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Arthritis of the Shoulder

This week’s osteoarthritis article is all about the shoulder.

This is one of the more common conditions that are present with patients we see for shoulder pain. Several weeks ago, I had an article I wrote talking about rotator cuff injuries. Several of the same rules and concepts overlap here. Just like with most arthritic conditions, this takes quite a while to develop. However, traumatic injuries such as dislocations can speed up the degenerative process. True OA is essentially inflammation in the joint that can lead to structural or bony changes at the joint over time.

For example, if you are a painter who works for several hours a day reaching overhead hundreds of times, this can result in breakdown of the cartilage tissue that lines the joint. The joint capsule can then become stiff, and with that stiffness structures around the joint get irritated. This creates the inflammatory response which leads to the structural adaptation by the joint. There are several other factors that can result in the breakdown of the joint, but this is just a common situation that we see.

We rarely see a shoulder patient who has absolutely zero arthritis in the shoulder. Usually if we are seeing someone for symptomatic osteoarthritis, it is because it has been present for an extremely long time. There is a certain pattern of movement that gets significantly restricted in most people whenever the joint capsule becomes dysfunctional. As PTs we are trained to identify that pattern.

In the past a ton of my patients get extremely concerned because their X-Ray had a bone spur (arthritic change) showing around the shoulder joint. I wanted to make sure in this post that I at least mentioned that this was by far the most common thing to see on X-Rays. It is not a significant reason to worry if that is the only thing showing on an Xray. If you undergo an MRI then you may see change in the cartilage lining the joint as well. Whenever there is bone on bone contact, this is usually indicative of late stage OA and may require surgical intervention depending on the progression.

Common Symptoms:

If you’re suffering from true shoulder osteoarthritis, what would the symptoms be? In the early stages there may be mild painful symptoms with certain movements of the shoulder. It’s also pretty common for a patient of mine to say that it hurts whenever they lay on their side at night to sleep. In the later stages we will be able to clearly identify a pattern of movement loss with both active and passive movements. Active movements are when you try to lift your arm yourself, for example. Passive movements are when we are doing the movement for you. Often times we can feel significant joint crepitus with the movements as well. This is the clicking, popping, or grinding sensation that you may be feeling with certain movements or activities.

What we can do to help:

Using the example of the painter from earlier, there are several ways we can help. First, we would be able to identify the affected tissue. We need to discern if this is truly a joint issue or is there irritation to the soft tissue structures in the same area. Second, we would have to identify the movement impairments and muscle imbalances present that are stressing the joint. For this painter, we need to see what is breaking down as they lift their arms overhead. And lastly, we would use an array of manual techniques and specific corrective movements that precisely address the detrimental factors that are causing the joint to breakdown and restrict your movement or activity. Through this we directly address the deficits seen at the joint, muscle, and nerves in the region. This will help ensure better joint function which should decrease your symptoms.

Overall, shoulder osteoarthritis is an extremely common condition that many people suffer from. We will gladly help if you feel like this is something that you may be suffering from. If you’re experiencing any pain in your shoulder or you have any questions for us, please feel free to call our office to setup a FREE 15-minute screen with us, our number is (817) 923-9000. We’re here to help!