If you have been diagnosed with shoulder osteoarthritis, your orthopaedic surgeon will set out the treatment options that are available to you. These will depend on a range of factors, including the severity of your condition, your general state of health and your age. As a general rule, the least invasive treatments will always be recommended first as the risk of complications increases with surgery.
What is shoulder osteoarthritis?
Osteoarthritis is a degenerative condition, which means it worsens as time goes on. It is caused by the loss of cartilage from the shoulder. In a healthy joint, cartilage is the tough rubber substance that covers the top of the bones, allowing them to move smoothly over each other. However, in a joint affected by osteoarthritis the cartilage starts to degenerate and wear away. As a result, the ends of the bones may start to rub together causing swelling. Pain and bony spurs – osteophytes – can begin to form. In its more advanced stages, osteoarthritis causes significant pain, swelling and loss of function in the affected joint.
What are the symptoms?
If you have shoulder osteoarthritis you may have pain during and after moving your shoulder. You may also experience pain while trying to sleep. Your shoulder will become less mobile and you may no longer have the range of motion you once did. When you move the joint it may crack or creak.
You may be offered a range of tests to confirm the diagnosis of shoulder osteoarthritis, including X-rays, CT scans or MRI scans. A blood test may be used to diagnose rheumatoid arthritis, which is an autoimmune disease, if this is suspected to be the underlying cause.
There is a range of different treatment options for shoulder osteoarthritis. In the early stages, you will normally be able to manage your symptoms with a combination of:
- Rest and modifying the way you use your shoulder during everyday activities to avoid exacerbating your symptoms.
- Taking painkillers and anti-inflammatories to relieve pain and inflammation.
- Exercises recommended by a physiotherapist to relieve pain and increase movement in the shoulder joint.
- Ice packs applied to the joint to reduce inflammation and swelling.
- Pain-relieving injections: A common treatment for shoulder osteoarthritis at Thames Shoulder and Elbow is to give painkilling injections of steroids and local anaesthetic directly into the affected joint or muscle using ultrasound to guide the position of the needle. Although the local anaesthetic works immediately, this wears after a short time and it may take up to two weeks for the steroids to take effect. Side-effects are rare but can include a flare-up of symptoms in around 10% of patients or thinning of the skin at the injection site.
As the disease progresses and loss of mobility worsens, your orthopaedic surgeon may recommend surgery to replace the damaged shoulder joint with a prosthetic implant. There are different surgical procedures depending on the location and extent of damage to your shoulder joint:
- A total shoulder replacement involves replacing the ball at the top of your upper arm with a metal ball and the socket in your shoulder blade with an artificial socket.
- In a partial shoulder replacement only the ball at the top of your arm is replaced and the natural shoulder socket is left intact.
- Nowadays, the most common type of shoulder replacement surgery is called reverse shoulder replacement. This involves switching the position of the ball and socket in your joint, so a metal ball is attached to the shoulder blade where the socket used to be and a new socket is attached to the upper arm where the ball was originally. The procedure can be particularly beneficial if you have a misshapen shoulder socket due to excessive wear and tear or if you have a severe fracture or a torn rotator cuff.
Your orthopaedic surgeon will discuss the range of treatments available to you at each stage of your disease and explain the pros and cons of the different approaches. If you would like to contact us, we would be happy to discuss your individual circumstances and options.
Orthopaedic Consultant & Surgeon | London
Thames Shoulder & Elbow are able to provide advice and support to anyone experiencing symptoms affecting the upper limbs (shoulder, upper arm, elbow, forearm and wrist).
Telephone: 020 376 15987
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