How You Can Beat Shoulder Arthritis, Part 3
Arthritis is inevitable, including shoulder arthritis. If you live long enough or exercise hard enough, someday arthritis is going challenge you. Here I show you how to avoid shoulder arthritis as long as possible, and if you have it, what to do to minimize the pain and lack of mobility. Read on and watch the videos.
Part 1 covered the difference between osteoarthritis and rheumatoid arthritis, how arthritis is diagnosed and treated, a general idea of the type of exercises to do and specific foods to eat and supplements to take to help alleviate the pain and mobility restrictions of arthritis.
Part 2 applied the information in Part 1 to neck arthritis, and now we will do the same here in Part 3 for shoulder arthritis.
Although I don’t think I have shoulder arthritis, I did have adhesive capsulitis once upon a time, and now am also experiencing some discomfort in my right shoulder when lifting weights, even though my shoulder mobility is excellent.
Adhesive capsulitis (also known as frozen shoulder) is a painful and disabling disorder of unclear cause in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff, greatly restricting motion and causing chronic pain.
I’ll do anything not to have that very painful condition return, and so am diligently doing the shoulder mobility exercises in the videos below.
If your shoulders are consistently sore, painful and lack the full range of motion they ‘re designed to do, you need to read on, watch the videos, do the exercises and take some of the inflammation-fighting supplements before things get worse.
In this article, we’ll cover:
- What is arthritis;
- What is shoulder arthritis;
- How to prevent shoulder arthritis;
- Conventional treatments for shoulder arthritis;
- Supplements for arthritis (wherever it occurs); and
- Shoulder mobility exercises (watch the videos).
Let’s dig in…
A Quick Review of Arthritis
Before I get specifically into shoulder arthritis, it’s helpful to learn a bit about arthritis itself. This is akin to opening an can of worms, because “arthritis” is not a single disease, but rather an informal way of referring to joint pain or joint disease.
And, by the way, Arthritis is the leading cause of disability in America. More than 50 million adults and 300,000 children have some type of arthritis. It’s most common among women and occurs more frequently as people get older.
The CDC says, that from 2013- 2015, an estimated 54.4 million US adults (22.7%) annually had been told by a doctor that they had some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia.
It’s projected that by 2040, 78 million (26%) US adults ages 18 years or older will have doctor-diagnosed arthritis.
Osteoarthritis (“OS”) occurs when the protective cartilage in a joint begins to break down and no longer facilitates smooth movement between bones, which can eventually result in the joint becoming swollen and painful. When this condition develops in the cervical spine, it is called cervical osteoarthritis.
Rheumatoid arthritis (“RA”), in contrast to osteoarthritis, is a type of arthritis in which your body’s immune system attacks healthy tissue in your joints. This is symptomatic of an autoimmune disease, which means the body’s immune system attacks healthy tissue, usually affecting the hands, wrists, elbows, knees, ankles and feet. And, yes, the shoulders as well.
The joint involvement of rheumatoid arthritis is symmetrical; for instance, if one shoulder is affected the other likely will be as well. With rheumatoid arthritis, the inflammation occurs in joints on both sides of the body, a symmetry that helps distinguish it from other types of arthritis.
Although the cause of rheumatoid arthritis is different than with osteoarthritis, in both cases you suffer from inflammation, lack of joint mobility and pain; therefore, foods, exercises and supplements that address these symptoms have the potential to be useful irrespective of the kind of arthritis you have.
What Is Shoulder Arthritis?
Now that we know a bit about arthritis, let’s address how it can affect our shoulders. The focus will be on shoulder osteoarthritis, the most common form of arthritis affecting the shoulder.
A quick shoulder anatomy lesson is helpful, courtesy of Spine-health.com:
Here’s a summary of the video:
- Shoulder osteoarthritis is a common name for glenohumeral osteoarthritis, a condition that involves degenerative changes to the cartilage and other structures in the glenohumeral joint.
- Shoulder arthritis involves the glenohumeral joint, which is the point where the head of the humerus, or upper arm bone, meets the glenoid—a circular depression in the scapula, or shoulder bone. It works like a ball and socket and is responsible for the shoulder’s wide range of motion.
- In a healthy shoulder, the humeral head and the glenoid are covered by slippery cartilage that allows the bones to glide smoothly against one another while acting as a shock absorber. But when shoulder arthritis happens, a segment of cartilage called the labrum that rings the glenoid becomes thinned, damaged, or even completely disappears. The layer of cartilage that covers the ball-shaped humeral head may also degenerate.
- The gradual loss of cartilage eventually causes the two bones to grind against each other, which can cause pain, stiffness, and inflammation in the joint.This bone-on-bone friction can lead to the development of scallop-shaped osteophytes, or bone spurs, as the bones naturally compensate for the deteriorated or missing cartilage.
- In shoulder arthritis, the shoulder may “catch,” or unintentionally stop in the middle of a movement. It may also emit popping sounds or crunching sensations, called crepitation. As the arthritis progresses, part or even all of the shoulder’s normal range of motion may be lost.
- Because nearly all movements of the arm involve the shoulder, even moderate glenohumeral osteoarthritis can cause significant pain and dysfunction.
OK, now that you have a sense of what it is, let’s review how to prevent shoulder arthritis from happening to you, after which symptoms, diagnosis and treatment will be addressed.
How To Prevent Shoulder Arthritis
Nearly everyone I know past 45 years of age has experienced significant discomfort in their shoulders.
Those, like myself, who have been physically active all their lives with activities that challenge the shoulder girdle often experience shoulder discomfort due to repetitive movements under load.
Those who don’t use their shoulder muscles also have a good chance to injure their shoulders due to lack of use and mobility, which leaves them unprepared to handle a mishap like falling; they fall, reach out to break the impact of the fall, and the shoulder is injured.
The best way to prevent shoulder arthritis or injury is to strengthen them throughout their full range of motion. This is why I’ve included the shoulder mobility exercises below.
In addition to the exercises and supplements listed below, do the following to help prevent shoulder arthritis and injury.
Learn simple, everyday stretching exercises. Consult a physical therapist if necessary. You should stretch every day especially before and after you exercise. If after exercising, your shoulder joint hurts, apply ice immediately and then alternate between heat and ice.
Consume magnesium. Notwithstanding arthritis, shoulder pain is most frequently the result of a muscle strain or sprain. Increasing your intake of magnesium — a mineral that aids in the contraction and relaxation of muscles — may help avoid pain- causing symptoms. Some pointers:
- Magnesium is commonly found in fruits, vegetables, beans, soy products, and whole grains. Read the nutrition labels on products to see how much of your daily-recommended amount of magnesium they provide.
- Magnesium can be absorbed through the skin by taking a warm bath with Epsom salt.
- Some people have success with the use of magnesium oil applied directly to wherever they’re sore after a warm shower or bath. I do this myself and use the Ancient Minerals brand. (Note: all magnesium oils itch and slightly burn when applied, but both sensations cease within a few minutes.)
Don’t restrict your shoulders to a limited range of motion. This is a must, especially sitting at your computer. Don’t let your shoulders slump forward for long periods of time. Regularly get up and stretch them.
Don’t “work through” the pain. If your shoulders are given you pain or are unusually tight, don’t continue to do exercises that may exacerbate the situation. Instead, put your energy into exercises that focus on shoulder stretching and mobility, rather than strength and conditioning.
Now you know what to do to prevent shoulder arthritis and pain, but maybe it’s too late. Perhaps you’ve got a nagging feeling that it’s no longer a question of prevention but of diagnosis and treatment. Before you consult a doctor, let’s review some shoulder arthritis symptoms.
Shoulder Arthritis Symptoms
You know something’s wrong with your shoulder joint if it’s causing you pain, or the range of motion is limited.
When I had adhesive capsulitis (“frozen shoulder”) in my right shoulder joint, it ached all the time, particularly at night, and I had no range of motion at all. It took me about a year to “unfreeze” the shoulder, gain full mobility in the joint and gain back my original strength.
Currently, I still have full range of motion in my right shoulder joint, but I’m feeling some pain when I do certain weight lifting movements involving it. Frankly, I don’t yet know what the issue is, and I’m trying to solve this on my own so far with supplementation and mobility exercises.
With osteoarthritis — whether in the shoulder or any other joint — the most commonly reported symptoms of osteoarthritis include pain and stiffness in the affected joints, as well as limited mobility.
Interestingly, Arthritis-health explains that there’s a wide range of osteoarthritis symptoms among patients, and their severity does not necessarily correlate with the degree of joint damage. For example, someone with a significantly degenerated joint may have fewer symptoms than a person with only mild joint degeneration.
For many, the symptoms come and go, often with long periods between flare ups. I’m experiencing this right now in my hip joints, which are arthritic.
Characteristic signs and symptoms of osteoarthritis include:
- Stiffness. A common marker of osteoarthritis is stiffness in the joint that is most pronounced first thing in the morning, or after a prolonged period of inactivity (such as sitting in a car or airplane). The stiffness usually resolves within 30 minutes of light activity, as the joints “warm up” through gentle movement.
- Pain. Another common symptom is pain in the joint that worsens during or after too much movement. The pain may be experienced as dull and aching, or sharp and piercing. In the most severe cases of osteoartritis, patients may also feel pain when the joints are at rest or only moving slightly.
- Soreness. The joint may feel tender to touch or with slight pressure.
- Inflexibility. Patients may experience loss of full range of motion in the affected joint.
- Swelling. The joint may swell due to excess fluid buildup. This type of swelling is clinically referred to as effusion. If the swelling is severe, the joint may also feel warm to touch.
- Grating or creaking. There might be a sensation of grating or slight grinding when moving the joint, as the surfaces of the articulating points of the joint no longer move smoothly against each other. (Is the grating or grinding sensation harmful? See What Is Crepitus?)
- Bone spurs. Sometimes, bone bumps – which are points of the bone that grow outward as a result of the joint friction and dysfunction – can be felt under the skin. Bone spurs may also be referred to as osteophytes.
- Deformity. In some types of osteoarthritis, physical deformity may be noticeable. This is less common in the shoulder, but for example, enlarged finger joints may result from the friction causes bony enlargements of the finger joints, or advanced degeneration of knee cartilage can lead to an outward, or bowlegged, curvature of the knee.
Shoulder Arthritis Diagnosis
Trying to find the exact cause of shoulder arthritis can be a guessing game, but most people get it in response to trauma, shoulder joint stress and chronic injury or age, says Arthritis-health.com.
Shoulder joint trauma: A broken bone, dislocation (when the humeral head pops out of its socket), or other serious injury or surgery can cause damage to the shoulder joint that eventually leads to shoulder osteoarthritis. Symptoms may not appear until many years after the trauma.
Shoulder joint stress and chronic injury: People whose jobs or recreation involve repetitively lifting objects overhead (shoulder presses), throwing, or doing high-impact activities, such as chopping wood or using an air-hammer, can experience “mini-traumas” in their shoulder joints, which in turn make them more likely to develop shoulder osteoarthritis.
Age: Shoulder arthritis most commonly affects people over the age of 50. The prevalence of symptomatic osteoarthritis increases with age because, over time, the shoulder joints experience wear and tear and cartilage thins and becomes less flexible.
Congenital defect or illness: Poor bone alignment can make it more likely that some people will suffer shoulder dislocations, as well as increase the risk of developing shoulder osteoarthritis. Other congenital conditions, metabolic disorders, and episodes of gout or septic arthritis can increase the risk.
Gender: Shoulder arthritis is more common in women.
Family history: Similar to height and hair color, the likelihood of a person developing shoulder osteoarthritis is influenced by genetics. A woman whose mother has shoulder osteoarthritis is more likely to develop the disease than another woman whose mother did not have shoulder osteoarthritis.
If you have persistent symptoms that are not responsive to self-treatment, consider making an appointment with a doctor. Osteoarthritis of the major joints is most effectively diagnosed through a combination of medical history, physical examination, and various lab tests including imaging studies such as X-ray.
A physical examination will usually follow the medical history as the physician looks for physical signs of the disease — mainly, swelling and tenderness of the joints, loss of movement in specific joints, or visible joint damage such as bony growths in the surrounding area. You may also be asked to perform a variety of physical tasks so the physician can evaluate range of motion and general joint mobility.
A primary care physician can diagnose most cases, but depending on perceived severity a patient may be referred to a specialist, such as an osteopath or orthopedic surgeon, for further evaluation.
Shoulder Arthritis Treatment
The three categories of treatment I want to cover are:
- Supplements; and
- Exercise (both mobility and strengthening)
In my case, I rarely use pharmaceuticals, such as Ibuprofen. Instead, I rely on the supplements mentioned below that work on reducing inflammation, as well as mobility and strengthening exercises. Of course, we’re all unique and therefore you need to find a combination of therapies that work for you.
1. Conventional Arthritis Treatments
Arthritis-health.com lists various conventional therapies for shoulder arthritis, such as:
- Analgesics. Pain relievers, or analgesics, such as acetaminophen (e.g. Tylenol), or tramadol (e.g. Ultram) are used to relieve pain, but do not alleviate inflammation or swelling. Because they have few side effects, analgesics are recommended for patients experiencing mild to moderate pain.
- Topical analgesics. Topical analgesics are creams that can be applied directly to the skin over the affected area. The primary ingredients in these creams are usually counterirritants, such as wintergreen and eucalyptus, which stimulate the nerve endings and distract the brain from joint pain. Topical analgesics are available in most drug stores, and can be used in combination with most oral pain medications.
- NSAIDs. Non-steroidal anti-inflammatory drugs, such as aspirin, ibuprofen (e.g. Advil), naproxen (e.g. Aleve), cox-2 inhibitors) are used to reduce swelling and inflammation, and are recommended for patients experiencing moderate to severe pain.
- Injections. The two typical injections used to treat pain from shoulder osteoarthritis are steroid injections and hyaluronic acid injections.
- The goal of steroid injections is to reduce swelling and thereby alleviate shoulder stiffness and pain.
- The goal of hyaluronic acid injections is to provide lubrication for the shoulder joint, as hyaluronic acid mimics the viscous synovial fluid that naturally lubricates joints. Hyaluronic acid injections are a type of treatment called viscosupplementation.
The degree of pain relief from injections is variable. In a review of non-operative treatments for shoulder arthritis, the American Academy of Orthopaedic Surgeons found one clinical study supporting viscosupplementation, but no rigorous studies to either support or discredit the use of steroid injections. Ideally, when injections are used they can be used in combination with a structured physical therapy program.
- Physical Therapy. A physical therapy program focused on stretching and strengthening muscles and maintaining the shoulder’s range of motion can be helpful. However, there is a lack of clinical research studying how physical therapy can benefit shoulder arthritis patients. Experts caution that aggressive physical therapy to expand range of motion can be detrimental to glenohumeral arthritis patients.
- Acupuncture. By targeting specific points along “meridians” that correspond to the nerve pathways affected by osteoarthritis of the shoulder, acupuncture may stimulate healing by increasing blood flow and can improve joint function. Acupuncture may also prompt the body to release endorphins, which are natural pain relievers.
- Shoulder arthroscopy to remove loose pieces of damaged cartilage.
- Shoulder osteotomy to shave off osteophytes and reduce friction between bones.
- Shoulder arthroplasty, or total joint replacement, to replace the ball-and-socket glenohumeral joint with an artificial one. The CDC reports that 41,934 total shoulder replacement (arthroplasty) surgeries were performed in 2004, making it the third most common joint replacement surgery, behind knee (454,652) and hip (232,857).
- Hemiarthroplasty, or partial joint replacement, to replace the humeral head. The employment of partial vs. total joint replacement is somewhat controversial. The AAOS reports that both can be successful, though pain relief and motion may be better with total joint replacement.
2. Supplements for Shoulder Arthritis
There are no supplements tailored for arthritis in the shoulders, as opposed to arthritis in any other joint, that I know about. Just like pharmaceuticals used for arthritis in general, the most effective supplements for osteoarthritis help relive pain and inflammation throughout the body.
I took a deep dive on this topic in Part 1, and recommend you take a peek.
Here are the top six supplements for arthritis based the robustness of studies indicating their effectiveness:
Supplement Arthritis Focus Recommended By Boswellia Serrata OA Arthritis.org (proven), Examine.com (proven) Curcumin OA and RA Arthritis.org (proven), Examine.com (proven) Fish Oil OA and RA Arthritis.org (proven), Examine.com (proven) Glucosamine Sulfate OA Examine.com (proven) Chondroitin OA Examine.com (proven) Vitamin C No mention Examine.com (proven)
Go to Part 1 and see the rest of the arthritis-relieving supplements that aren’t necessary proven, but listed by Examine.com and Arthritis.org as possibly useful.
3. Shoulder Arthritis Responds to Exercise
Unless it’s too painful to do, joint mobility exercises can benefit the shoulder joints. Some exercises can relieve the compression pressure and pain caused by the bone rubbing against the joint cavity due to insufficient cartilage, it being worn away by arthritis. Other exercises stimulate the synovial fluid, which reduce friction between the articular cartilage of joints during movement.
Up next is a series of shoulder mobility videos I’ve curated for you to consider and experiment with. Try those that appeal to you, but don’t summarily dismiss those that seem to difficult or advanced until you try them. As you progress with your shoulder mobility, some exercises that seemed impossible at the start will progressively be more attainable as you improve.
let’s begin with a video from the soft-spoken Dr. Ben Kim. His series of shoulder mobility exercises are gentle and would be a good place to start if you’re in pain:
Next up, the good folks at GMB Fitness:
If you’re shoulder issues flare up when you’re exercising them, such as lifting weights (my issue), check out some tips provided the irrepressible physical trainer and fitness coach, Jeff Cavaliere:
If none of the above videos offer shoulder mobility exercises that suit you, just go to Youtube and search for “shoulder mobility exercise”.
Here are three things to remember:
- Most of us will get some sort of arthritis eventually, simply because our joints wear out over time.
- Some type of shoulder restriction, pain and/or arthritis is likely to happen to you either because you’re overusing your shoulders, or you don’t use them at all, and thus they’re insufficiently strong and flexible to serve you when needed.
- You can reduce the pain and lack of should mobility caused by arthritis by various pharmaceuticals and surgeries, but first try the supplements and exercises presented above.
I hope you share this arthritis series with your friends and family. It will help with a chronic condition that for most of us is inevitable, because it’s just part of living, eventually.
The Arthritis Series
- Part 1 How You Can Beat Arthritis
- Part 2 How You Can Beat Arthritis In Your Neck
- Part 3 How You Can Beat Arthritis In Your Shoulders (You’re reading this now.)
- Part 4 How You Can Beat Arthritis In Your Elbows and Writs
- Part 5 How You Can Beat Arthritis In Your Lower Back
- Part 6 How You Can Beat Arthritis In Your Hips
- Part 7 How You Can Beat Arthritis In Your Knees and Ankles