Arthritis & Diseases that Affect the Shoulder
Joint inflammation and other problems that may be to blame for shoulder pain.
Many forms of arthritis and related conditions that affect the joints, muscles and/or bones can cause problems like pain, stiffness and swelling in the shoulders. Here are some diseases that can affect the shoulders.
- Osteoarthritis. The most common form of arthritis, osteoarthritis is a chronic condition characterized by the breakdown of the cartilage that cushions the ends of the bones where they meet to form joints. This breakdown causes the bones to rub against each other, causing stiffness, pain and loss of movement in the joint. Bony projections, or spurs, can develop around the joint. In the shoulder, osteoarthritis often occurs after an injury.
- Rheumatoid arthritis. Rheumatoid arthritis is a chronic inflammatory disease of the joints that occurs when the body’s immune system – which normally protects us from infection – mistakenly attacks the synovium, the thin membrane that lines the joints. The result can be joint damage, pain, swelling, inflammation, loss of function and disability. The joint involvement of rheumatoid arthritis is symmetrical. That means if one shoulder is affected the other likely will be too.
- Juvenile arthritis. Juvenile arthritis is the term used to describe arthritis when it begins before age 16. There are several different types of juvenile arthritis that can cause pain, swelling and potentially destruction of the shoulders.
- Gout. Gout is a form of arthritis that occurs when excess uric acid, a bodily waste product circulating in the bloodstream, is deposited as needle-shaped monosodium urate crystals in tissues of the body, including the joints. For many people, the first symptom of gout is excruciating pain and swelling in the big toe – often following a trauma, such as an illness or injury. Subsequent attacks may occur off and on in other joints, typically the feet, ankles, hands, wrists, elbows and knees. Shoulder involvement is less common, but can occur.
- Calcium pyrophosphate dihydrate crystal deposition disease (pseudogout). Like gout, pseudogout occurs when crystals form within the joints. With pseudogout, however, the crystals are formed from a salt called calcium pyrophosphate dihydrate. Although pseudogout occurs mostly in older people, it can affect younger people, particularly if they have other health problems. And like gout, pseudogout can cause intense pain and swelling, which often comes during the night. Pseudogout most commonly affects the knee, wrist and shoulder joints.
- Reactive arthritis. Reactive arthritis is a chronic form of arthritis that often occurs following an infection of the genital, urinary or gastrointestinal system. Features of reactive arthritis include inflammation and swelling of the joints, eyes and structures within the gastrointestinal or genitourinary tracts, such as intestines, kidneys or bladder. Although the ankles, knees and joints of the feet often are the first joints affected by reactive arthritis, it also can affect the shoulder.
- Lupus. Lupus is a chronic autoimmune disease, meaning the body's immune system creates antibodies that attack healthy tissues, including the joints, skin, heart, lungs, and kidneys. The joints farthest from the body, such as those of the hands and feet, are most commonly affected by lupus; however, muscle inflammation that often accompanies lupus usually affects the shoulders as well as the muscles of the neck, pelvis, thighs and upper arms.
- Infectious arthritis. Also called septic arthritis, infectious arthritis refers to arthritis that is caused by an infection within the joint. Infectious arthritis is often caused by bacteria that spread through the bloodstream to the joint. Sometimes it is caused by viruses or fungi. Infectious arthritis can affect the shoulders. Untreated, infection can lead to joint destruction.
- Polymyositis. Polymyositis, meaning inflammation of many muscles, is one of a group of disorders characterized by inflammation and muscle weakness. The main symptom of polymyositis is symmetric weakness of the large muscles closest to the trunk. Initially, the hips, thighs and shoulders are commonly affected. The shoulder and pelvic girdle muscles are most severely affected. The weakness may make it difficult to lift heavy objects or even lift your arm to comb your hair or to put on a coat.
- Dermatomyositis. Dermatomyositis is an inflammatory disease of the muscles, like polymyositis. However, dermatomyositis has a somewhat severe onset and affects both children and adults. In addition to the symptoms of polymyositis, including pain and weakness of the muscles around the shoulders and pelvis, symptoms of dermatomyositis also include a patchy skin rash, purplish discoloration of the eyelids, swelling around the eyes, changes around the nail beds and calcium deposits in the shoulders, pelvis, hips, calves and thighs, which may limit motion.
- Polymyalgia rheumatica. Polymyalgia rheumatica is a rheumatic disorder characterized by pain and stiffness in the neck, shoulders and hips. It usually develops gradually but may come on suddenly. It is rare in people less than age 50, but becomes more common with age. It often resolves on its own over time.
- Osteonecrosis. Also called avascular necrosis, aseptic necrosis or ischemic necrosis, osteonecrosis is a disease in which a temporary or permanent loss of blood supply to the bone causes the bone to die and eventually collapse. It often occurs in a bone near the joint, which causes the collapse of the joint surface. The disease is most common in the top of the thigh bone (femur). Other common sites include the upper arms, knees, shoulders and ankles.
- Lyme disease. Lyme disease is an infectious disease spread by the bite of deer ticks infected with the bacteria Borrelia burgdorferi. The first symptoms are often a bulls-eye-shaped rash and flu-like symptoms. If not treated early, the disease symptoms may progress to involvement of the heart, nervous system and joints, including the shoulder.
- Other diseases. Sometimes pain in the shoulders is due to causes outside the joint. Causes of pain to the shoulder are as diverse as gallstones, liver abscess, angina or heart attack, or even an ectopic pregnancy. If you experience unusual shoulder pain it is important to see a doctor to find the cause.