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Osteoarthritis of the Shoulder

→ a degenerative condition that causes the cartilage of the shoulder joints to wear away.

What is osteoarthritis?

Osteoarthritis is a condition that affects the body’s joints – most commonly the knees , hands and hips, but also the shoulder joints. Put simply, it involves the deterioration of cartilage; cartilage is the smooth covering that protects the endings of bones, allowing them to move freely and painlessly against each other. When this protective layer wears away, the space between the joints decreases and the bones begin to rub against each other, causing pain and stiffness. The joints in the shoulder most commonly affected by osteoarthritis are the glenohumeral (the ball-and-socket of the arm) and the acromioclavicular (the joint directly under the collarbone, also known as the AC). Typically, someone suffering from osteoarthritis of the shoulder will experience pain, stiffness and decreased movement. The pain can intensify the more the joint is moved, and can make have a negative impact on sleep. It is sometimes also accompanied by a grating sensation, or even a ‘creaking’ noise, in the joint (this is known as crepitus).

Who does osteoarthritis affect?

With more than eight million sufferers in the UK, osteoarthritis is by far the most common form of arthritis – though it is less commonly seen in the shoulders. It is most prevalent in people over the age of 50, but can occur in younger patients too. The condition may develop after an injury, such as a fracture or dislocation of the shoulder (this is known as post-traumatic osteoarthritis). Research suggests that there could also be a genetic link to osteoarthritis.

How is it diagnosed?

Diagnosing osteoarthritis begins with a physical examination of the shoulder, and an analysis of your symptoms. Stiffness that begins early in the day and lasts for a short period can be an indicator of osteoarthritis (whereas prolonged periods of stiffness may indicate rheumatoid arthritis, an autoimmune disease that attacks the joints). Other tools for diagnosing osteoarthritis include blood tests (partly to exclude the possibility of rheumatoid arthritis and other conditions), x-rays and arthroscopy (keyhole surgery).

What happens next?

There is no cure for osteoarthritis, but the condition does not necessarily deteriorate over time; with careful treatment, it may even improve. Doctors will generally look to manage the symptoms of shoulder osteoarthritis with physiotherapy, pain relief (such as steroid injections) and lifestyle changes (such as regular exercise, and avoiding intense, repetitive activities like decorating or canoeing) before resorting to surgery. Where surgery is advised, procedures range from an osteotomy (where the bones are ‘shaved’ to reduce friction in the joint) to an arthroscopy (where loose cartilage in the joint is removed) and arthroplasty (where a part or the whole of the joint is replaced with an artificial joint).