Shoulder Osteoarthritis (Shoulder OA)
Shoulder Osteoarthritis (Shoulder OA): Understanding the Condition
Shoulder osteoarthritis (Shoulder OA) is a degenerative joint condition characterized by the breakdown of cartilage in the shoulder joint, leading to pain, stiffness, and reduced range of motion36. While shoulders are less susceptible to wear and tear compared to weight-bearing joints, longer lifespans and increased sports participation have contributed to rising numbers of shoulder problems earlier in life3.
Symptoms of Shoulder Osteoarthritis
The most common symptoms of shoulder OA include16:
- Pain: Tenderness and pain deep in the back of the shoulder, which may worsen with activity and at night, making it difficult to sleep267. If the glenohumeral shoulder joint is affected, the pain will be felt at the back of the shoulder and may feel like a deep ache1. If the AC joint is affected, pain will be focused on the top of the shoulder and may radiate up the side of the neck1.
- Stiffness or Loss of Motion: Decreased range of motion, making everyday activities like washing and dressing difficult2.
- Crepitus: Hearing and feeling grinding and clicking noises as you move your shoulder17. A feeling of friction as you move your shoulder2.
Causes and Risk Factors
Shoulder OA can be primary or secondary1:
- Primary OA: Has no specific cause but is related to age, genes, and sex. It is usually seen in people over 50, and women are affected more often than men13. It can develop as part of the natural aging process4.
- Secondary OA: Has a known cause or influencing factor, such as a previous injury, history of shoulder dislocations, infection, or rotator cuff tears1. It can also be caused by wear and tear over time from repetitive or forceful movements of your shoulder, such as in tennis, weight lifting, golf, or manual jobs involving overhead work2.
- High-dose steroid use
- Heavy alcohol consumption
- Sickle cell disease
- Traumatic injury, such as fractures of the shoulder
- Avascular necrosis (AVN)
In some cases, no cause can be identified; this is referred to as idiopathic AVN5.
Diagnosis
To diagnose shoulder OA, your doctor will13:
- Ask about your symptoms and medical history
- Look for muscle strength
- Check for tenderness to the touch
- Evaluate mobility – both active and passive range of motion
- Check for signs of new or old injuries
- Examine other joints for signs of arthritis
- Look for crepitus (a grating sensation inside the joint) with movement
- Look for pain in certain positions
- Check for swelling or joint enlargement
X-rays are used to look for a narrowing joint space and damage related to the bones in the shoulder joint, as well as for the formation of bone spurs, which indicate arthritis3. An MRI may also be needed to gauge the condition of the rotator cuff3. Other diagnostic tests may be used to rule out causes of joint pain. Blood tests and analysis of joint fluid can rule out rheumatoid arthritis or infection3.
Treatment
Shoulder OA is highly treatable3. Depending on the severity of the diagnosis, non-surgical or surgical treatment options may be recommended3.
Non-surgical interventions can help preserve the health of your shoulder3:
- Physical therapy
- Medications
If non-surgical treatments don’t relieve symptoms, surgical options may be recommended3.
