Inflammatory arthritis is a category of arthropathies caused by an overactive immune system. If you are experiencing debilitating shoulder pain from inflammatory arthritis and need additional pain relief options, you may want to discuss a synovectomy with your orthopedic surgeon.
Poor Relief From Prescription Treatments
Although inflammatory arthritis typically affects many joints, it is not uncommon to have one or more joints that are disproportionately affected. You may have reached a point in your current treatment where prescription pain medications and immunosuppressive treatments do little to alleviate the inflammation in your shoulder.
Steroid shots injected directly into your shoulder are an option, but you are limited in the number of shots you can receive due to concerns of bone and tissue destruction. Since long-term use of prescription anti-inflammatory medications and corticosteroids can have numerous side effects, it may be safer and more effective to have surgery that directly affects your shoulder.
To Prevent Substantial Joint Destruction
When you have inflammatory arthritis, it is likely your rheumatologist has taken x-rays of your affected joints. Your rheumatologist may notice increased radiographic evidence that signals more destruction of your shoulder. To avoid or minimize the likelihood you will need a partial or complete shoulder replacement in the future, removing the synovium can decrease or halt the destruction of your shoulder.
You are more likely to benefit from a shoulder synovectomy if you have evidence of inflammation and damage that has not reached the point of causing significant destruction to the joint or rotator cuff. Since continual inflammation and swelling can eventually cause partial or complete tears in the ligaments, a synovectomy may prevent shoulder instability from occurring in the future.
Inadequate Range Of Motion
In addition to constant shoulder pain, you may experience a significant decrease in your range of motion (ROM), which can impede daily activities. For a synovectomy to be a potential treatment option, your decreased ROM should be attributed to pain and swelling, and not damage to the ligaments necessary to support your shoulder.
There is concern about decreased ROM after a synovectomy, because the synovium helps line the joint and provides lubrication. The surgery is best for situations when pain relief and prevention of further joint destruction is the major concern, and ROM is of lesser importance or may improve after surgery.
Although surgery is often a last resort for inflammatory arthritis affecting the shoulder, there are instances when a synovectomy should not wait. Contact a local specialist, such as Interior Alaska Orthopedic & Sports Medicine, for more information on treatment options. Removal of your shoulder's synovial lining can give you a better quality of life when conservative treatments have failed and potentially delay or prevent the need for a joint replacement.