Brief overview
- Causes and risk factors: Age-related wear and tear, overuse and improper use due to sports or occupation; unexplained factors; secondary osteoarthritis due to previous injuries or diseases of the shoulder.
- Symptoms: Pain in the shoulder especially when lifting the arm; increasing inability to move the shoulder
- Diagnosis: Medical history, physical examination, X-ray examination, magnetic resonance imaging and computer tomography
- Treatment: Mainly symptomatic, conservative with pain medications, exercise therapies and others; surgical with arthroscopy or in severe cases joint prosthesis.
- Prognosis: Osteoarthritis is not curable; conservative therapy as well as surgery relieve pain and maintain joint mobility
- Prevention: Avoid over- and incorrect stress in sports and work; use work techniques that are easy on the joints; heal and cure injuries and diseases of the joints and extremities properly
In osteoarthritis of the shoulder, the shoulder joint wears out. Primarily, the cartilage is damaged, but in the long term, bones and surrounding tissue are also damaged.
Omarthrosis is less common than osteoarthritis of the hip or knee. In addition, it is usually accompanied by fewer complaints. This is because the shoulder only has to bear a small part of the body’s weight and is therefore subjected to less strain.
In five to eleven percent of cases, omarthrosis is present when older people complain of shoulder pain. However, there are also many people who have no complaints.
You can read more about joint wear and tear in the article Arthrosis.
ACG osteoarthritis
The shoulder is made up of three bones:
- Upper arm bone
- Shoulder blade
- Clavicle
ACG osteoarthritis is more common than Omarthrosis. Since injuries in the AC joint occur up to ten times more often in men than in women, ACG osteoarthritis also occurs more frequently in men. Almost all men over the age of 50 have ACG osteoarthritis on X-ray.
How does omarthrosis develop?
Basically, the risk of omarthrosis increases with age. In addition, other factors play a role. As with other forms of arthrosis, a distinction is made between a primary and a secondary form of omarthrosis.
Secondary osteoarthritis of the shoulder occurs when the shoulder osteoarthritis is the result of another disease. If the joint is injured or diseased, it is less able to withstand stress than a healthy joint. Thus, even minor stress promotes secondary omarthrosis. The following diseases promote wear and tear of the shoulder joint:
- Instability due to anatomical variants (glenohumeral instability)
- Shoulder dislocation (“dislocated” shoulder)
- Upper arm fracture in the shoulder region (proximal humerus fracture)
- Rheumatoid joint inflammation (rheumatoid arthritis)
- Joint inflammation caused by germs (septic arthritis)
- Dead tissue in the shoulder (necrosis)
- Cartilage disease (chondromatosis)
- Malfunction of the rotator cuff (functionally important muscle-tendon group at the shoulder)
Symptoms
In addition, omarthrosis renders the shoulder joint immobile. For example, patients are sometimes unable to lift their arm. Many affected people nevertheless cope well with daily life. Their mobility is not as restricted as with hip or knee osteoarthritis.
Diagnosis
First, the doctor asks the patient about his or her complaints. He then examines the shoulder joint. To do this, he has the patient move his arm and in turn checks the mobility of the arm and shoulder. Imaging procedures (such as X-rays) finally confirm the diagnosis.
You can read more about the diagnosis of joint wear and tear in the article on osteoarthritis.
Treatment
The doctor initially treats osteoarthritis conservatively, for example with medication, exercise therapy and heat. Injections with “cortisone” or hyaluronic acid are also possible. However, there is little data on the latter, which is why they are more likely to be used as a supplement to conventional treatment.
Surgery
If conservative measures do not sufficiently alleviate the symptoms, doctors operate on shoulder osteoarthritis.
In many cases, especially in younger patients, the doctor performs an arthroscopy. In this procedure, he inserts a thin tube with a small video camera into the shoulder joint. This allows him to see the damaged parts of the joint. The doctor smoothes rough surfaces with a scalpel and removes abraded cartilage or bone parts. In the course of such a joint endoscopy, for example, bone outgrowths (osteophytes) can be removed or a stiffened joint capsule can be loosened.
This so-called CAM procedure (CAM = “comprehensive arthroscopic management”) is often useful in the early stages of the disease. In many cases, it delays joint replacement with a prosthesis. Over time, however, omarthrosis usually progresses anyway and later causes renewed complaints.
Prognosis
Like all osteoarthritis, the disease is usually not curable. However, in many cases conservative therapy and, above all, exercise succeed in relieving the pain and keeping the shoulder mobile.
Arthroscopy can often slow the progression of osteoarthritis, and an artificial joint can significantly relieve pain and restore mobility.
Under certain circumstances and depending on the activity, osteoarthritis affects the ability to work. For example, working overhead is often no longer possible without further ado. Whether and how omarthrosis affects a possible occupational disability or even severe disability depends on the individual case, the activity and the severity of the symptoms. In principle, recognition as an occupational disease is also possible, depending on the case.
After an operation, a period of rest and rehabilitation is often necessary, which lasts several weeks or even months, depending on the case.
Prevention
Regular balanced exercise, especially sporty, also prevents through many effects. Swimming in particular is usually a suitable sport even for people already affected by omarthrosis.
In order to prevent secondary omarthrosis as a result of an injury or disease of the shoulder and arm area, it is important to heal and cure it properly. Rehab measures may be helpful in this regard.