Joint swelling is a common symptom of rheumatoid arthritis (RA), an autoimmune disease that occurs when the immune system mistakenly attacks the body’s cells and tissues. Although RA usually affects the joints in the hands, wrists, and knees, as many as 70 percent of all people with the condition develop symptoms in their shoulder joints at some point.
There are two joints in the shoulder. The acromioclavicular (AC) joint is found where the clavicle (collarbone) meets the tip of the shoulder blade. The joint located where the head of the humerus fits into the shoulder blade is known as the glenohumeral joint. RA can affect either of these joints and is equally common in both.
The most common symptom of shoulder arthritis is pain. When RA affects your AC joint, you’ll feel pain centered around the top of your shoulder. The pain may also radiate or move toward the side of your neck.
RA in the glenohumeral joint leads to deep, aching pain focused in the back of the shoulder. This pain may worsen with changes in the weather. People whose rheumatoid arthritis affects both joints may feel pain throughout the shoulder.
Members of myRAteam have said RA shoulder pain causes many different sensations. As one member wrote when their symptoms flared up in the winter, “The pain started in my left shoulder and now has migrated to my right shoulder. And if it goes like previous years, it ping-pongs back and forth between the two shoulders — for the next few months, anyway — until spring comes along.”
RA in the shoulder can also limit your range of motion. You may have trouble lifting your arm above your head, or you may hear a clicking, grinding, or snapping sound (known as crepitus) when moving your shoulder. Another member shared that the discomfort in their shoulders, shoulder blades, and neck causes “more stiffness than pain.”
Pain and stiffness in the shoulders can often lead to difficulties sleeping. “My shoulders are so painful. I got very little sleep last night,” wrote one member. “The pain seems somewhat better for the day, but at nighttime, [my shoulders] were uncooperative!”
As another member wrote, just trying to lie down can cause pain: “I can hardly lie on my shoulders.”
Shoulder pain is common in RA — up to 70 percent of people with the condition experience it at least once. If you start noticing discomfort, redness, or swelling in your shoulder, talk to your doctor. They can take your medical history and perform tests like X-rays or an ultrasound to help determine if you have some type of inflammatory arthritis. Once they’ve collected enough information, they can provide medical advice.
Many different treatment options exist for shoulder pain from RA. Some myRAteam members find pain relief from their systemic medications. Others use additional at-home remedies, such as hot and cold therapy, to help ease stiffness and discomfort.
If you’re experiencing RA symptoms in your shoulder, talk to your doctor about finding the right combination of treatments to alleviate pain and swelling. They may prescribe or recommend the following options.
Your rheumatologist may recommend a combination of systemic drugs, which treat the underlying disease, as well as over-the-counter or prescription pain relievers for shoulder pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and reduce inflammation caused by RA. NSAIDs include over-the-counter medications, such as ibuprofen (Advil), as well as other options available only by prescription.
Some medications can help treat the underlying inflammatory response that causes RA symptoms. These medications, which include disease-modifying antirheumatic drugs (DMARDs) and biologics, work to treat rheumatoid arthritis by slowing disease progression and preventing joint damage and deformity.
If you’re experiencing a flare-up of RA symptoms in your shoulder, your doctor may prescribe injections of corticosteroids. Steroid injections are mainly used in the short term to control RA symptoms during disease flares. Some people may find these treatments uncomfortable or even painful initially. One myRAteam member shared, “I had a cortisone shot in my shoulder yesterday … Holy cow, Batman, it hurt! I’m hoping to get some relief — my shoulders have been killing me.”
If nonsurgical treatments are unsuccessful in providing relief, your doctor may recommend shoulder surgery. Surgeries for RA in the shoulder include arthroscopy — which involves debriding (cleaning out) the inside of the affected joints — and shoulder joint replacement (also called arthroplasty or shoulder replacement surgery).
Your rheumatologist may recommend physical therapy to help improve flexibility, strength, and range of motion. Physical therapists teach specific exercises to help people manage pain, reduce the symptoms of an injury or disease, and improve movement and function.
You might also consider working with an occupational therapist, who can help you make adjustments in your environment and everyday tasks to reduce pain and discomfort during activities and when sleeping.
Some myRAteam members have found that gentle movements help provide relief. “I don’t know how to describe it, but I kind of sit up and ‘roll’ my shoulders a few times. It seems to help to keep them moving,” one member shared.
Another member found a way of managing nighttime pain: “I was diagnosed almost 50 years ago with RA. For 30-plus years, I’ve slept with a pillow under my arms. It keeps my shoulders open and helps me sleep.”
Applying heat or cold where you experience pain can bring some relief, notes Cleveland Clinic. Cold can ease swelling and relieve pain through numbing. Heat can boost flexibility and circulation by loosening your muscles.
To apply heat, try taking a hot bath or a warm shower. You could also apply a heating pad or a damp washcloth you’ve warmed up in the microwave for 20 seconds. (Be careful that it’s not too hot before applying!)
For cold therapy, the American Academy of Orthopaedic Surgeons recommends icing your shoulders for 20 to 30 minutes two or three times each day to relieve pain and reduce inflammation. You could use cold packs, bags of frozen vegetables, or ice cubes in a bag.
One member shared that icing their shoulders was effective alongside using corticosteroids in managing their discomfort: “I spent all day on Christmas balancing ice bags on my shoulders. It looked silly, but I didn’t really care. I have had luck with prednisone.”
Another member shared a similar holiday experience: “I had shoulder pain before Thanksgiving and was also using ice packs. My RA doc gave me an injection in each [shoulder] and started me on prednisone. So far, so good.”
One myRAteam member found that hot and cold therapy worked particularly well with the addition of a pain-relieving spray. “I use heat and cold compresses and gently apply Biofreeze. I will wear a sling, too,” they said.
On myRAteam — the social network for people with RA and their loved ones — more than 197,000 members come together to share advice, offer support, and discuss daily life with rheumatoid arthritis.
Have you had shoulder pain with your RA? What has helped you find relief? Share your tips in the comments below or by posting on myRAteam.