An innovative approach to pain relief could provide hope for sufferers of rheumatoid arthritis.
In a limited trial at the University of Amsterdam, 17 rheumatoid arthritis sufferers were fitted with an electronic implant in the vagus nerve that controls many of the important functions of the body, including inhibiting inflammation which is the underlying cause of rheumatoid arthritis.
In this degenerative condition, the body’s immune system mistakenly attacks the joints causing swelling, stiffness and pain. The implant works by releasing an electric pulse that stimulates the vagus nerve, reducing the levels of immune cells that cause the damage.
All patients enrolled on the trial had previously failed to respond to medication and all reported a marked reduction in stiffness and discomfort. Rheumatoid arthritis is just one of many different types of arthritis that can affect any joint of the body, including the shoulder. The most common type of shoulder arthritis is osteoarthritis, which is often associated with ageing.
Understanding shoulder arthritis
Arthritis means inflammation of a joint in the body. As the shoulder is a very mobile joint it can develop wear and tear over a lifetime. The cartilage which lies on the bones of the shoulder joint becomes thinner and ultimately can be destroyed. As a result, one bone then rubs on the other causing pain, stiffness and loss of functional abilities. One option is to then consider a shoulder replacement. Whilst this type of surgery is not as common as hip or knee replacements, on average, approximately 4,500 shoulder replacement surgeries are carried out each year in the UK.
Unsurprisingly, the National Joint Registry found that osteoarthritis was indicated in 58% of shoulder replacements, but there are other types of arthritis or conditions that can affect the shoulder requiring replacement surgery. These include
Affecting the joint lining of the shoulder, rheumatoid arthritis is one of the more common types experienced by patients. The autoimmune condition can present itself in one or both shoulders, causing stiffness and pain. Over time, it can lead to deformity of the shoulder joints, as well as an erosion of the shoulder bones.
Shoulder injuries are common, particularly in young athletes. When an injury occurs, it can trigger post-traumatic arthritis. Patients who have experienced shoulder dislocation or fractures are particularly at risk of developing the condition. In this type of arthritis, fluid can build up within the joint, causing pain and swelling.
Rotator cuff tear arthropathy
Rotator cuff injuries are fairly common and they can lead to a type of arthritis known as rotator cuff tear arthropathy. It is most commonly caused by a longstanding tear of the rotator cuff tendons, which results in muscle weakness and loss of support for the shoulder. As a result, a painful arthritis then develops.
Avascular necrosis is a condition whereby the blood supply to the humeral head (ball) is disrupted. This then causes bone cells to die. The body attempts to regenerate itself but the process is flawed and the ball can become very irregular. Conditions that can cause avascular necrosis include sickle cell disease, high dose steroids, excessive alcohol consumption, previous fractures and radiotherapy.
What are the treatment options for shoulder arthritis?
As consultant shoulder surgeon Mr Andy Richards of the London Shoulder Specialists commented in a recent lecture on shoulder arthritis: “There is no cure for arthritis so all the surgeon can do is reduce the symptoms and pain. Range of movement and function may be increased through reducing pain.”
This new electric shock implant may prove beneficial for patients suffering with rheumatoid arthritis. It is worth noting, though, that the trial was very limited so although results are promising, more in-depth studies are required. Also other types of arthritis will require a different approach and these include a range of non-surgical and surgical options. At London Shoulder Specialists, we will first assess the type of shoulder arthritis prior to offering expert, impartial advice on the most appropriate treatment.