Arthritis: Should I Have Shoulder Replacement Surgery?

Osteoarthritis is a painful problem with the cartilage in the joints. It occurs when the cartilage that cushions your joints breaks down and wears away. When this happens, the bones rub together and cause damage and pain. In most cases, it takes years for cartilage to break down.

As your arthritis gets worse, you may not be able to fully rotate, flex, or extend the joint that hurts. Or you may not be able to use the joint at all.

In shoulder replacement surgery, the surgeon removes the ends of the damaged upper arm bones and replaces them with plastic or metal pieces.

Most people are able to get out of bed with some help on the day of surgery and go home 1 to 3 days later.

You will start physical therapy right away and continue to do it for several months to get the best use of your new joint. A physical therapist will teach you how to use a pulley device so you can also do arm exercises at home.

After surgery:

• You may be able to go back to doing your normal activities with less pain. Many people are able to go back to playing sports such as golf, swimming, riding a bike, and cross-country skiing.
• Your shoulder won't move as far as it did before you started to have shoulder problems. How much you'll be able to move your shoulder depends on how much you could move it before you had surgery and whether the soft tissues around your shoulder were also damaged.

Artificial shoulder joints typically last 10 to 20 years. You may need to have another surgery if the new joint becomes loose or wears out. Your new joint may last longer if you don't do hard physical work or activities that put a lot of stress on the joint.

Shoulder replacement surgery has some risks. They include:

• Infection and problems with wound healing.
• Injury to the nerves or blood vessels of the shoulder.
• Lack of good range of motion.
• A dislocated shoulder.
• A fracture of the upper arm bone.
• An unstable or wobbly joint.
• A blood clot.
• Problems from general anesthesia.

Most people can manage their symptoms with treatments that don't involve surgery. These may include:

• Medicine. If your pain is mild, over-the-counter pain medicines may help. These include acetaminophen (for example, Tylenol) and nonsteroidal anti-inflammatory drugs, such as ibuprofen (for example, Advil, Motrin) or naproxen (for example, Aleve). But if these don't get rid of your pain, you may need a stronger prescription medicine. Be safe with medicines. Read and follow all instructions on the label.
• Exercise. It can help keep your muscles strong and your joints moving well.
• Physical therapy. This includes specific exercises that can help you stretch and strengthen your shoulder muscles and reduce pain and stiffness.
• Heat. It can reduce pain and stiffness and can help you loosen up before an activity.
• Ice. It can help reduce pain and swelling and is a good pain reliever after an activity.
• Pain-relieving gels or creams, such as capsaicin. Or shots of medicine may also help.

Some other things that you may try include:

• Acupuncture. It involves putting very tiny needles into your skin at certain places on your body to try to relieve pain.
• Relaxation and breathing exercises, such as meditation, guided imagery, and yoga. These can help reduce stress and relax your mind and muscles.

Your doctor might recommend shoulder replacement if:

• You have very bad pain.
• You can barely move your arm and shoulder.
• You have lost a lot of cartilage.
• You have tried medicine and other treatments, but they haven't helped.
• Your health is good.