Shoulder Osteoarthritis​

Shoulder osteoarthritis (OA) is a degenerative joint disease that affects the shoulder, specifically the glenohumeral joint (where the upper arm bone, or humerus, fits into the shoulder blade, or scapula) or the acromioclavicular (AC) joint (where the collarbone meets the shoulder blade). In osteoarthritis, the cartilage that cushions the ends of the bones gradually wears away, leading to pain, stiffness, and loss of joint function.

Causes

Shoulder osteoarthritis can develop due to several factors:

• Aging: The most common cause, as the cartilage naturally deteriorates over time.
• Previous injuries: Shoulder injuries such as fractures, dislocations, or rotator cuff tears can increase the risk of developing osteoarthritis later in life.
• Repetitive stress: Repeated overhead motions or heavy lifting, common in certain sports or occupations, can contribute to joint wear and tear.
• Genetics: A family history of osteoarthritis can increase the likelihood of developing the condition.
• Inflammatory conditions: Conditions like rheumatoid arthritis or chronic shoulder inflammation can also lead to the development of osteoarthritis.

Symptoms

The symptoms of shoulder osteoarthritis typically develop gradually and may include:

• Pain: A dull, aching pain in the shoulder that worsens with activity and improves with rest. Pain may also be felt at night, disrupting sleep.
• Stiffness: Reduced range of motion, particularly when lifting the arm above the head or reaching behind the back.
• Grinding or clicking: A sensation of grinding, clicking, or catching in the shoulder, caused by the rough surfaces of the joint rubbing against each other.
• Swelling: Mild swelling around the shoulder joint due to inflammation.
• Weakness: Muscle weakness in the shoulder, making it difficult to perform daily tasks.

Diagnosis

Diagnosing shoulder osteoarthritis typically involves:

• Medical history and physical examination: The healthcare provider will assess symptoms, examine the shoulder for signs of pain, swelling, and reduced range of motion, and inquire about any previous injuries or conditions.
• Imaging: X-rays are commonly used to confirm the diagnosis, showing joint space narrowing, bone spurs (osteophytes), and other signs of joint degeneration. MRI or CT scans may be used in some cases to assess the extent of cartilage damage or evaluate soft tissue involvement.

Treatment

Treatment for shoulder osteoarthritis aims to relieve symptoms, improve joint function, and enhance the quality of life:

• Non-surgical treatment:
  • Medications: Over-the-counter pain relievers (such as acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.
  • Physical therapy: Exercises to strengthen the shoulder muscles, improve flexibility, and maintain range of motion are essential for managing symptoms.
  • Corticosteroid injections: These can provide temporary relief from pain and inflammation, especially during flare-ups.
  • Lifestyle modifications: Avoiding activities that exacerbate symptoms, using heat or cold therapy, and maintaining a healthy weight to reduce joint stress.
• Surgical treatment:
  • Arthroscopy: A minimally invasive procedure to clean out loose fragments, smooth rough cartilage, or remove bone spurs. This may provide temporary relief in less severe cases.
  • Shoulder replacement surgery (arthroplasty): In severe cases where non-surgical treatments are ineffective, shoulder replacement surgery may be recommended. This involves replacing the damaged parts of the shoulder joint with artificial components.

Recovery and Prognosis

The prognosis for shoulder osteoarthritis varies depending on the severity of the condition and the treatment approach:

• Non-surgical management: Many individuals can manage symptoms effectively with medication, physical therapy, and lifestyle changes, allowing them to maintain a good quality of life.
• Post-surgical recovery: Recovery from shoulder replacement surgery typically takes several months, involving physical therapy to restore strength and range of motion. Most patients experience significant pain relief and improved joint function following surgery.

Living with Shoulder Osteoarthritis

Living with shoulder osteoarthritis often involves making adjustments to daily activities to minimize pain and preserve joint function. Regular exercise, maintaining a healthy diet, and avoiding overuse of the shoulder can help manage symptoms and prevent further joint damage.

In summary, shoulder osteoarthritis is a degenerative condition that affects the cartilage of the shoulder joint, leading to pain, stiffness, and reduced function. While there is no cure, a combination of non-surgical treatments and, in some cases, surgery can effectively manage symptoms and improve quality of life.