Shoulder osteoarthritis (OA) stereotypically develops after damage to the articular cartilage (smooth connective tissue which covers the end of bones) and surrounding structures within the shoulder. There are two joints in the shoulder. The acromioclavicular joint (ACJ) is formed where your collar bone meets the tip of your shoulder blade (acromion). The glenohumeral joint is formed by the head of your arm bone (humerus) and the outer side of your shoulder blade. Shoulder osteoarthritis is more common in the acromioclavicular joint than in the glenohumeral joint. Almost all of us will develop osteoarthritis in some of our joints as we get older, though we may not even be aware of it.
The main symptoms of shoulder osteoarthritis are pain, stiffness, reduced strength and limited movement.
Symptoms might progress over time or might come and go; this is often referred to as an acute flare-up (an exacerbation of symptoms does not always mean further joint damage).
The reason for flare-ups is not always clear (5). Some factors reported by patients include:
Shoulder osteoarthritis can be primary or secondary.
This is not an exhaustive list. These factors could increase the likelihood of someone developing shoulder osteoarthritis. It does not mean everyone with these risk factors will develop symptoms.
The prevalence of shoulder osteoarthritis increases with age. It has been reported that approximately 33% of people over 60 years of age have shoulder osteoarthritis, although it is very common to have no symptoms at all (1).
Musculoskeletal physiotherapists and other appropriately qualified healthcare professionals can provide you with a diagnosis by obtaining a detailed history of your symptoms. A series of physical tests might be performed as part of your assessment to rule out other potentially involved structures and gain a greater understanding of your physical abilities to help facilitate an accurate working diagnosis.
Your treating clinician will want to know how your condition affects you day-to-day so that treatment can be tailored to your needs and personalised goals can be established. Intermittent reassessment will ascertain if you are making progress towards your goals and will allow appropriate adjustments to your treatment to be made.
A thorough assessment from your treating clinician will normally suffice in establishing a suspected working diagnosis of shoulder osteoarthritis. You might be sent for X-rays if the clinician has any concerns about the joint or if you have exhausted appropriate conservative management. However, X-rays produce a level of radiation and thus should only be reserved for appropriate cases.
Your musculoskeletal physiotherapist will discuss lifestyle modifications that may help you be more active, lose weight (3) and gain a better understanding of your symptoms. It is a common myth that moving joints will cause them to wear out. In fact, it is quite the opposite; movement is important for preventing the progression of arthritis. Inside your cartilage is a substance called synovial fluid which acts as a lubricant and shock absorber which is heavily aided by regular movement. Your physiotherapist may use the phrase “motion is lotion” which is a nice way of explaining the benefits of getting the joints moving. Possessing this knowledge should give you the reassurance to know that keeping yourself active will not cause further damage.
Your musculoskeletal physiotherapist assists in finding the most enjoyable and suitable exercise for you. Exercise has been shown to be the single most effective way of managing symptoms and if someone is given a diagnosis of osteoarthritis it is important that that person then works to strengthen the joint and help to achieve optimal mobility. Through regular reassessment, your physiotherapist can track your progress and ensure that your exercise plan remains challenging enough for positive changes to occur.
Building strength and flexibility is important to give you longevity in all the tasks you want to keep doing. We advise consulting with your musculoskeletal physiotherapist prior to trying any of these exercises.
Your musculoskeletal physiotherapist may also use other treatment approaches to help manage your symptoms alongside your exercise programme. They will also provide you with ongoing advice and support to effectively manage symptoms long-term and to reduce, or slow, the progression of symptoms.
Below are three rehabilitation programmes created by our specialist musculoskeletal physiotherapists targeted at addressing shoulder osteoarthritis. In some instances, a one-to-one assessment is appropriate to individually tailor targeted rehabilitation. However, these programmes provide an excellent starting point as well as clearly highlighting exercise progression.
This programme aims to carefully begin to increase movement in the shoulder. Pain should not exceed 4/10 on your self-perceived pain scale whilst completing this exercise programme.
Here we aim to continue to increase movement but also introduce exercises to start to build the strength of the muscles around the shoulder. Pain should not exceed 4/10 on your self-perceived pain scale whilst completing this exercise programme.
This programme progresses the strength exercises from the last programme to further increase the strength and stability of the shoulder. Pain should not exceed 4/10 on your self-perceived pain scale whilst completing this exercise programme.
For patients wanting to achieve a high level of function or return to sport we would encourage a consultation with a physiotherapist as you will likely require further progression beyond the advanced rehabilitation stage.
As part of a comprehensive treatment approach, your musculoskeletal physiotherapist may also use a variety of other pain reliving treatments to support symptom relief and recovery. Whilst recovering you might benefit from further assessment to ensure you are making progress and establish appropriate progression of treatment. Ongoing support and advice will allow you to self-manage and prevent future re-occurrence.
Medications prescribed by your doctor may be helpful in reducing symptoms. This might include a cortico-steroid injection if you have not responded favourably to appropriate conservative management.
Dietary supplements can be taken such as glucosamine and chondroitin. Evidence is conflicting on whether they really help. You should also discuss using these with your doctor due to the possible interactions with other medications.
If non-surgical treatments do not work effectively, there are surgical options available. However, it needs to be carefully considered due to potential side effects such as infection or problems with anaesthesia. These surgical options include:
An injury which typically occurs following a road traffic collision, often affecting the soft tissues of the neck.
Pain and weakness affecting the shoulder and limiting function.
An insidious (no clear cause), painful/stiff condition of the shoulder persisting for more than 3 months.
With PCN partnerships from Cornwall to Durham, Weston-Super-Mare to Southwold, our network of specialist physiotherapists operate face-to-face or remotely depending on your local needs.
Pure Physiotherapy Limited (PP) understands that your privacy is important to you and that you care about how your personal data is used and shared online. We respect and value the privacy of everyone who visits this website, www.purephysiotherapy.co.uk (“Our Site”) and will only collect and use personal data in ways that are described here, and in a manner that is consistent with Our obligations and your rights under the law.
Strictly necessary cookies are required on this website to help us remember your options, and also protect our website and our users.
We use a range of technologies on our website that restrict and deter the use of bots. These include Google's ReCaptcha service. https://www.google.com/recaptcha/about/
To read more about our Strictly Necessary Cookies, Please Click Here
If you disable this cookie, we will not be able to save your preferences. This means that every time you visit this website you will need to enable or disable cookies again.
This website uses Google Analytics to collect anonymous information such as the number of visitors to the site, and the most popular pages.
Keeping these cookies enabled will help us to improve your experience on the Rehab Direct website.
Please enable Strictly Necessary Cookies first so that we can save your preferences!
Pure uses cookies when you use our website, https://purephysiotherapy.co.uk to help improve security and improve the experience of our users.
Before any cookies are placed on your device, we will present you a message bar and the opportunity to learn about the cookies we use, and we will allow you to give consent to the use of cookies that are not strictly necessary.
Click Here to view our cookie policy.
