Having a shoulder to cry on is a good thing. Having one that you want to cry about is anything but. Unfortunately, that’s not an uncommon experience if you have shoulder arthritis. It’s common for the structures in your body to change with time, including your joints. While shoulder arthritis doesn’t always cause symptoms, it can contribute to pain, stiffness, and reduced range of motion.

Arthritis isn’t the only cause of persistent shoulder pain, and a lot of people can achieve pain-free living in spite of an arthritis diagnosis. While it can be difficult to live with, conservative measures, such as over-the-counter medications, hot and cold treatment, activity modification, and physical therapy, can go a long way in managing arthritis symptoms.

Here, learn about how to cope with and overcome the problems shoulder arthritis can pose, especially with therapeutic exercises from Hinge Health physical therapists. 

Shoulder Arthritis: A Hinge Health Perspective

Your first instinct when you hear you have shoulder arthritis may be to avoid moving your shoulder. After all, the pain is often aggravated by activity, right? Movement is actually one of the best things you can do for shoulder arthritis. “Our mental model is that if something — like an arthritic shoulder — hurts when we move it, we’re probably doing more damage by moving it,” says Dylan Peterson, PT, DPT, a physical therapist at Hinge Health. 

Movement helps shoulder arthritis in a myriad of ways, such as promoting healthy cartilage in your shoulder joint and strengthening weaker muscles that often accompany arthritis and contribute to pain. “The body responds really well to challenges, whether that’s carrying groceries or doing specific exercises,” says Dr. Peterson. “If you think about a muscle, it stays much healthier as you use it. The same is true with a joint.” 

You may not be able to control every factor involved in your shoulder arthritis, but with exercises from Hinge Health physical therapists, you’ll be able to manage your symptoms and help get your shoulder moving properly again.   

What Is Shoulder Arthritis?

Arthritis is a term that comes from the Greek words arthro (meaning “joint”) and itis (meaning “inflammation”). Arthritis literally means “joint inflammation,” though it’s more broadly considered a condition that affects joints, often by causing pain, stiffness, and swelling.

The shoulder is actually made up of two joints — the main “ball and socket” joint that connects the upper arm to the shoulder blade (aka the glenohumeral joint) and a second, smaller joint (the acromioclavicular or AC joint), where the collarbone meets the shoulder blade. The ends of the bones in these joints are covered in a smooth, slippery tissue called articular cartilage. Along with lubricating synovial fluid, articular cartilage allows your bones to “glide” during joint movement. Arthritis is the wearing down of the articular cartilage, which can cause increased friction and sometimes can even result in bones of either the glenohumeral or AC joints to rub together. This can cause an increase in inflammation and can result in pain and stiffness.

While arthritis may be more common in weight-bearing joints (such as knees and hips), shoulder arthritis can be life-altering. As a joint that connects three bones, the shoulder is responsible for maintaining the widest range of motion of any joint in your body. Its ability to fully rotate allows you to reach overhead, behind your back, behind your head, and in many other directions. When arthritis causes symptoms, everything from waving hello to lifting a toddler can be challenging.

Types of Shoulder Arthritis

There are more than 100 types of arthritis, five of which are most important to know about when it comes to your shoulders: 

• Osteoarthritis (OA) is the most common type of arthritis. It’s characterized by gradual cartilage changes in a joint. For some, it can cause symptoms such as pain and stiffness that tend to worsen after activity.

• Rheumatoid arthritis (RA) is an autoimmune and inflammatory disease, which means that your immune system mistakenly attacks healthy cells, including the lining of your joints. RA usually occurs symmetrically, meaning symptoms will be present in both the right and left shoulders.  

• Post-traumatic arthritis may develop if the bones of the shoulder were fractured, dislocated, or otherwise injured. 

• Rotator cuff tear arthropathy may develop after injuries to the rotator cuff, a group of muscles and tendons that hold the ball portion of the shoulder joint in place.  

• Avascular necrosis is much rarer and results from the disruption of blood supply to the ball of the shoulder joint, due to causes like disease or injury. This causes changes to the shoulder’s bones, which can affect cartilage of the joint. 

What Causes Shoulder Arthritis?

Like all types of arthritis, shoulder arthritis is more common in older people (usually over age 50), but younger people can develop it after trauma or injury to the joint, such as a fracture, dislocation, or infection. In some cases, shoulder arthritis can be influenced by genetics.

Regardless of why it occurs, shoulder arthritis results in changes to the cartilage that cover the bones of your shoulder joint. A lot of factors can contribute to anatomical changes in your shoulder. Cartilage naturally loses some volume with age, just as some people lose hair on their head. Though these changes may be unnoticeable, they can cause symptoms, such as: 

• Pain is one of the most common signs of arthritis. The location of the pain will vary, depending on which shoulder joint is affected.

• Stiffness or a loss of range of motion in the shoulder.

• Crepitus, or grinding, clicking, popping, or cracking sensations due to changes in the surface of the cartilage. Because the surface isn’t smooth, the shoulder may also “lock up” or slide into certain positions. Crepitus can be painful and loud enough for others to hear, but many people have crepitus without any pain. 

Living with symptoms related to arthritis is hard. It’s also personal. While certain medications, supplements, and steroids may work for your coworker or cousin, maybe they haven’t worked for you. There’s no one-size-fits-all approach when it comes to managing pain, but know this: Your body has the amazing ability to adapt, and there are always ways you can improve joint health and manage arthritis-related symptoms.

Treatment Options for Shoulder Arthritis

There’s currently no cure for shoulder arthritis, but the following treatment options can help you manage symptoms, stay active, and thrive: 

• Physical therapy. “Physical therapy seems to be the most effective thing we can do for arthritis at this point,” says Dr. Peterson. He notes that even if you end up having surgery, if you’ve used physical therapy exercises to address all the factors that can contribute to your pain, it can make your surgery far more successful. A physical therapist can help you learn range-of-motion exercises, as well as stretching, strengthening, and stabilization exercises. You can see a physical therapist in person, or use a program like Hinge Health to access a PT via telehealth/video visit.

• Over-the-counter pain medication. Nonsteroidal anti-inflammatory medication (NSAIDs) such as naproxen (Aleve), ibuprofen (Advil), and aspirin are a first-line remedy for shoulder arthritis. It’s important to make sure that you are safely able to take these medications, based on your medical history. For acute pain flares, your doctor may prescribe OTC medications in combination with other medications, such as oral corticosteroids, or muscle relaxants.

• Ice and heat. There’s no right or wrong choice here — each therapy can help with shoulder arthritis in its own way. Ice can help with swelling, while heat can reduce tightness. “Try both and lean toward the one that makes you feel better,” Dr. Peterson suggests. “Often, you’ll intuitively know.”

• Lifestyle changes. “Anything that makes you healthier can also affect your shoulder and make it feel better,” says Dr. Peterson. This includes: 

  • Gentle movements. Try things like carrying your groceries, opening the car door, or blow drying your hair with your painful shoulder. This helps keep your shoulder engaged, making it a little bit stronger and more resilient to pain. 

  • Get good sleep. If you don’t get enough sleep, you feel it all throughout your body, even if you don’t have pain in specific places, says Dr. Peterson. “But poor sleep can affect your shoulder directly because it’s already primed to be more sensitive to pain. It can be difficult to find a comfortable sleeping position when you have shoulder arthritis. These tips can help you get a good (or at least better) night’s sleep. 

Surgery for Shoulder Pain

If shoulder arthritis causes severe and persistent pain that’s not relieved by nonsurgical treatments, your doctor may recommend surgery — typically shoulder replacement surgery. This may help reduce shoulder pain and stiffness and improve range of motion, helping you to maintain an active lifestyle. Talk to your doctor about whether you’re a good candidate for surgery. 

The good news about shoulder arthritis is that there aren’t any exercises or activities that you have to avoid. The key is to listen to your body and modify activities when necessary. “Nothing is off-limits forever,” says Dr. Peterson. “You may not be ready for a particular exercise right now, but you can always modify it or come back to it later.”

The given exercises recommended by Hinge Health physical therapists engage your shoulder, arm, and upper back muscles to help improve strength, endurance, and range of motion, making it easier to lift or reach overhead. Start by doing those exercises once per day and gradually increase the frequency and duration if you find them helpful.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Practice Relaxing Your Muscles

When you have shoulder pain, it’s common to tense up. “Tensing your muscles is a protective habit and, in small doses, it can be helpful,” says Dr. Peterson. “But when you tense your muscles too often throughout the day, your neck and shoulder muscles can get stiff and sore, and put pressure on sensitive shoulder structures, causing more discomfort.” To avoid overdoing it, practice relaxing your muscles as you work and move, Dr. Peterson advises. “Check in with your body every once in a while by taking a deep breath, and relaxing the muscles around your shoulder as you exhale.” 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Shoulder Arthritis. (n.d.). Johns Hopkins Medicine. Retrieved from ​​https://www.hopkinsmedicine.org/health/conditions-and-diseases/shoulder-arthritis

2. Shoulder Arthritis. (2022, February 28). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22491-shoulder-arthritis

3. Arthritis of the Shoulder. (n.d.). Hospital for Special Surgery. Retrieved from https://www.hss.edu/condition-list_arthritis-shoulder.asp

4. Athwal, G. S. & Wiater, J. M. (2021, March). Arthritis of the Shoulder. OrthoInfo – American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-shoulder

5. Chillemi, C., & Franceschini, V. (2013). Shoulder Osteoarthritis. Arthritis, 1–7. doi:10.1155/2013/370231