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RA in the Shoulder: Symptoms and Treatments

Posted on February 25, 2021
See how 1699 members reacted on this article
Medically reviewed by
Diane M. Horowitz, M.D.
Article written by
Victoria Menard

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, more than half of all people with rheumatoid arthritis will develop symptoms in their shoulder joints.

There are two joints in the shoulder. The acromioclavicular joint, or 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.

What Does RA in the Shoulder Feel Like?

The most common symptom of shoulder arthritis is pain. When RA affects the AC joint, a person will feel the pain centered around the top of the shoulder. The pain may also radiate or move toward the side of the 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.

Some myRAteam members have said RA shoulder pain causes many different sensations. As one member wrote when their symptoms started "acting up” again 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.”

Aside from pain, RA in the shoulder can also cause limited 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 — up to 70 percent of people experience it at least once. If you start noticing discomfort, redness, or swelling in your shoulder, talk to a doctor or your dermatologist. They will be able to determine if RA is, in fact, causing your symptoms.

Pain Management and Treatment for RA in the Shoulder

Many different treatments exist for shoulder RA symptoms. Some myRAteam members find pain relief from their systemic medications, and 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.

Medications

Your rheumatologist may recommend a combination of systemic drugs, which treat the underlying disease, and over-the-counter or prescription pain relievers.

Nonsteroidal Anti-Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and reduce inflammation caused by RA. NSAIDs include over-the-counter medications, such as Advil (ibuprofen), as well as other options only available by prescription.

Systemic Arthritis Medications

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 deformities.

Steroid Injections

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.”

Surgery

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.

Physical and Occupational Therapy

Your rheumatologist may recommend physical therapy to help improve flexibility, strength, and range of motion. An occupational therapist 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 have helped 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.”

Heat and 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.

As one member shared, icing their shoulders was effective alongside 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 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.

Find Your Community

On myRAteam, more than 142,000 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.

Diane M. Horowitz, M.D. is an internal medicine and rheumatology specialist. Review provided by VeriMed Healthcare Network. Learn more about her here.
Victoria Menard is a writer at MyHealthTeam. Learn more about her here.

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