Shoulder Arthritis (Osteoarthritis)

Shoulder osteoarthritis is a degenerative joint disease that affects millions of adults worldwide. This post aims to provide an in-depth look at the condition, its symptoms, and various treatment options.

What is Shoulder Osteoarthritis?

Shoulder osteoarthritis is characterised by the gradual deterioration of the cartilage within the glenohumeral joint. This wear and tear process can lead to pain, stiffness, and reduced range of motion in the affected shoulder. As the protective cartilage diminishes, bone-on-bone contact may occur, exacerbating symptoms and potentially leading to the formation of bone spurs.

Symptoms and Diagnosis

Common symptoms of shoulder osteoarthritis include:

• Persistent pain, especially during movement

• Stiffness and reduced range of motion

• Crepitus (a grinding or clicking sensation in the joint)

• Weakness in the affected arm

Diagnosis can involve a combination of physical examination, patient history, and imaging studies such as X-rays or MRI scans to assess the extent of joint damage.

Treatment Options

Management of shoulder osteoarthritis often involves a multi-faceted approach, including:

1. Conservative measures: physiotherapy, activity modification, heat or cold therapy

2. Pharmacological interventions: Oral pain relievers (NSAIDs, paracetamol), topical analgesics

3. Intra-articular injections: corticosteroid injections, hyaluronic acid injections

4. Surgical options (for severe cases): shoulder replacement, arthroscopic debridement

How can steroid injections help?

Corticosteroid injections have emerged as a popular treatment option for shoulder osteoarthritis. These injections deliver potent anti-inflammatory medication directly into the affected joint, offering several many benefits:

• Rapid pain relief: Many patients experience significant reduction in pain within days of the injection.

• Improved function: By reducing inflammation and pain, steroid injections can help restore range of motion and improve overall shoulder function.

• Delayed need for surgery: For some patients, steroid injections may postpone or even eliminate the need for more invasive surgical interventions.

Steroid injections can be highly effective for pain relief, typically lasting several weeks to a few months. This can allow effective physiotherapy or other treatments to be planned. However, in the long term, repeated injections may have diminishing returns and potential side effects.

Conclusion

Shoulder osteoarthritis is a complex condition that requires individualised treatment approaches. Steroid injections offer a valuable tool in the management of this condition. They should be considered as part of a comprehensive treatment plan developed in consultation with a healthcare professional. If you are struggling with symptoms of shoulder arthritis, you can contact us to discuss your needs, or book in directly for a consultation.

References

1. Hsu JE, Gee AO, Lippitt SB, Matsen FA. The Glenohumeral Joint and Shoulder Arthroplasty. In: Rockwood and Matsen's The Shoulder. Elsevier; 2017:593-761.e16.

2. Buchbinder R, Green S, Youd JM. Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev. 2003;(1):CD004016.

3. Zhang YK, Yang J, Zhang P, et al. Effectiveness of Hyaluronic Acid Injection for Shoulder Pain: A Systematic Review and Meta-analysis. Arthroscopy. 2019;35(9):2847-2861.

4. Buchbinder R, Green S, Forbes A, et al. Efficacy and safety of steroid injections for shoulder and elbow tendonitis: A meta-analysis of randomized controlled trials. Annals of the Rheumatic Diseases. 2009;68(12):1843-1849. doi:10.1136/ard.2008.099572

5. Van der Windt DAWM, Koes BW, Deville W, Boeke AJP, De Jong BA, Bouter LM. Effectiveness of corticosteroid injections versus physiotherapy for painful stiff shoulder in primary care: Randomised trial. BMJ. 1998;317(7168):1292-1296. doi:10.1136/bmj.317.7168.1292

6. Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomised controlled trials. The Lancet. 2010;376(9754):1751-1767. doi:10.1016/S0140-6736(10)61160-9