I have shoulder pain; do I have Shoulder Osteoarthritis?

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What is shoulder osteoarthritis?

Shoulder osteoarthritis (OA) refers to the loss of joint cartilage that is normally found over the shoulder joint surfaces. The shoulder joint is a joint formed between the humerus head (arm bone) and the glenoid (part of the shoulder blade). This is a very flexible joint with a wide range of possible motions and is stabilised by a variety of ligaments and tendons.

This is a degenerative process, and maybe in response to a variety of causes, including injuries and infections affecting the shoulder joint. Of note, the chronic damage to the rotator cuff tendons around the shoulder can result in a particularly severe type of shoulder OA known as rotator cuff arthropathy. Similar processes are found in other joints in the body.

The loss of joint cartilage results in pain, stiffness, and loss of shoulder joint function. As the shoulder joint is a critical part of the arm, patients can sometimes find themselves severely debilitated, with patients reporting the inability to lift their arms and carry heavy loads. Some patients even have problems feeding and clothing themselves.

What are the symptoms of shoulder arthritis?

The loss of joint cartilage results in pain, stiffness, and loss of shoulder joint function. As the shoulder joint is a critical part of the arm, patients can sometimes find themselves severely debilitated, with patients reporting the inability to lift their arms and carry heavy loads. Some patients even have problems feeding and clothing themselves.

In severe cases, patients may find themselves complaining of pain even when their arms are not being used, and may also experience pain when lying on the affected shoulder, such as when side-sleeping.

How is shoulder arthritis diagnosed?

If you suspect that you have shoulder OA, please seek medical help. Your doctor will first conduct a medical interview and perform a focused clinical examination of the shoulders. Based on the information gained from this, he/she may recommend a battery of tests.

This may include plain radiographs (X-rays) of the shoulders, looking specifically for characteristic changes of shoulder OA. Additional imaging such as CT scans and MRI scans may also be necessary. In patients with acute shoulder swelling, a shoulder tap may also be offered. The fluid will be extracted for testing, and this usually reduces the pain and swelling over the shoulder joint as well.

What are the treatment options?

Arthritis can be treated by both surgical and non-surgical means. Non-surgical means are often opted for before surgery is considered.

Non-surgical Treatment

Non-surgical treatments for shoulder OA is usually used in the early stage of the disease and may include the following,

  • Modifications in daily activities, such as the avoidance of activities that cause shoulder pain.
  • Physical therapy exercises to improve the range of shoulder motion, and shoulder function.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to reduce inflammation and pain.
  • Corticosteroid injections may be given to reduce severe pain in the shoulder. 

Surgical Treatment

Surgical treatment for shoulder OA depends on the stage of the disease, as well as other factors such as the patient’s age, occupation and expected functional outcomes. Factors such as the condition of the rotator cuff tendons and muscles of the shoulder may also influence the method used to treat shoulder OA.

In general, treatment for late-stage shoulder OA will necessitate the replacement of part of or the entirety of the shoulder joint. These options are,

  • Hemiarthroplasty, where only the arm bone part of the shoulder joint is replaced.
  • Total shoulder arthroplasty, where both the shoulder blade part, and the arm bone part of the shoulder joint are replaced.
  • Reverse total shoulder arthroplasty, where the entire shoulder is replaced, but with the reversal of the ball and socket part of the joint. This procedure is reserved especially for patients with OA due to rotator cuff arthropathy.

Rehabilitation and recovery

Depending on the treatment options offered for your condition, you may be required to also undergo a course of shoulder physical therapy. This usually entails a range of motion exercises and shoulder strengthening exercises performed in a monitored and controlled fashion. The type and duration of therapy really depend on the severity of OA and the type of treatment. For assessment of your condition, please book an appointment with Dr. Yong Ren.

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Sarah Taylor

Obstetrics & Gynaecology