Dr. IV Mirus on arthritis

Tatiana: Hello, Dr. IV! I want to ask something related to my mom. She has arthritis sometimes. What should we do? Does arthritis mean you have to exercise or wait until it recovers?

When sleeping, it can be hard to put pressure on the shoulder because of the pain. She has to toss and turn. So, how can we resolve the shoulder pain from the arthritis?

Dr. IV Mirus: Hello, I’m Dr. IV. Thank you for your question about shoulder arthritis. I want to explain what is arthritis. It is when your bone is touching another bone.

For example, in the knee, there usually is a cushion between the bones. No pain there. When you grow up and walk around, the weight pushes down on that cushion. That cushion degrades over time and becomes thinner and thinner. Once it goes away, that’s when you see the bone-on-bone contact. It’s uncomfortable.

[Image of bones around the knee area touching each other with no thick cushion]

That is what causes the pain. It’s called osteoarthritis. You can have arthritis in the knees, typically in the hips, and sometimes in the fingers too. The treatment varies. Sometimes we give anti-inflammatory pills, but it depends on what your doctor says. Some people can’t take them. So the treatment varies. There are some ointments. Sometimes you have a joint injection with steroids to reduce inflammation. It can help the area to heal a little bit. Sometimes, if it is really severe, we’ll do a knee replacement surgery. Because that cushion between the bones is not something that the human body can make more of. Once it’s broken down, it’s gone forever. So that’s why you have to be careful and if you exercise often throughout life, it will prevent that cushion from degrading.

But the shoulder issue is different. You don’t commonly see arthritis in the shoulders. That joint is different because it is a ball and socket. There are many tendons that connects to the muscles to allow it to move around.

[Image of the shoulder joint showing muscles and bones. You can see a few tendons connecting the arm bone to the shoulder bones]

There is not a lot of weight on the shoulders. You don’t see bone-on-bone pressure. It is rare. But what commonly happens is tendonitis, when the bands causes problems. Sometimes the tendons tear. Sometimes it gets inflamed if you injure it. Sometimes the fluid there swells up and it hurts when you move around.

[Image of the arm and shoulder bones with an emphasis on it experiencing pain]

You need to find out if it is actually arthritis or if it is something else. If it is something else, the treatment options changes, right? The doctor can look at your shoulder and see what hurts. Maybe X-ray or a sometimes a MRI to see the tendons and be sure what’s wrong. Once you diagnose and know what’s wrong, it will be clear what treatment you need.