What is Shoulder Osteoarthritis?
Osteoarthritis is a condition where the cartilage that normally covers the head of the humerus and the glenoid socket of the shoulder joint wears. Healthy joint cartilage is a smooth material of a rubbery consistency that cushions the joint. It allows the ball and socket components of the shoulder joint to move smoothly and without pain.
The wearing of the cartilage can progress over many years. There may no warning signs in the early stages of arthritis. Once areas of bear bone are exposed due to cartilage loss symptoms emerge. There may be vague, intermittent niggles that are not sufficient to alert patients to a problem. Once pain symptoms emerge they can progress very slowly or sometimes quite rapidly.
The pain can be in many forms. There may be an ache in the shoulder and upper arm. This may be more obvious after having performed physical tasks with the shoulder. Pain can also be in the form of a painful catch with certain shoulder movements. The shoulder might feel that it locks up in some positions. There may be a clicking or grinding sensation in the joint. Pain when trying to sleep tends to be one of the most troublesome symptoms. It is also the complaint that most often indicates the possible need for a surgical treatment.
Another common complaint that patients notice is shoulder stiffness or limitation of movement. This relates not just to pain but to the inflammation and thickening that develops in the synovial lining of the joint and the surrounding joint capsule.
Impairment of shoulder function due to a combination of pain and stiffness may also be reflected in the form of muscle weakness.
What Causes Shoulder Osteoarthritis?
The joint cartilage can wear for a variety of reasons. The most common cause is the so called “wear and tear” arthritis that may develop with age. Physical activity such as leisure pursuits or employment tasks over the course of a lifetime may be contributing factors.
Some patients report a family history of osteoarthritis.
Injuries may contribute to the development of shoulder osteoarthritis. Patients with chronic untreated shoulder instability may develop arthritis. Repeated shoulder dislocation may damage the cartilage surfaces. Fractures of the upper humerus may damage the cartilage bearings of the joint. More severe fractures can interfere with the blood supply and nutrition of the head of the humerus. This is called avascular necrosis or osteonecrosis of the humerus. It causes the ball component of the shoulder joint to weaken and collapse leading to osteoarthritis.
What Are Your Treatment Options?
Choice of treatment will be determined by the severity of symptoms.
- Lifestyle Modification:Many patients with early osteoarthritis symptoms find that some common sense modification of leisure activities or work practices can keep the condition manageable without the need for additional treatment.
- Medications: Simple analgesics such as paracetamol may be helpful. It can be taken if the shoulder has been aggravated by excessive activity. It might also help to stop shoulder pain disturbing sleep. Another strategy can be the regular use of slow release paracetamol to address low grade shoulder aching. Anti-inflammatory medication may defer the need for more aggressive treatment. However this type of medication can have side effects when taken on a long term basis. As such it should be monitored by your family doctor. Stronger opioid pain medication is best avoided. Long term use of this type of pain killer can cause side effects and drug dependency. If you are requiring opioid drugs to control your osteoarthritis pain, the time to consider surgery may be approaching.
- Cortisone Injections:This is not a long term solution. It may be appropriate to try once for patient who have fairly manageable pain symptoms but experience a sudden aggravation of pain. It might return the shoulder to a manageable situation but if not, the next step may be required.
- Surgery:Shoulder Joint replacement surgery is considered as an option when the pain is so severe that it affects your ability to carry out normal activities and especially if loss of sleep due to pain is becoming a problem.
What do I do next?
If your shoulder osteoarthritis symptoms are becoming more than a nuisance Mr Lyons will be pleased evaluate your condition and advise your treatment options. Remember that although Mr Lyons has a long experience in performing shoulder joint replacements he will always discuss simpler treatment options that might avoid or delay the need for surgery.
You may arrange an evaluation by Mr Lyons by calling or by using the patient enquiry link.