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Shoulder Osteoarthritis

The shoulder is made up of two joints — the glenohumeral joint and the acromioclavicular (AC) joint. The glenohumeral joint is the ball-and-socket portion of the joint where your humerus (arm bone) meets your scapula. The AC joint, as its name implies, is where the acromion (tip of the shoulder blade) meets the clavicle (collarbone). Either joint can have osteoarthritis. 

The shoulder joint is held together by a complex system of muscles, tendons and ligaments that help support the joint and allow you to move your shoulder in all different directions. Cartilage and synovial fluid produced within the joint allow for ease of motion and cushioning.

This joint is prone to wearing and tearing (osteoarthritic) as is any other joint in the body and is particularly painful as the joint is used with a lot of activities of daily living. Osteoarthritis is a result of chronic degeneration of the joint, usually in the elderly, but may be brought on sooner by past history of trauma to the joint, chronic dislocations or through old sports injuries.    

Symptoms

Shoulder pain related to osteoarthritis of the glenohumeral joint can be felt anywhere around the shoulder joint. Pain related to the AC joint is usually felt when someone directly touches the joint line. You may feel a cracking or popping feeling with movement of the shoulder in all directions, a decrease in the range of motion of the shoulder, and pain with activity.  Patients typically describe the pain as achy, sharp, stiff and gnawing, with pain increasing with increase in activity. 

Causes

Osteoarthritis is a degenerative disease of the joint.  Chronic wear and tear is the culprit, and certain risk factors may hasten the occurrence and severity.   

Treatments

Treatment for glenohumeral and AC joint osteoarthritis may include a referral to a pain management specialist. At the JLR Center for Pain Medicine, your doctor will work with you to design a customized treatment plan. This will depend on your symptoms and physical examination. On the initial visit, we will take a thorough history and perform a physical exam.  Early treatment focuses on confirmation of the diagnosis and the initiation of a treatment plan to alleviate pain. Imaging such as x-rays and MRIs may be ordered to confirm the source or cause of your pain.

Your treatment plan may involve some lifestyle modifications, physical therapy to strengthen the muscles around the joint, non-steroidal anti-inflammatories if your medical history allows, and topical creams and patches.

If pain is not improved with some of these modifications, you and your pain management physician may discuss injection therapy. This usually consists of injecting local anesthetic and steroids directly into the joint under x-ray guidance, but may also be done by palpating bony landmarks. The injection allows diagnostic information regarding the cause of your pain and can also provide sustained relief. Surgery may also be an option prompting referral to orthopedic surgeon.