A Complete Guide to Shoulder Arthritis

February 20, 2020

A Complete Guide to Shoulder Arthritis

So you’ve got pain in your shoulder joint that won’t go away – is it just an injury or could it be a chronic condition?

If you can predict an impending storm faster than the weatherman on TV by the pain in your shoulder joint, read on. 

54.4 million Americans experience the debilitating pain of arthritis per year, collecting more casualties than any other musculoskeletal condition. Shoulder arthritis ranks 3rd as the most common type of arthritis over a hundred types (but only ranks next to the weight bearing joints which are your knees and hips.)

In this article, we’ve rounded up the 6 ways shoulder arthritis can be triggered and the risk factors involved. While there is no cure for most types of shoulder arthritis, we will discuss the possible courses of symptom management and pain relief.



What is Shoulder Arthritis?

Before we go full nerd on the different ways we can effectively deal with shoulder arthritis, let’s dive into what it actually is. 

Shoulder arthritis is the wearing out of the cartilage surrounding your glenohumeral joint.(Need a quick refresher on your shoulder’s anatomy? Here’s a comprehensive guide for your reference.)

The glenohumeral joint, commonly referred to as the shoulder joint, is the ball and socket joint that connects your humerus and glenoid cavity. It allows you to swing your arms forward and back, basically giving you your full range of motion.

Shoulder arthritis affects the cartilage or the living tissue that serves as a surface cover for your humerus.

How arthritis develops

Shoulder arthritis develops in stages. Your cartilage is around 2-3 mm thick and while it’s as thin as a cardboard, it takes a while (and a lot) for it to fully wear out. 


Stage 1: The cartilage becomes soft. 

Stage 2: The cartilage undergoes fibrillation, where the cartilage develops cracks in the surface before it begins to deteriorate and flakes.

Stage 3: As your shoulder arthritis worsens, the cartilage fully wears away and exposes the bone surface.


Once the bone surface is exposed and the cartilage completely corrodes, any movement by the shoulder joint becomes painful. Luckily, shoulder arthritis does not always reach its advanced stages since the degeneration of the cartilage stabilizes most of the time. 

Early detection of symptoms becomes even more important to make adjustments to prevent your shoulder arthritis from getting worse. 

General symptoms 

The symptoms of arthritis are generally characterized by severe pain, limited function, and joint stiffness. 

Symptoms may vary due to cause and progression. There are individuals who may experience acute pain but have normal range of motion, have acute range of motion without pain, or in some cases might have both pain and a loss of flexibility. 

During the initial stages of arthritis, pain is the most distinct symptom. Pain can manifest in the front, side, or back of the shoulder as a result of the inflammation around the joint. Sometimes, the pain can also shoot down to the arm. When arthritis progresses, the pain can radiate to the elbow and wrist, and activities like lifting, carrying heavy objects or exercising can be a real challenge. 

As it advances, additional symptoms can manifest such as stiffness of the joint where the shoulder joint may feel like it’s locking up, thus causing a loss of range of motion. In the same vein, a grinding, clicking, or cracking sensation may also be felt in the surface of the cartilage.

Types of Arthritis: 

Now that we have a clear idea of what arthritis is, what it affects, and the different signs to watch out for, let’s proceed to the different reasons why your shoulder joint can wear away. 

Arthritis wears away pretty much in the same manner and progresses in the same stages. However, the different causes as to why the cartilage deteriorates varies. 


Osteoarthritis is commonly known as the wear and tear arthritis and is the most common type. It’s what we usually associate with aging since osteoarthritis is common among individuals over 50 years old. However, osteoarthritis can also happen to younger individuals. 

Risk Factors: 

  • Age - People over 50 years old are more at risk to osteoarthritis. The risk also increases with age.
  • Genetics - People who have family members with osteoarthritis are more likely to develop it. Similarly, once you have osteoarthritis in one part of the body, you are more likely to develop it in other parts of the body.
  • Joint injury and overuse - Overworking the shoulder joint can speed up the wear and tear of the cartilage. 

Severe osteoarthritis 

Severe osteoarthritis is the extensive or complete loss of cartilage. When this occurs, bone friction may cause increased pain due to swelling and inflammation. In turn, the synovial fluid inside the joint also increases, a phenomenon otherwise known asjoint effusion.

Rheumatoid Arthritis

Osteoarthritis and Rheumatoid arthritis have similar symptoms, except rheumatoid arthritis is an autoimmune condition. What happens with rheumatoid arthritis is that the immune system mistakes the soft lining around the joints to be a threat and ends up attacking it. The cartilage then  thins out until it completely wears down.

Compared to other types of arthritis, rheumatoid arthritis is a systemic disease. This makes it a  long-term and disabling condition, and leaves the other joints such as the wrists, hips, and knees vulnerable. Individuals with rheumatoid arthritis may also develop non-arthritic conditions such as carpal tunnel syndrome, septic arthritis, or vasculitis. 

Risk Factors: 

  • Genetics - Specific genetic traits can trigger rheumatoid arthritis.
  • Age  - People over 60 years of age are more prone.
  • Gender - Based on statistics, females are more likely to develop rheumatoid arthritis than men.
  • Lifestyle - Individuals who smoke or are obese have an increased chance in developing rheumatoid arthritis. 

Septic Arthritis

Septic arthritis is a painful infection of the joint. It might seem unlikely that a joint can be infected, but septic arthritis can originate from germs that travel through the bloodstream from another part of the body. 

Causes of septic arthritis can vary between a bacterial, viral, or fungal infection. Other infections such as a UTI or a skin infection may also  travel through the bloodstream and affect the shoulder joint cartilage. 


Risk Factors: 

  • Existing joint problems - Joint problems such as osteoarthritis, gout, rheumatoid arthritis, or lupus is an easy target for septic arthritis. 
  • Suppressed immune system - Taking medications for existing joint problems like rheumatoid arthritis can leave you vulnerable to infection. 
  • Skin fragility - Since skin infections can easily bring damage to existing arthritic conditions, a fragile skin barrier can leave you at a higher risk for septic arthritis. 


Post Traumatic Shoulder Arthritis

Post Traumatic Shoulder Arthritis is a type of arthritis that occurs typically after a physical injury. Injuries compromise your shoulder’s range of motion, thus affecting the mechanisms of the shoulder joint. This can trigger the cartilage to wear out faster. 

If the trauma is not caught early on,  continued injury might aggravate the condition and accelerate the wearing out of the cartilage. Post Traumatic Shoulder Arthritis can’t be prevented but it can be minimized by preventing injuries.

Rotator Cuff Tear Arthropathy

Rotator cuff tear arthropathy is a severe and complex form of arthritis. It is a hybrid of two painful conditions: a shoulder arthritis and a large rotator cuff tear.

Rotator cuff tear arthropathy is a chronic condition and rarely needs medical attention. However, should you experience any of the following, see your physician immediately: 

  • Alarming degree of swelling around the shoulder accompanied by increased pain
  • Swelling that shows redness and is accompanied by a fever
  • Any tell-tale signs of an infection such as swollen lymph nodes in the armpit, nausea, or fatigue

Risk Factors: 

  • Age - Individuals older than 65 years old are at a higher risk for shoulder injuries and shoulder arthritis.
  • Existing rotator cuff injury - A compromised rotator cuff injury can progress to shoulder arthritis.
  • Rheumatoid arthritis - Individuals with severe rheumatoid arthritis may develop a condition similar to rotator cuff arthropathy. 

When not addressed immediately, rotator cuff tear arthropathy can lead to the progressive destruction of the humerus (arm bone) and the glenoid activity. 


Arthritis due to Avascular Necrosis

Avascular Necrosis is otherwise known as osteonecrosis (aseptic necrosis or ischemic bone necrosis), which is the death of bone cells. 

It might seem irrelevant to arthritis since it is a disease resulting in the death of bone cells. However, if it affects the bones near the shoulder joint, it can lead to the collapse of the shoulder joint surface, resulting in arthritis.

Causes of avascular necrosis: 

  • Interrupted blood supply to the shoulder area
  • Traumatic impact injuries to the blood vessels of the shoulder
  • Diseases which produce areas of abnormal circulation
  • Excessive alcohol consumption (can cause fatty substances to build up in the blood vessels and decrease the blood supply to the bones)

Risk Factors: 

  • Lifestyle habits - Cigarette smoking and obesity can trigger avascular necrosis.
  • Medications and Treatments - Radiation and chemotherapy treatments as well as steroid medications can also be triggers. 
  • Bone marrow & blood diseases
  • Autoimmune diseases - Underlying autoimmune diseases such as lupus, vasculitis, and inflammatory bone disease can cause avascular necrosis. Bone marrow and blood diseases can also do the same. 

The treatment for avascular necrosis operates in the same way as that for arthritis. The treatment focuses on managing symptoms as well as preserving the shoulder bone and preventing further bone loss. 

How to Treat Arthritis

There are surgical procedures that are associated with the treatment of arthritis and these are joint replacement surgery and arthroscopy of the shoulder.

In shoulder joint replacement surgery, otherwise known as arthroplasty, the procedure focuses on removing scar tissue and replacing the damaged joint surfaces with prosthesis - an artificial body part. The prosthesis will be installed in the shaft of the arm bone and the glenoid cavity. Arthroscopy is a minimally-invasive procedure wherein an arthroscope, a tiny camera, examines and repairs the scar tissues around the damaged joint surfaces. 

There is no known method to reverse arthritis and surgery isn’t always an option. In the initial stages of arthritis, pain management can effectively cope with the pain of living with this condition. 

Pain Management

Managing arthritis highly depends on the symptoms that you are experiencing. Different forms of treatment can be applied for pain, stiffness, or loss of range of motion.  

For pain, inflammation, and stiffness, cold and hot therapy are highly accessible forms of treatment. Cold therapy such as ice packs help to constrict blood vessels which can diminish inflammation. Applying ice or gel packs reduces the fluid in the cartilage and decreases swelling. 


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Heat therapy on the other hand opens the blood vessels and increases circulation. Using a heat therapy pack stimulates the blood vessels and allows the essential nutrients and proteins to repair the compromised tissue. 

Heat therapy and cold therapy can be used in combination as needed. When heat therapy and cold therapy aren’t enough, NSAIDs and steroid injections can help in managing inflammation. 

To recover range of motion, an increase in physical activity and physical therapy with muscle therapy exercise can improve flexibility. However, it is important to consult your physician since physical therapy can aggravate arthritis depending on its progression. Here are some exercises you can try to do at home. 


Final Thoughts

Whether you play pro or you’re just a regular joe, the pain that arthritis brings to your shoulders can significantly reduce the quality of your life. 

Our shoulder joints are celebrated as our most mobile joint. It allows us to do so much in our day to day lives, and losing the ability to move our shoulders will impact your life for the worse. 

It is imperative that you listen to your bodies during the first signs of rotator cuff injuries or over-fatigue to the shoulders. Truly, preventing worse conditions from developing is better than cure. Shoulder arthritis might not be reversed, but the pain and other symptoms can be manageable when done correctly. 

Since the risks are higher as we grow older, it is important to take care of our health and develop an active lifestyle right now. Be a friend to your body, learn to rest, and arm yourself with knowing the many ways you can relieve yourself of pain.

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