Shoulder Osteoarthritis

What is osteoarthritis of the shoulder?

Osteoarthritis (OA) is a common condition which affects the joints causing pain and loss of function.

Your shoulders, like other joints, constantly undergo normal wear and repair processes from everyday use. The majority of the time these processes will go on unnoticed and you wil not experience any symptoms. This is because there is a good balance between the wear and repair. Sometimes if we do more with our bodies than usual, or if there is an injury, this balance may be disturbed and you may start to experience some symptoms of pain, swelling and heat in the joint. This is known as a flare up and may last for up to 24 weeks.

You may have had an X-Ray confirming OA, but it is important to know that there is often a poor link between what is seen on an X-Ray and the symptoms. Sometimes minimal changes are associated with a lot of pain and moderate to severe changes have no symptoms at all. An X-Ray is not always required and a diagnosis can be made based on your symptoms and how your shoulder moves. It is important to remember that pain felt in the shoulder maybe from other causes such as the muscles and tendons. Please read our rotator cuff related shoulder pain page for more information.

What are the symptoms?

  • Typically discomfort/pain felt in the shoulder and upper arm. However, for some these symptoms can spread a little further towards the neck and further down the arm.
  • Pain and stiffness usually comes on gradually over several months or years, but at times may flare up, where the symptoms suddenly increase for several weeks and then settle again.
  • The shoulder may be stiff and have a limited range of movement.
  • You may feel pain/discomfort when you reach up, when you reach behind your head, or when you reach behind your back.
  • Your sleep may be disturbed.
  • Symptoms are usually worse first thing in the morning but ease within 30 minutes.

What are the causes?

OA in the shoulder is less common than in other joints and the exact cause is not known. It may be linked to several factors such as;

  • Age- over 50.
  • Gender. It is more common in women than men.
  • Having a previous history of Gout or Rheumatoid arthritis in the shoulder joint.
  • Previous injury to the shoulder joint.
  • Previous surgery to the shoulder.
  • Smoking. 

What can I do to help myself?

Osteoarthritis is a long term condition and can be managed well with some simple lifestlye changes.

  • Reduce or modify any activities that aggravate your symptoms, but dont stop using the arm completely. There are various devices that you could use to help you with some movements such as 'grabbers'.
  • Re-arrange your kitchen cupboards so the items that you use regularly are on the lower shelves and are easy to reach.
  • Try to avoid lying on the affected arm in bed. Lie on the other side with a pillow under the arm to support it.
  • Use pain relief. They will reduce your pain allowing you to remain more active. Guidelines suggest trying paracetamol and anti inflammatory gels to begin with. If you are not sure if these are safe for you to use, or if they are not working, then speak to a pharmacist or GP. 
  • Try using heat or ice packs. Ensure the pack is wrapped in a dry towel to protect the skin.
  • Stopping smoking.
  • Regular exercise focusing on strengthening and stretching the shoulder. Increasing general aerobic exercises such as brisk walking, cycling or swimming have also been shown to help.
  • Self Refer to see a physiotherapist.

What will physiotherapy do?

A physiotherapist will take a thorough history of your symptoms and will conduct a physical examination to confirm the diagnosis.

The main aim is to restore strength and function to the shoulder and surrounding muscles. Treatment will be based on active rehabilitation, focusing on strength and flexibility.

Your physiotherapist will create an individual and progessive exercise programme to address your individual needs. We have provided some exercises in our resources pages for you to try.

Acupuncture, electrotherapy and massage have not been shown to be helpful and therefore are not offered.

The benefits & risks of steroid injections can be discussed with your physiotherapist or GP. Due to the current coronavirus pandemic we will not be offering injections until further notice.

 

 

 

Symptoms to check

Click the plus sign to see a list of problems that could be a sign you may need to be checked urgently

Get advice from 111 now if:

  • the pain is sudden or very bad
  • you cannot move your arm
  • your arm or shoulder has changed shape or is badly swollen
  • you have pins and needles that do not go away
  • your arm or shoulder is hot or cold to touch
  • the pain is severe and started after an injury or accident, like a fall
  • hurts when you exercise but goes away when your rest
  • you are experiencing chest pain/tightness with your shoulder pain

111 will tell you what to do. They can tell you the right place to get help if you need to see someone.

Go to 111.nhs.uk or call 111.

Immediate medical advice is available by contacting NHS 111

Exercises & Resources area

If you have already received a diagnosis from a medical professional you may find some the following links helpful:

5 star service. An outstanding service by all staff. They have identified my symptoms with great professionalism & empathy. Best health care and results I have ever had.

Excellent, supportive and professional approach. Could not achieve these results on my own! Thank you.

Everyone was so friendly and helpful. Wonderful experience.

Having formerly been a rugby player needed physiotherapy on a number of occasions I have never has as comprehensive a diagnosis and treatment as I have had from Alison Starkey. She was excellent.

Shafeeq Younus was very knowledgeable and courteous. Made me feel so much better mentally. Nothing could be improved.

Very helpful. Exercises really seemed to work for me.

Yohann & Diane are brilliant. Yohann was the only one who realised I had, had a mini stroke, if it hadn't been for him I don't know where I would be today. Diane was brilliant today, she really helped me and calmed me down.

Bart (Klimek) was great, feel like the exercises he gives are helping loads and I'm getting sorted.

Excellent service. Good follow up each time with the care given. All instructions for therapy were very clear.

Within days of attending I was doing exercises, more movement and less pain and everything was explained to me in great detail.

Referral information

If your shoulder pain persists then you can self-refer to see a physiotherapist who can help diagnose your problem and guide you on how best to help recovery.

Refer