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Shoulder and Elbow Arthritis

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Disease Awareness Page for R3 Stem Cell – Shoulder and Elbow Arthritis

 

What is Elbow/Shoulder Arthritis?

Arthritis is a condition characterised by the inflammation and degenerative changes of a joint. These changes often affect the cartilage of the joint, as well as the bone surfaces in the joint. These bone parts are called the articulation surfaces, and the changes they undergo can range from wearing and tearing to the growth of tiny bony fragments called osteophytes on their surfaces.

Elbow arthritis refers to a condition in which these changes occur at the elbow joint, while shoulder arthritis refers to these changes when they occur at the shoulder joint

How does arthritis progress?

As mentioned earlier, elbow arthritis is an inflammation of the joint space around the elbow. The phrase joint space refers to the membrane around the joint (the synovial membrane), the fluid that lubricates the joint (the synovial fluid), the articulating surfaces of the bones, as well as other cartilages that may be in the joint. The inflammation usually begins within the synovial lining. At this stage, the inflammation can be felt by the individual. The joint is also warm to the touch. 

As the inflammation becomes chronic (long-standing), the joint space also begins to reduce (this means that the gap between the two articulating surfaces of the bones reduces), and arthritis erodes the cartilage. If allowed to progress, the next phase involves complete erosion of the cartilage, and the exposure of the bones underneath. Here, the bones rub against each other, causing severe pain every time the joint is moved. This rubbing together often gives rise to the grinding crepitus sign heard in arthritis (more on this later).

 

Elbow arthritis

The most common cause of elbow arthritis is rheumatoid arthritis. Osteoarthritis and injuries have also been known to be a less common cause of elbow arthritis. Individuals suffering from elbow arthritis find it difficult to bend and straighten their elbows, which can make it difficult for them to perform simple activities of daily life like picking up objects.

Elbow arthritis is a very stubborn condition and is often difficult to treat. Additionally, if not treated properly and on time, it can lead to a permanent loss of elbow function.

Shoulder arthritis

Shoulder arthritis is more severe than elbow arthritis because the shoulder is very crucial to the functioning of the upper arm. The bulk of the movements performed by the arm originate from the shoulder, and the more severe the arthritis, the less the individual is able to do with the entire upper limb.

Unlike elbow arthritis, osteoarthritis is the major cause of shoulder arthritis. Other causes may include trauma, rotator cuff tears, as well as inadequate blood supply.

Types of arthritis

Arthritis is a blanket term for inflammation and degeneration of the joint space and associated cartilages. There are up to 90 different kinds of arthritis, based on their causes, the areas of the body they affect, and their unique symptoms. While several of them have overlapping causes and symptoms, some others are distinct. Here are some of the most prevalent types of arthritis: 

  • Rheumatoid arthritis: Rheumatoid arthritis is an autoimmune disorder, which means that it happens when the body’s immune system attacks the joint space. The cause of the autoimmune attack in rheumatoid arthritis is unknown, although it has been linked to several genetic and age-related factors. Rheumatoid arthritis is unique because it affects mostly small joints of the body, usually on both sides at the same time.
  • Osteoarthritis: Osteoarthritis is the most common type of arthritis, and it is caused by wear and tear of the joint spaces. Factors like age and overuse are common causes of osteoarthrosis
  • Gout
  • Psoriatic arthritis

Causes of elbow/shoulder arthritis

As mentioned earlier, there are several kinds of arthritis, and each of them have its causes. Common factors include:

  • Age: arthritis is more common in older people
  • Hereditary: Certain kinds of arthritis, like rheumatoid arthritis, can be passed down in families
  • Sedentary lifestyle
  • Trauma
  • Obesity
  • Infections
  • Tennis elbow
  • Radial nerve compression
  • Ligament Tears

The possible causes of this condition are numerous; almost as many as the types of arthritis. However, it all boils down to abnormal occurrences. Anything that happens at these joints, which is not supposed to happen can cause elbow/shoulder arthritis.

How common is it, and who is at risk?

Elbow arthritis

It is difficult to determine the prevalence of arthritis affecting the elbow joint. In one research, a random sample of individuals was taken, and elbow osteoarthritis was discovered in 27% of the population. In another unrelated study, the prevalence was found to be as low as 2%. This study also found the condition to be more present in men and workers who were involved in heavy manual labour. 

The risk factors for elbow arthritis are:

  • Overuse of the joint
  • Increased stress

Shoulder arthritis

Just like elbow arthritis, the prevalence of shoulder arthritis is difficult to determine. However, studies have shown that between 4 and 26 out of a hundred people will develop shoulder arthritis at some point in their life. 

What are the symptoms?

In the early stage, the major symptom of elbow/shoulder arthritis is pain. The pain is felt when the individual tries to use the joint, and the more severe the arthritis, the greater the pain associated. This pain also leads to loss of range of motion. To avoid the pain and discomfort, the induvial avoid using the joint or only limit the movement to within the painless range. This causes the available movement in the joint reduces over time and can become permanent without adequate treatment.

Other symptoms of the condition include:

  • Muscle weakness
  • Joint stiffness
  • Fatigue
  • Tenderness
  • Swelling
  • Joint deformity
  • Fever
  • Crepitus. A grinding sound heard on the movement of the joint

How is it diagnosed?

Arthritis is usually diagnosed with a series of physical tests, history taking, and imaging scans (in some cases).

The history is taken to assess the individual’s past, with a lookout for any causes like trauma or disease. Special consideration is given to individuals who have risk factors like jobs that require repetitive use of the joints in their history. Since genetics and family hereditary have a role to play in some forms of arthritis, these are also red flags in the detection of this condition.

Physical tests are also performed to identify the structures affected by the arthritis and to separate it from other conditions like referred pain. Diagnosing elbow arthritis with physical tests is difficult because the elbow joint has a limited range of motion. As a result, any conditions affecting the joint can mimic the effects of arthritis during the exam. Imaging scans are often performed to support the tests’ findings.

X-rays can reveal a reduction in the joint space, as well as any degenerative changes that might have occurred in the joint. Advanced scans like CT and MRIs may not be necessary, except in cases where other conditions are also suspected.

What are the treatment options available?

Medication

Medications are effective in managing arthritis, depending on the kind of drug, and the severity of the condition. Analgesics help reduce the pain experienced by the individual and enables them to carry on with their daily activities without limitation. 

However, analgesics do not affect the cause of the arthritis or the resulting inflammation. For this, NSAIDs (Non-steroidal anti-inflammatory drugs) like ibuprofen are prescribed as they can help reduce inflammation. Disease-modifying antirheumatic drugs (DMARDs) are also prescribed in rheumatoid arthritis.

Physiotherapy

Physiotherapy is very effective in certain types of arthritis and can help to maintain and improve the joint range of motion. It can also prevent deformity and progression of the disease

Surgery

Surgeries like joint repair and replacement can also be performed, depending on the severity of the condition. However, the operative approach is always reserved for when all others have failed.

 

Learn More about ongoing clinical studies sponsored by R3 Stem Cell HERE.

 

References

https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772 

https://rheumatoidarthritis.net/symptoms/inflammation-of-joints/

https://www.cedars-sinai.edu/Patients/Health-Conditions/Arthritis-of-the-Elbow.aspx 

https://www.webmd.com/rheumatoid-arthritis/the-causes-of-rheumatoid-arthritis 

https://www.hopkinsmedicine.org/health/conditions-and-diseases/shoulder-arthritis 

https://www.ncbi.nlm.nih.gov/pubmed/15474391 

https://www.ncbi.nlm.nih.gov/pubmed/22958843 

https://www.medicinenet.com/rheumatoid_arthritis_early_symptoms/article.htm 

https://www.mayoclinic.org/diseases-conditions/arthritis/diagnosis-treatment/drc-20350777 

https://www.arthritis.org/living-with-arthritis/treatments/natural/other-therapies/what-is-physical-therapy.php 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408004/ 

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