The diagnosis can be made by describing the above-mentioned symptoms and by pointing out the specific causes of shoulder arthrosis (see above). In addition to the physical examination to differentiate the symptoms, an X-ray examination is also crucial. On the X-ray image, typical changes such as: can be seen.
To confirm the involvement of the tendon group around the shoulder joint (rotator cuff), an MRI examination can be performed. This is particularly important when deciding on a shoulder prosthesis, as the model is chosen according to the tendon conditions. – Joint space narrowing
- Increased whiteness of the joint surfaces (sclerotherapy)
- Cysts in the bone (cysts of debris) and
- Bony extensions (osteophytes)
The therapy options
As with complaints of arthrotic changes in other joints, arthrosis of the shoulder should initially be started conservatively. Depending on how you feel, cooling the shoulder (cryotherapy), but also keeping the joint warm can provide relief. To compensate for incorrect loading, targeted muscle building and other physiotherapeutic measures are important.
This can slow down the progression of arthrosis and alleviate the symptoms. In addition, a suitable diet can alleviate the symptoms of osteoarthritis to a certain extent. Correction of possible incorrect posture in the upper sections of the spine can also support the healing process.
In some cases, X-ray stimulation can also prevent the progression of arthrosis in the shoulder. For further pain therapy, drugs such as ibuprofen, Voltaren or Arcoxia can be used. During inflammatory phases, a cortisone preparation injected directly into the shoulder can relieve the symptoms.
To maintain and improve the quality of cartilage, injections of hyaluronic acid can be made into the joint space. If the conservative methods do not sufficiently relieve the patient, a surgical therapy can be decided upon. Surgical therapy may be advisable in cases of advanced shoulder arthrosis.
For example, the sliding space in the shoulder can be widened and the shoulder musculature (so-called rotator cuff) can be reconstructed. Relief or removal of parts of the shoulder joint can also be performed. In the case of very pronounced arthrosis of the shoulder, an artificial joint replacement should be considered in order to treat the pain in the long term and improve the limited shoulder mobility.
There are various shoulder joint prostheses (e.g. cap prosthesis, humeral head prosthesis, total shoulder prosthesis, inverse shoulder prosthesis) that can be used in cases of advanced arthrosis. Depending on the severity of the arthrosis, simple cleaning of the shoulder joint (debridement) by means of arthroscopy may be sufficient. Since arthrosis of the shoulder results in wear and tear of the joint cartilage, the joint partners involved cannot slide well.
This causes pain. Hyaluronic acid is intended to improve this lack of sliding and protect the remaining cartilage from further wear and tear. For this purpose, the hyaluronic acid is injected directly into the joint.
This does not lead to the formation of new cartilage, so the injection of hyaluronic acid into the shoulder joint only has a temporary effect and must be repeated at certain intervals. Homeopathic remedies can be used to support drug therapy or physiotherapy. Taking globules can therefore help to alleviate the symptoms of shoulder arthrosis.
For example, 5 globules of Harpagophytum procumbens can be taken three times a day to relieve joint swelling and pain. If the joints are rather stiff and movement is restricted, Hedera helix or Hekla lava can help to improve the symptoms. Bryonia or Symphytikum can also be taken for osteoarthritis in the shoulder.
Osteopathy can also help to relieve the symptoms of osteoarthritis in the shoulder and slow down the progression of the disease. It can also improve movement restrictions caused by arthrosis. The concept of osteopathy is that the body is stimulated to heal itself by manipulating and mobilising the joint and loosening muscles.
The treatments often have to be carried out over weeks or months, as one treatment is usually not sufficient. Whether or not surgery is beneficial in cases of shoulder arthrosis must be decided on an individual basis. A distinction is made between minor operations, in which for example the joint cartilage is smoothed or inflamed tissue is removed, and major operations, in which parts of the joint or the entire joint is replaced.
Surgery is considered for patients who have not been able to reduce their pain through physiotherapy or medication and whose quality of life is severely restricted because movements can no longer be carried out or the pain is strongly felt at rest or at night. Especially with younger patients it is important to improve movement and to achieve freedom from pain. For older patients and patients suffering from many diseases (lat. polymorbid) the risks of surgery must always be lower than the benefits and success of treatment. Whether an operation is a possibility and whether it makes sense should be discussed with an experienced doctor.