Condition
Understanding shoulder osteoarthritis and maintaining movement
You can still put on your jacket, but only by finding a different way to move. Reaching for a high shelf brings on shoulder pain, and finding a comfortable position at night becomes difficult. If an X-ray report then says “osteoarthritis”, it is easy to worry that nothing can be done.
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What you can bring to your appointment
Existing shoulder images with their reports, information about previous injuries or operations and your current medication plan are helpful. You may wish to note two activities you would like to manage more easily again. Knowing which exercise or treatment helped or made symptoms worse also matters for planning.
A suddenly hot, very swollen shoulder with fever, or a marked loss of function after an accident, needs urgent medical assessment. Have this assessed by a doctor the same day. Contact our practice or your GP directly; if timely assessment is not possible, attend an emergency department. Shoulder or arm pain together with chest pressure, breathlessness or circulatory problems is a reason to call 112 immediately and not wait for a routine appointment.
Understanding
A closer look
Shoulder osteoarthritis can explain pain and stiffness. However, its significance for your symptoms and which treatment may help only become clear by considering examination, imaging and everyday life together. At OrthoCoast in Wolgast, we want to clarify with you what your shoulder can still do well, what limits it and what goal you would like to achieve.
What does glenohumeral osteoarthritis mean?
Glenohumeral osteoarthritis, also called omarthrosis, affects the main shoulder joint between the head of the upper arm bone and the socket of the shoulder blade. It involves changes to cartilage and other joint structures. The shoulder may become more painful and less mobile. The term describes a joint finding; it does not determine how much a person is affected.
We distinguish this from osteoarthritis of the smaller joint between the collarbone and the acromion, the bony roof of the shoulder. This is called the acromioclavicular joint, or AC joint. Both may be mentioned in the same report, but they affect different joints. It is therefore important to establish where your symptoms actually come from. Tendons, bursae or shoulder stiffness may also play a part.
What the examination aims to establish
We want to know whether symptoms developed gradually, whether there was a previous injury and which movement is particularly difficult. During the examination, we compare, among other things, movements you perform yourself with gently guided movements and assess strength. This helps distinguish joint stiffness from protective movement caused by pain or an additional tendon problem. We also assess whether the joint capsule, rotator cuff or other shoulder muscles contribute to your symptoms.
X-rays can show changes to the joint space and bone. However, they do not determine the treatment you need on their own. Ultrasound may help answer an additional question about tendons; MRI is considered selectively if its result would influence the next decision. We include existing images and reports. New images are not needed simply because you change practice.
Further information
Find an achievable goal for your shoulder
Perhaps you would like to sleep better again, wash your hair independently or compensate less when swimming. These goals give us a way to assess non-surgical treatment. The aim is to reduce pain and make use of the function you have. It cannot reliably restore lost joint cartilage.
Adapted movement and exercises guided by a physiotherapist can help maintain mobility and strength. How much you do depends on how easily the joint becomes irritated. Forcing a painful movement further and further is not a sensible exercise goal. Equally, continually avoiding all movement can make everyday life more restricted. We discuss which level of activity is practical to begin with and how to recognise when it is too much.
Weighing pain relief and additional treatments
A time-limited course of medication to relieve symptoms may be considered if pain makes movement or sleep very difficult. The choice also takes account of your stomach, kidneys, heart and other medicines. Please therefore mention painkillers you buy without a prescription too.
An injection is a separate decision. Its possible benefit, limitations and risks must fit your specific situation; a course does not follow automatically from the word osteoarthritis. Results from treatment of the knee also cannot simply be transferred to the shoulder joint. A promise that hyaluronic acid or treatment using your own blood (PRP/ACP) will build new cartilage would not be justified. If a medicine is injected at our practice, allow for at least 30 minutes of observation afterwards, or longer depending on how you feel. This does not automatically mean you are fit to drive afterwards.
When a surgical assessment may be useful
If pain and limitations remain substantial despite appropriate non-surgical measures, a consultation with a shoulder surgeon may be useful. This assesses whether a joint replacement suits your findings and goals. The condition and function of the shoulder tendons also affect the choice of procedure.
The decision is not based on an X-ray alone. You should understand what benefit is realistic, what risks are involved and what rehabilitation requires. We can review the existing findings with you and identify specific questions for further assessment.
Frequently asked questions
Does severe osteoarthritis mean I need a shoulder replacement straight away?
No. Your symptoms, function and response to treatment so far are what matter. Marked changes on an image alone do not determine the need for surgery.
Can I keep using my shoulder?
Appropriate movement generally remains helpful. Which activities and exercises are suitable depends on the findings and current irritation. After an injury or rapid deterioration, your tolerance of activity needs to be reassessed.
How does osteoarthritis differ from frozen shoulder?
Osteoarthritis mainly involves changes to the joint. Frozen shoulder primarily affects the joint capsule and follows a different course. Both can cause pain and stiffness; they are distinguished through examination and imaging where needed.
Your next step
