Rheumatoid arthritis (RA) is an autoimmune disease in which the body mistakenly attacks its own joints, leading to pain in the affected areas. The symptoms of RA differ from those of other types of arthritis, so there are special requirements for its diagnosis and treatment.
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The treatment options for RA depend on the symptoms. In some cases, doctors may recommend nonsurgical treatments, such as physical therapy and exercises, while in others, they might suggest surgery.
Learn about what causes RA and the different ways to treat it.
RA is an autoimmune disease, which means that the immune system attacks other areas of the body. In RA, this causes inflammation and pain in the joints, including those in the hands, knees, and wrists.
The damage that RA causes leads to wear and tear of the bone cartilage. RA is a symmetrical disease, which means that a person with joint pain in the right shoulder blade will also experience pain in the left shoulder blade. This characteristic helps doctors differentiate RA from other types of arthritis, such as osteoarthritis.
The exact causes of RA are still unconfirmed. However, experts know that people living with RA feel pain because their immune system sends antibodies to attack the synovial lining of their bones. The antibodies release chemicals that damage the cartilage and the tendons and ligaments.
A delay in treating RA can result in joint destruction and functional disability.
RA is an inflammatory disease that affects the joints of the body. People living with RA experience alternating periods of remission, during which the pain reduces, and flares, when the pain is intense.
Common areas of attack include joints in the hands, knees, and ankles. However, it can affect other tissues and organs in the body, including the heart, lungs, and eyes.
When RA affects the shoulders, the symptoms may include:
- pain and stiffness in the shoulder
- tenderness and swelling of the shoulder joints
- bilateral joint pain
- deformed joints
- low grade fever
- loss of appetite
The symptoms can be mild or severe, but it is best not to ignore them either way. Notifying a doctor of any early symptoms will help in treating and managing RA promptly.
Pain in the shoulder is the primary symptom of shoulder arthritis, and it may vary among individuals. While some people may feel a deep pain in their shoulder joint, others may feel pain that spreads up to their neck.
Aside from pain, the symptoms may include an inability to move the shoulder blades. People with shoulder injuries or stubborn aches that do not resolve should speak with a doctor. They will check for any obstruction to movement and ask the person whether they feel pain on moving the shoulder.
After the examination, the doctor will use X-rays to check the bones and see whether any unusual changes have taken place. To confirm a diagnosis of RA, the doctor will administer a steroid injection into the affected joint. If the person has RA, this treatment should reduce or eliminate the pain in the short term.
It is possible to treat shoulder arthritis. A doctor can work with a person to create a treatment plan that is likely to be effective for them based on their symptoms and preferences. The nonsurgical treatment options may include:
- physical therapy exercises to improve movement in the shoulder
- heat or cold therapy, which involves heating or icing the affected area for 20–30 minutes at a time
- maintaining a nutrient-dense diet that is low in sugar and saturated and trans fats, as these can exacerbate arthritis inflammation and symptoms
- nonsteroidal anti-inflammatory medications (NSAIDs), such as aspirin or ibuprofen, which can help reduce inflammation and pain
- disease-modifying antirheumatic drugs, such as methotrexate
- corticosteroids injections, such as cortisone, which doctors deliver directly into the shoulder for a short-term reduction in inflammation and pain
Surgical treatments that doctors may recommend for shoulder arthritis include:
- Arthroscopy: During this procedure, the surgeon will make a small incision and insert a tiny camera into the joint. This camera will guide them as they use miniature surgical instruments to clean out the inside of the joint.
- Joint replacement surgery: Joint replacement of the shoulder, which is also called arthroplasty, involves replacing the damaged parts of the shoulder with an artificial prosthetic joint.
- Resection arthroplasty: After trying all other reconstructive options, a doctor may recommend this procedure as a last resort. The surgeon will need to remove any prosthetic implants, due to either infection or unsuccessful surgery.
Many conditions and factors can cause or contribute to shoulder pain. As well as arthritis, these include:
- Tendon tear: These tears may partially or completely remove the tendon from the bone. In the case of a complete tear, the tendon falls off the bone.
- Instability: Shoulder instability arises when injury or overuse of the joint causes the forceful removal of the head of the upper arm bone from its socket.
- Impingement: Shoulder impingement is when the top of the shoulder blade presses on the underlying soft tissues as the arm moves away from the body.
- Fracture: Shoulder fractures can involve the collarbone, upper arm bone, or shoulder blade. They often cause severe pain, swelling, and bruising around the shoulder.
Rheumatoid arthritis in the shoulder is treatable but only when the treatment begins early. It is best not to ignore any symptoms of arthritis.
Seeking a diagnosis from a doctor is the first step toward managing and treating RA in the shoulder.