Dr. Ryan Simovitch: Options for Treating Shoulder Arthritis
Dr. Ryan Simovitch
Ask the Shoulder Surgeon
Question: I have been diagnosed with shoulder arthritis. I really want to avoid surgery. What are my options?
Answer: Shoulder arthritis occurs when cartilage — the smooth surface covering the humeral head and socket — degenerates. As this process progresses, patients experience range-of-motion limitations, joint noise (crepitus) and pain.
Initial treatment usually involves activity modification (avoid painful movements), ice, and the use of over-the-counter anti-inflammatories when not contraindicated by a gastro-intestinal issue.
When these measures fail to provide relief, your surgeon will typically offer you a cortisone injection. These are safe if administered correctly and used judiciously. Over time, though, they can contribute to degeneration of the rotator cuff and shoulder joint.
Other injections that might be considered are hyaluronic acid injections (viscosupplementation), platelet-rich plasma injection and stem-cell injections. None of these are considered the standard of care and are not typically covered by insurance carriers.
Stem-cell injections and PRP injections have not convincingly been shown to arrest the progression of arthritis in orthopaedic peer-reviewed literature.
Hyaluronic-acid injections have not been demonstrated to be effective in the shoulder, but it is effective in the knee, so it holds some promise.
When these treatments fail, shoulder replacement remains a viable and successful option for improving function and lessening pain.
You may read the original article here, published Dec. 29, 2013.
Dr. Ryan Simovitch specializes in treating Sports Injuries, Shoulders & Arthroscopy and is available in the Palm Beach Gardens, West Palm Beach, Wellington, and Jupiter locations.
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