Osteoarthritis of the Shoulder

Definition

Osteoarthritis (OA) is the most common chronic condition in joints. In a normal joint, cartilage covers the end of each bone and provides a smooth gliding surface for joint motion to occur and acts as a cushion between the bones. In joints where osteoarthritis is present, this cartilage breaks down; causing pain, swelling and problems moving the joint. As OA worsens over time, bones may break down and develop growths called spurs. In the final stages of OA, the cartilage wears away and bone rubs against bone, leading to joint damage and increased pain.

Causes

Risk factors for developing OA include age, gender, obesity, structural changes, weakness in the muscles surrounding the shoulder joint and history of trauma. OA could occur through aging and usually begins to occur from the ages 55-60 and is more common in females. Generally, this is known as normal wear and tear of the joint. 

There may be some triggers that can also intensify the cartilage breakdown including injury, obesity, genetic factors, and some medical conditions such as diabetes and rheumatoid arthritis. 

Long-standing rotator cuff tendon tears can also lead to OA. This occurs when the rotator cuff tendons and muscles can not provide stability to the shoulder joint;  subsequently damaging the surface of the bones and causing OA. Having weakness in the rotator cuff tendons, combined with arthritis of the joint can cause severe pain, weakness and reduced arm movement and function. 

Signs & Symptoms

The most common symptoms of shoulder OA is the pain limiting movement and a clicking or grinding sound. People with shoulder arthritis often feel a deep ache on the side and back of the shoulder joint. This pain usually worsens throughout the day and occasionally people feel that their pain gets worse with the colder weather. 

As a result of the pain and lack of use, muscles begin to get weak. This can limit activities such as being able to wash your hair, put your arm behind your back or lift a kettle. 

Treatment

It is usually recommended to trial a period of rehabilitation before going through more invasive treatment options such as corticosteroid injection or shoulder surgery. 

Pain can be managing in various ways, including: 

• Medication and anti-inflammatories – You can speak to your GP about the appropriate medication for you. 
• Task modification and pacing
• Taking regular breaks 
• Using the arm within the range of comfort 
• Physiotherapy 
• Heat or ice packs
• Exercise

If the problem is considered severe and a period of rehabilitation has not been effective, this may indicate the need for a corticosteroid injection – however, people often find that this has a  short-term effect. The last option would be for shoulder surgery; such as an arthroscopy and shoulder joint replacement surgeries.

How Can I Prevent Osteoarthritis of the Shoulder?

Maintaining joint mobility, living a healthy lifestyle, regular stretching and strengthening can help with the prevention of shoulder OA.

Melbourne Hand Therapy Can Help You

At Melbourne Hand Therapy we have very experienced physiotherapists who specialise in the treating of problems involving the shoulder joint and can help guide you through the correct treatment you require. We also work alongside many excellent shoulder surgeons and can provide a referral if required. 

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