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Shoulder joint arthritis

Good therapy often makes prosthesis avoidable

If arthrosis occurs in the shoulder joint, doctors refer to it as omarthrosis or shoulder joint arthrosis. Like all types of osteoarthritis, the degenerative disease is based on wear and tear, which can be caused by age or by chronic overuse and incorrect loading. A hereditary predisposition to osteoarthritis is also suspected due to familial clustering of cases, but is not considered to be unreservedly scientifically proven. The pain and immobility caused by osteoarthritis in the shoulder joint seemed for a long time to be corrected only with a prosthesis. Today, however, modern treatment options are available that make the use of a prosthesis avoidable or at least delay the need for it.

Like all types of osteoarthritis, the disease is still not considered curable and can only be alleviated in its course through early prevention and treatment. Working techniques that are gentle on the joints, the protection of joints after injuries and the preventive training of healthy movement sequences enable good prevention and ensure that mobility is maintained – often into old age.

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Orthopädie Zentrum München Ost - Schulter - Erkrankungen

Table of Contents:

What is arthritis of the shoulder joint?
Causes of omarthrosis

Primary omarthrosis
Secondary omarthrosis

Symptoms of shoulder joint arthrosis

Diagnostics and therapy for arthrosis of the shoulder joint
Treatment of shoulder joint arthrosis at the Orthopaedic Center Munich East (OZMO)

What is arthritis of the shoulder joint?

In omarthrosis (shoulder osteoarthritis), painful symptoms and restricted movement result from wear and tear in the tissues of the shoulder joint. In the first instance, the wear and tear affects the cartilage, which becomes brittle, but in the long term, without treatment, bone and surrounding tissue parts are also attacked and surrounding tissue is damaged. Omarthrosis is very rare, accounting for 1-2% of arthroses, and carries less discomfort than, for example, osteoarthritis of the knee or hip. Occasionally, arthrosis of the shoulder joint is also manifested merely by restricted movements that cause no or only load-related pain. This is mainly due to the comparatively low weight that the shoulder joint has to cope with under normal circumstances. This is due to the fact that the shoulder joint is inherently relieved by the arm pull.

Osteoarthritis of the shoulder joint should not be confused with acromioclavicular joint arthritis, also known as ACG osteoarthritis. While omarthrosis arises between the scapula and humerus bones, the base of ACG osteoarthritis lies between the clavicle, scapula, and acromio-clavicular joint. In it, pain is triggered when the patient pulls up the shoulders, for example, when the shoulder twitches. ACG osteoarthritis is one of the common forms of osteoarthritis in men over the age of 50 and is based almost entirely on former injuries to the shoulder, which are up to 10 times more common in men compared to women. However, ACG osteoarthritis does not always produce symptoms and is only discovered as an incidental diagnosis on an X-ray.

Causes of omarthrosis

The risk of developing omarthrosis increases with age and the associated age-related joint wear in the shoulder joint. The forms of osteoarthritis are fundamentally differentiated between a primary disease with an unexplained cause (idiopathic osteoarthritis) and a secondary variant, which is usually based on a previous disease that has not healed sufficiently.

Primary omarthrosis

In primary shoulder osteoarthritis, the causes are largely unknown. However, medical science believes that several factors combine to promote omarthrosis. In addition to a genetic predisposition, this includes heavy physical strain on the shoulder joint, for example working overhead in some occupations or frequently lifting the arms in everyday work with movements that are distant from the body. Intensive sporting activities, in which the arms and shoulders are often lifted and / or loaded (weight training, etc.) can also put stress on the shoulder joints due to the special strain and promote wear and tear.

Secondary omarthrosis

Causes of shoulder joint arthrosis are mostly previous injuries to the shoulder joint, such as dislocation of the shoulder joint, but also joint fractures or already required operations on the shoulder joint. If these injuries are not sufficiently cured or the joint is additionally stressed with incorrect loads, arthrosis can develop in the shoulder joint. Examples of conditions and injuries that promote later development for secondary shoulder joint osteoarthritis include:

Upper arm fractures in the shoulder area
rheumatic joint inflammations
Shoulder luxation / dislocation (“dislocated shoulder”)
Cartilage diseases
Rotator cuff defects, etc.

Symptoms of shoulder joint arthrosis

Omarthrosis is usually inconspicuous at first, but begins with pain when lifting the arms and turning them outward. At first, the discomfort does not occur at rest, but later the shoulder hurts even then, which is why those affected by shoulder joint arthrosis can no longer lie on the affected shoulder. Slowly and usually insidiously, the shoulder joint begins to become more immobile. Lifting the arms becomes increasingly difficult, although mobility is not restricted as with osteoarthritis in the knees or hips.

The cartilage layer covering the joint surface becomes increasingly worn away as the disease progresses. There are several stages of omarthrosis, in which the symptoms are manifested with different pain and movement restrictions. The more the disease or wear progresses, the more restricted the movement, especially in external rotation and lateral elevation of the arm. This limitation goes unnoticed for a long time, especially since the problem of lifting the arm laterally over the shoulder blade can be compensated.

With further development, the patient increasingly experiences friction noises in the joint. In the inflammatory stage, there is a pulling pain that becomes more intense during activities away from the body and during overhead activities in the front of the shoulder.

Diagnostics and therapy for arthrosis of the shoulder joint

For the diagnosis, the doctor will first ask about the patient’s complaints and perform a physical examination focusing on the shoulder joint. Various movement tests support the physician in the examination, in which the mobility of the arms and shoulders is tested. In addition, examinations with imaging methods, for example magnetic resonance imaging or an X-ray, are performed to determine the specific actual situation of the shoulder. The specialist then recommends appropriate measures to slow the progression of the disease with medication and conservative therapies.

Shoulder joint arthrosis can be treated well in the early stages conservatively with physiotherapy and, if necessary, with anti-inflammatory drugs or even anti-inflammatory injections. If this does not lead to the desired success, hyaluronic acid injections or also autologous blood therapy can significantly alleviate the symptoms for a longer period of time. In addition, in the early stages of osteoarthritis, minimally invasive surgery can be performed using keyhole surgery to smooth the cartilage and corresponding cartilage protrusions.

The final stage, however, is when the cartilage is completely used up and bone rubs directly on bone. At this advanced stage, permanent pain and a massive restriction of movement develop. Then the only option left for treatment is an artificial joint.

Treatment of shoulder joint arthrosis at the Orthopaedic Center Munich East (OZMO)

If you are affected by shoulder pain and restricted movement, our team of experienced orthopedic specialists at the Orthopedic Center Munich East (OZMO) will be happy to help you. Through meaningful diagnostics in our well-equipped practice, we can use our many years of experience and high level of expertise to diagnose shoulder joint arthrosis or differentiate it from other shoulder diseases. Our practice team would be very happy to welcome you to contact us. Make an appointment at the Orthopedic Center Munich East if you suspect joint diseases such as shoulder joint arthrosis.

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