The popular perception of arthritis is that it is a condition that only really affects the elderly. Although of course it is more prevalent in older people, younger people (and by this we mean people aged under 50) can - and do - develop the condition. And there are also types of arthritis that can have a very early onset – in childhood or adolescence.
Shoulder arthritis affecting younger people can be the result of a range of different causes. The following is a short (but not exhaustive) summary of some of these causes...
Trauma to the shoulder
Cartilage loss and/or destruction of joint due to trauma to the shoulder (including dislocation and fracture), which may be as a result of an accident or sports injury or a physically demanding occupation, for example active military service. This is referred to as post-traumatic arthritis.
Primary Osteoarthritis
Osteoarthritis (wear and tear of the joint cartilage) usually affects people after 55 to 60, but can affect people as young as 40, causing significant pain, stiffness and dysfunction.
Overuse of the shoulder
Though arthritis cannot be directly linked to overuse injuries at work or sport, where this overuse has occurred over a period of time, the joint and surrounding tissues may suffer repetitive microtrauma resulting in rotator cuff injuries and/or cartilage damage that do not have time to recover properly. This may later on lead to secondary osteoarthritis.
Infection
'Septic' or 'infectious' arthritis can set in when the joint is affected by an infection. This can be caused by bacteria (transmitted by the blood) or by a virus or fungal infection.
Rheumatoid arthritis
Although rheumatoid arthritis develops mainly in people in the 30-80 age bracket, it can appear, albeit rarely, at a younger age. A recent study indicated that there is an increased risk for women in developing the condition in their twenties over men, with a 1 in 714 chance for women in this age group, as against a 1 in 2778 chance for men*. As with other types of autoimmune conditions, research indicates that there may be a hereditary component with rheumatoid arthritis, however other risk factors or triggers for the condition include viral/bacterial infection, some specific hormones, emotional stress, physical trauma and smoking.
Juvenile idiopathic arthritis (JIA)
This refers to a range of autoimmune conditions that can affect children under 16. One in eight hundred children under 16 in Australia has some form of this condition.
Pseudogout
Although very rare in young people, it can occur especially where the person has other health issues.
Treatment
Even though treatment depends entirely on the specific cause of the arthritis, a common thread is that a healthy diet is beneficial in almost all cases. There is no one food that 'fixes' arthritis, however research shows that a diet with plenty of vegetables, fish and olive oil (the 'Mediterranean Diet') can help the body manage inflammation better. Omega 3 rich foods such as oily fish, walnuts and linseed all play a role in reduction of inflammation in the body.
If symptoms affect work, sport and activity, seeing a physiotherapist, regular stretching and range of movement exercises along with a healthy diet and pain management with simple analgesics (like paracetamol) is the first line of management.
Patients should see their GP and if required an orthopaedic surgeon to discuss other options as symptoms worsen. Other options may include joint injections or surgery. Surgery in the form of joint preserving procedures (eg. arthroscopic surgery) or joint replacement options may be required once all conservative measures are exhausted, but is best delayed for as long as possible – preferably until the individual is at least about 55 years of age.
Shoulder arthritis is not often 'on the radar' of younger people and so they can often miss early symptoms, but with increasing participation in sports at a young age, it is worth keeping an eye out for early signs of the condition.
*Investigating asthma, allergic disease, passive smoke exposure, and risk of rheumatoid arthritis Arthritis & Rheumatology February 2019 https://onlinelibrary.wiley.com/doi/abs/10.1002/art.40858 doi: 10.1002/art.40858
