Managing Osteoarthritis of the Shoulder: Treatment Options and When to Consider Surgery

Osteoarthritis (OA) of the shoulder is a condition characterized by the gradual breakdown of cartilage in the shoulder joint, leading to pain, stiffness, and a reduced range of motion. This degeneration can make daily activities like lifting, reaching, or even simple tasks more difficult and painful. While osteoarthritis cannot be cured, there are effective ways to manage symptoms and improve quality of life. In some cases, when conservative treatments are no longer effective, shoulder replacement surgery may be considered.

Here’s a closer look at how to manage shoulder osteoarthritis and what to consider if you’re thinking about surgery.

Understanding Shoulder Osteoarthritis

The shoulder joint is one of the most mobile joints in the body and consists of two parts:

1. The glenohumeral joint – where the ball at the top of the arm bone (humerus) meets the socket (glenoid) of the shoulder blade.

2. The acromioclavicular (AC) joint – where the clavicle (collarbone) meets the top of the shoulder blade.

   
   

Osteoarthritis most commonly affects the glenohumeral joint, where wear-and-tear or previous injuries cause the cartilage that cushions the joint to thin or wear away completely. Over time, this degeneration leads to symptoms like pain, swelling, and loss of movement in the shoulder.

Managing Osteoarthritis of the Shoulder: Non-Surgical Options

For many individuals with shoulder OA, non-surgical treatment options can help reduce pain, improve range of motion, and delay the need for surgical intervention.

1. Physical Therapy

Physical therapy is often one of the first lines of treatment for shoulder OA. Through a tailored exercise program, a physiotherapist can help you:

• Improve range of motion with stretching and mobility exercises.

• Build strength in the surrounding muscles to support the shoulder joint.

• Correct posture and body mechanics to reduce unnecessary strain on the shoulder.

  
  

These exercises can enhance shoulder stability, reduce pain, and improve function, making it easier to perform daily activities.

2. Pain Management Techniques

• Heat and Cold Therapy: Heat can help relax tight muscles and improve circulation around the shoulder, while ice can reduce inflammation and numb pain.

• Medications: Over-the-counter anti-inflammatory medications (such as ibuprofen) or acetaminophen can help manage pain. In some cases, a doctor may prescribe stronger medications or topical creams.

3. Activity Modification

Adjusting activities that put excess strain on the shoulder can reduce flare-ups. For example:

• Avoid repetitive overhead movements.

• Use supportive techniques for activities that involve lifting.

• Incorporate regular rest periods into your daily routine to reduce joint stress.

  
  

4. Assistive Devices

Using supports like braces or slings can reduce pressure on the shoulder joint and allow it to rest and recover. Modifying your environment with tools such as reachers, jar openers, or other aids can also help you carry out daily tasks more comfortably.

5. Corticosteroid Injections

For individuals with moderate to severe shoulder OA, a doctor may suggest corticosteroid injections directly into the shoulder joint. These injections can reduce inflammation and provide temporary pain relief for several weeks to months, allowing patients to perform physical therapy and manage daily activities more comfortably. However, repeated injections are generally not recommended, as they may accelerate joint degeneration.

6. Hyaluronic Acid Injections

Although more commonly used for knee OA, hyaluronic acid injections may also be an option for shoulder OA. These injections act as a lubricant and can reduce friction in the joint, potentially relieving pain and improving mobility.

When to Consider Shoulder Replacement Surgery

When non-surgical treatments no longer provide adequate relief and shoulder osteoarthritis significantly impacts daily life, shoulder replacement surgery may be an option. Surgical options for shoulder OA vary, depending on the extent of joint damage, the specific joint involved, and the patient’s age, activity level, and overall health.

Types of Shoulder Replacement Surgery

1. Total Shoulder Replacement (Arthroplasty)

   In total shoulder replacement, the damaged ball (humeral head) and socket (glenoid) of the shoulder joint are replaced with artificial components made of metal and plastic. This surgery is typically recommended for patients with severe OA and significant cartilage loss in both the humeral head and glenoid.

2. Partial Shoulder Replacement (Hemiarthroplasty)

   If only the humeral head (ball) is damaged, a partial shoulder replacement may be considered. In this procedure, only the ball of the shoulder joint is replaced, leaving the natural glenoid socket intact. This may be an option for patients with OA primarily affecting the humeral head, with the socket in relatively good condition.

3. Reverse Shoulder Replacement

   Reverse shoulder replacement is a specialized surgery often recommended for patients with both OA and significant rotator cuff damage. In this procedure, the position of the ball and socket is reversed, allowing the deltoid muscle to take on more of the work of moving the arm. This surgery can provide relief for patients with extensive joint damage and weak or torn rotator cuff muscles.

   
   

Indications for Shoulder Replacement Surgery

Shoulder replacement surgery may be considered when:

• Non-surgical treatments no longer provide relief and daily pain remains significant.

• Shoulder function is severely limited, making it difficult to perform even simple tasks like dressing, eating, or reaching overhead.

• There is extensive joint damage on imaging tests, showing a significant loss of cartilage or bone spurs that interfere with movement.

• Pain interrupts sleep or is persistent, even at rest.

Recovery and Rehabilitation

Recovery from shoulder replacement surgery includes physical therapy to restore strength and movement. Most patients can expect to see improvements in pain and function within a few months, although full recovery may take up to a year. Your surgeon and physiotherapist will provide a structured rehabilitation plan that includes range-of-motion exercises, strength training, and activity modifications.

Considering Home-Based Physiotherapy in Mid Cornwall

For those in Mid Cornwall, Physio@Home offers personalized physiotherapy services in the comfort of your home. If you’re managing osteoarthritis of the shoulder, our at-home care can support you with targeted exercises, pain management techniques, and post-surgical rehabilitation if you decide to pursue shoulder replacement surgery. Our approach is customized to your unique needs, ensuring you receive high-quality care without needing to travel, so you can focus on your recovery journey in a familiar and convenient setting.

Disclaimer: This post is intended for educational purposes only. Please consult a healthcare provider for an accurate diagnosis and a personalized treatment plan.