Shoulder Arthritis
Treatment by Dr. Senthilvelan – Shoulder, Elbow & Wrist Specialist
Overview
Shoulder arthritis is a condition in which the smooth cartilage lining the shoulder joint gradually wears away. Cartilage normally allows the joint surfaces to glide smoothly during movement. When it becomes damaged, the bones begin to rub against each other, leading to pain, stiffness, and loss of motion.
Patients with shoulder arthritis often find it difficult to perform daily activities such as lifting the arm, combing hair, reaching overhead, or dressing.
Although damaged cartilage cannot regrow naturally, modern treatment methods — including advanced arthroscopic procedures and shoulder replacement — can effectively relieve pain and restore function.
Shoulder Anatomy
The shoulder is a ball-and-socket joint made up of three bones:
Humerus (upper arm bone)
Scapula (shoulder blade)
Clavicle (collarbone)
The rounded head of the humerus fits into a shallow socket in the scapula called the glenoid. This joint is stabilized by muscles and tendons collectively known as the rotator cuff.
There are two main joints in the shoulder:
Glenohumeral joint
Main ball-and-socket joint Responsible for most shoulder movement
Acromioclavicular (AC) joint
Located at the top of the shoulder Where the collarbone meets the shoulder blade Arthritis can affect either or both of these joints.
Types of Shoulder Arthritis
- Osteoarthritis Also called “wear-and-tear” arthritis Caused by gradual cartilage degeneration More common after age 50 Often affects the AC joint, but glenohumeral arthritis causes more symptoms
- Rheumatoid Arthritis Autoimmune condition Body’s immune system attacks joint lining Usually affects both shoulders symmetrically Causes pain, swelling, and stiffness
- Post-Traumatic Arthritis Develops after shoulder injuries Common after fractures or dislocations Can affect either shoulder joint
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Rotator Cuff Tear Arthropathy Occurs after long-standing large rotator cuff tears The humeral head moves upward due to lack of tendon support Leads to severe arthritis and weakness
- Avascular Necrosis (AVN) Caused by loss of blood supply to the humeral head Bone gradually collapses Leads to arthritis
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Common causes of AVN: High-dose steroid use Excessive alcohol consumption Sickle cell disease Trauma Unknown causes (idiopathic)
Causes and Risk Factors
- Age-related degeneration
- Previous shoulder injuries
- Autoimmune diseases
- Rotator cuff tears
- Steroid use
- Alcohol abuse
- Metabolic conditions
Symptoms of Shoulder Arthritis
The most common symptom is pain, which gradually worsens over time.
Pain Location
Glenohumeral arthritis: deep ache in the side or back of shoulder.
AC joint arthritis: pain at the top of the shoulder Other Symptoms Stiffness, Difficulty lifting the arm, Grinding or clicking sensation (crepitus), Night pain, Reduced range of motion.
Evaluation by Dr. Senthilvelan
Clinical Examination
Dr. Senthilvelan performs a detailed assessment including:
- Muscle strength testing
- Range of motion evaluation
- Joint tenderness
- Crepitus during movement Assessment of surrounding tendons and ligaments
- Examination of other joints (if rheumatoid arthritis suspected)
Imaging Investigations
- X-rays
- Joint space narrowing
- Bone spurs
- Joint deformity
- CT Scan Used for surgical planning
- Diagnostic Injection
- Local anesthetic injected into the joint
- If pain improves, arthritis is confirmed as the source
Non-Surgical Treatment
- Initial treatment is usually conservative.
- Treatment Options
- Activity modification
- Physiotherapy to improve mobility and strength
- Anti-inflammatory medications
- Corticosteroid injections
- Heat or ice therapy
- In rheumatoid arthritis, disease-modifying medications may be prescribed in coordination with a rheumatologist.
Surgical Treatment
Surgery is considered when pain persists despite proper non-surgical treatment and begins to affect daily life. Dr. Senthilvelan personally evaluates each patient and selects the most appropriate surgical option.
1) Arthroscopic Debridement (Early Arthritis)
Minimally invasive keyhole surgery
Removal of loose cartilage
Cleaning inflamed tissue
Smoothing bone spurs
Best for: Early or mild arthritis Younger patients
Note: Relief may be temporary in advanced arthritis.
2) Shoulder Replacement Surgery (Advanced Arthritis)
In shoulder replacement, the damaged joint surfaces are replaced with artificial components.
a) Hemiarthroplasty
Only humeral head replaced Used in selected cases
b) Total Shoulder Replacement
Both ball and socket replaced Best for patients with intact rotator cuff
c) Reverse Shoulder Replacement
Ball and socket positions reversed Relies on deltoid muscle instead of rotator cuff
Ideal for:
Rotator cuff tear arthropathy
Elderly patients with severe arthritis
3) AC Joint Arthritis Surgery (Distal Clavicle Excision)
Small portion of collarbone removed
Eliminates painful bone contact
Performed arthroscopically or open
Recovery After Surgery
Recovery depends on the type of surgery.
General Timeline
Hospital stay: 1–4 days (replacement)
Sling: 3–6 weeks
Physiotherapy: structured program
Functional recovery: 3–6 months
Dr. Senthilvelan personally supervises the rehabilitation process and follow-up care.
Possible Surgical Risks
All surgeries carry some risks, including:
- Infection
- Bleeding
- Blood clots
- Nerve or vessel injury
- Implant-related complications
These risks are minimized through proper surgical technique and postoperative care.
Patient FAQs – Shoulder Arthritis
What causes shoulder arthritis?
Shoulder arthritis develops when the cartilage lining the joint wears away. This can happen due to aging, previous injuries, autoimmune diseases, or long-standing rotator cuff tears. I evaluate each patient to identify the exact cause before recommending treatment.
How do you diagnose shoulder arthritis?
I begin with a detailed clinical examination. X-rays are usually sufficient to confirm arthritis. In some cases, I may recommend a CT scan or MRI for better assessment.
Can shoulder arthritis be treated without surgery?
Yes. Many patients experience good relief with physiotherapy, medications, and injections. I recommend surgery only when pain persists and daily activities become difficult.
When is shoulder replacement necessary?
Shoulder replacement is recommended when arthritis is advanced and non-surgical treatments no longer provide relief. It is especially useful when pain interferes with sleep or basic daily activities.
How do you decide between total and reverse shoulder replacement?
I assess the condition of your rotator cuff, bone quality, and functional needs. If the rotator cuff is damaged, a reverse shoulder replacement usually gives better results.
Will you perform the surgery yourself?
Yes. I personally perform the shoulder replacement and supervise the entire treatment and rehabilitation process.
How long will the artificial shoulder last?
Modern implants usually last 15–20 years or more, depending on activity level and bone quality.
Will I regain full movement after surgery?
Most patients regain comfortable, functional movement that allows them to perform daily activities without pain.
How long does recovery take after shoulder replacement?
Most patients resume light daily activities within 6–8 weeks. Full recovery and strengthening typically take 3–6 months.
How closely will you monitor me after surgery?
I schedule regular follow-up visits, monitor healing, and guide your physiotherapy program to ensure the best possible outcome.
