Shoulder Conditions

What is shoulder joint arthritis?

Glenohumeral joint osteoarthritis, often simply called shoulder arthritis, is a condition that affects the main shoulder joint. It can cause pain, stiffness, and reduced function, making everyday tasks challenging.

The shoulder joint, or glenohumeral joint, connects the upper arm bone (humerus) with the shoulder blade (scapula). Like all joints, it has smooth tissue called cartilage covering the ends of the bones. This cartilage helps the bones glide against each other. In osteoarthritis, this cartilage gradually thins, leading to pain and stiffness.

How Does It Develop?

Osteoarthritis is often called “wear-and-tear” arthritis because it usually develops over time as we age. However, other factors can contribute, including:

Previous Injuries: A shoulder injury can damage the joint, increasing the risk of arthritis later on
Overuse: Repeated use of the shoulder in activities like sports or certain jobs can accelerate cartilage breakdown
Genetics: If your family has a history of arthritis, you might be more prone to developing it
Rheumatological conditions: some auto-immune joint disorders affect the shoulder in particular which can accelerate the loss of cartilage and development of inflamtion.

As the cartilage thins, the joint becomes painful and inflamed. Over time this progresses to restricted movement, particularly rotating the shoulder inwards and outwards.

Symptoms of shoulder joint arthritis

The symptoms of shoulder joint osteoarthritis typically include:

Pain: This is usually the first symptom. It can be a dull ache or sharp pain, often worsening with activity and improving with rest.
Stiffness: You might find it hard to move your shoulder, especially after periods of inactivity.
Swelling: The joint may appear swollen or feel warm to the touch.
Crepitus: A grinding or clicking sensation when moving the shoulder.

Diagnosing shoulder joint arthritis

If you suspect you have shoulder arthritis, a visit to a healthcare provider is recommended. Following a detailed history and examination, investigations are usually used to confirm the diagnosis. X-rays are the first line, however sometimes an MRI or CT scan may be needed for a more detailed view.

Managing shoulder joint arthritis

While there is no cure for osteoarthritis, several treatment options can help manage symptoms and improve quality of life:

1. Lifestyle Changes:

Activity modification: Where possible try to avoid or minimise activities that exacerbate pain.
Exercise prescription: Gentle exercises and stretching can maintain mobility and strengthen surrounding muscles. A physiotherapist can guide you in a safe and effective exercise routine.

2. Medications:

Pain Relievers: Over-the-counter medications like paracetamol or ibuprofen (if appropriate and tolerated) can help manage pain and inflammation.
Prescription Medications: For more severe pain, stronger pain relieving medication may be appropriate

3. Injection therapies:

Previously corticosteroid injections were recommended, however there are concerns around the impact these may have on the health of the joint should a shoulder replacement be considered in the future, so many specialists do not routinely recommend these.
Hyaluronic Acid Injections: This treatment aims to improve joint lubrication and is commonly used in the knee and ankle. The evidence on benefit in the shoulder is less certain so, again, many specialists do not routinely recommend these.
Suprascapular nerve block: The nerves which detect pain in the shoulder joint can be blocked for an extended period using an injection technique. This has the benefit of significantly reducing pain, whilst avoiding the pitfalls of injection into the joint itself. The procedure can be repeated if needed without any ongoing concerns so, for this reason, nerve block is recommended by many specialists.

4. Surgery:

Arthroscopy: A minimally invasive procedure to clean out the joint, however this is rarely of sustained benefit and often provides no better relief than a combination of the other options outlined above
Shoulder Replacement: In severe cases, replacing the damaged joint with an artificial one might be the best option. Previously the success of this type of joint replacement was mixed however, with newer techniques and implants, many people find this an effective way to improve pain and function.

Living with shoulder joint arthritis

Managing shoulder arthritis involves a combination of treatments and lifestyle adjustments. Staying active, eating a healthy diet, and protecting your joints can also make a significant difference.

See below for a patient information leaflet from Versus Arthritis.

Patient information leaflet Download

Summary

Remember, while shoulder arthritis can be challenging, many people live full, active lives with the right approach to treatment and self-care. If you have any concerns about your shoulder pain or mobility, don’t hesitate to contact us to arrange an appointment with Dr Collins.

1 – The symptoms

From nowhere, and for no apparent reason, you start to notice an ache in the upper arm. Gradually the pain worsens causing sudden, more severe spasms when you move the arm or bang it against something. Soon you can’t sleep on that side and are getting interrupted nights along with finding it harder and harder to get dressed.

2 – Why does it happen?

Frozen Shoulder, also called Adhesive Capsulitis, is a condition which will affect around 5% of us, mainly during middle age. For such a common condition we don’t exactly know what causes it. It’s more common in women and people who are diabetic can get a more severe form of the condition but otherwise there may be no obvious reason for why we get it.

3 – What can I do for the pain?

Once started, the lining of the joint becomes inflamed causing pain at rest or on moving the joint. At this point the most important treatment is to settle the inflammation. In mild cases this can be through the use of over-the-counter anti-inflammatory medication but in most cases the best treatment is a steroid injection into the joint. If administered early then symptoms can settle quickly and return you to normal function.

4 – What can I do for the stiffness?

If the inflammation stage is ignored and left untreated then the joint lining becomes thickened making the shoulder stiff and, instead of pain, you may find it hard to do daily activities. This stiffness can last up to 12 months (with some studies showing it can go on for even longer than that) so, if things are very disabling, further treatment is recommended. This can be keyhole surgery called capsular release which frees up the joint lining or an injection treatment called hydrodistension which uses a large volume of fluid to loosen the stiffened joint.

5 – What if I do nothing?

If left completely untreated, Frozen Shoulder gradually settles down by itself and typically doesn’t recur on the same side, however once you’ve had it you have an increased chance of getting it on the other side, so being aware of this and seeking early treatment if you notice the tell-tale symptoms will get you back to your old self more quickly.

For more detailed information on Frozen Shoulder click here and to contact us to find out what treatments I offer feel free to call or email us.

Category: Shoulder Conditions

Shoulder joint arthritis