What You Need to Know About Shoulder Osteoarthritis

Osteoarthritis of the shoulder can affect the two joints in the shoulder area—the acromioclavicular joint and the glenohumeral joint. if you have persistent shoulder pain, it could be caused by osteoarthritis— early diagnosis and treatment help you manage your symptoms.

Causes

The shoulder is considered the most movable joint in the body, but because of its range of motion, it's also less stable than other joints. To remain stable, the shoulder is supported by muscles, tendons, and ligaments.

The degenerative process associated with osteoarthritis can affect the shoulder, though it is less commonly affected than other joints.

• Osteoarthritis in the acromioclavicular joint can be painful and can cause problems when you move your shoulder during everyday tasks.
• When osteoarthritis develops in the glenohumeral joint, it is usually the result of a previous injury. The shoulder is a common site of injury.

Diagnosis

In order to diagnose osteoarthritis of the shoulder, your healthcare provider will consider your medical history, physical examination, and X-rays.

Your healthcare provider will look for certain signs and symptoms during your physical examination including:

• Muscle weakness or atrophy
• Tenderness to the touch or pain when pressure is applied to joint
• Decreased range of motion—both assisted and self-directed
• Signs of injury to muscles, tendons, ligaments around the shoulder
• Evidence of previous injuries
• Crepitus, a grating sensation upon movement of the shoulder
• Joint effusion (fluid within the joint space)

X-ray evidence of osteoarthritis includes narrowing of joint space, changes in bone, and the presence of osteophytes.

Symptoms

Pain is the most common symptom associated with shoulder osteoarthritis. The shoulder pain worsens with activity and weather changes.

Symptoms can vary:

• If your glenohumeral shoulder joint is affected, pain is centered in the back of the shoulder
• If your acromioclavicular joint affected, pain is concentrated in the front of the shoulder

Limited range of motion is another primary symptom of shoulder osteoarthritis. It may become difficult to reach a shelf, raise your arm to brush your hair, and do other activities that require you to move your shoulder. You might also feel and hear crepitus when you move your shoulder.

As shoulder osteoarthritis progresses, pain can increase in intensity and occur with any shoulder movement. And your pain may occur at night too, interfering with sleep.

Treatment

Nonsurgical treatments are tried before surgery is considered for shoulder osteoarthritis.

Treatment options include:

• Rest the shoulder
• Change or adapt routine activities to lessen pain
• Applying heat to relieve pain
• Medications, including NSAIDs or steroid injections, to reduce inflammation
• Ice shoulder for 20 to 30 minutes, two or three times a day to reduce pain and inflammation

Surgical options can be a last resort when all other treatments have failed. A total shoulder arthroplasty can be done to replace the glenohumeral joint. When the head of the upper arm bone is the only portion replaced, the procedure is called a hemiarthroplasty. Resection arthroplasty (removing the last half inch of the clavicle) can be used to repair the acromioclavicular joint.

With shoulder osteoarthritis, accurate diagnosis and early treatment can help decrease pain and improve function. You might need changes to your treatment if your shoulder osteoarthritis progresses.