulder replacement and reverse shoulder replacement.
With a traditional, or anatomic, shoulder replacement, the replacement components are designed to replicate the shoulder's natural anatomy. The arthritic ball and socket are replaced while maintaining the normal relationship between the two parts of the joint.
Anatomic shoulder replacement still relies on a functioning rotator cuff to help move and stabilize the shoulder. For patients with significant arthritis and a healthy, functioning rotator cuff, this can be an excellent treatment option.
A reverse shoulder replacement changes the normal anatomy of the joint by essentially reversing the position of the ball and socket. This approach can be particularly useful when the rotator cuff is severely damaged, irreparable, or no longer functioning effectively. It may also be used in cases of certain traumatic injuries and fractures.
By changing the mechanics of the shoulder, a reverse replacement allows other muscles—particularly the deltoid muscle—to take on a greater role in moving the arm, helping patients regain shoulder function even when the rotator cuff cannot adequately do its job. The decision between anatomic and reverse shoulder replacement depends on several factors, including the condition of the shoulder joint, the rotator cuff, the patient's overall health, and the goals of treatment.
How Does 3D Planning Help with Shoulder Replacement?
Modern shoulder replacement surgery can incorporate advanced 3D planning technology to help surgeons better understand each patient's individual anatomy. We use 3D planning software to create a surgical plan specific to the patient. In certain situations, this technology can also help with the development of custom implants when a patient's anatomy or condition requires a more individualized solution. The goal is to use these tools to help create a treatment plan tailored to the patient's unique shoulder.
What Is Recovery Like After Shoulder Replacement?
Recovery after shoulder replacement is different for every patient. Your rehabilitation plan will depend on the type of procedure performed, your overall health, the condition of your shoulder, and your individual goals. In general, recovery includes a period of sling use during the early stages, followed by physical therapy. Rehabilitation plays an important role in helping restore strength, mobility, and function.
The goal isn't simply to replace the damaged joint. It's to help patients get back to the activities that matter to them. Whether that means returning to recreational activities, exercising, working, or simply being able to perform everyday tasks more comfortably, treatment and rehabilitation are tailored around the individual patient.
When Should You See an Orthopedic Specialist?
If shoulder pain, stiffness, or loss of function is limiting your daily activities or preventing you from doing the things you enjoy, it may be time to have your shoulder evaluated. Shoulder arthritis doesn't look exactly the same in every patient, and treatment should be individualized. An orthopedic evaluation can help identify the source of your symptoms and determine whether conservative treatment, injections, surgery, or another approach may be appropriate.
Reaves M. Crabtree, MD is an orthopedic surgeon practicing with St. Vincent's Orthopedics.
