What is shoulder osteoarthritis?
Osteoarthritis refers to collection of changes that occur at a joint that affects it health. These changes include:
-Thining of the cartilage that covers the surfaces of the joint exposing the underlying bone
-Subsequent tear, flair and repair process causing bony irregularity across joint surfaces
-Tightening of soft tissues around the joint.
The shoulder is one of the less common places in the body for osteoarthritis to develop. In fact it is quite rare in people under the age of 60. It can cause varying degrees of pain and stiffness of the shoulder joint. For some people the symptoms are hardly noticeable, for others they can have a massive impact on the ability to use the arm.
There are some risk factors than can predispose you to developing the problem in your shoulder these are:
1. Age. It is very rare under the age of 60
2. Previous fracture or dislocation. Previous significant joint trauma is linked to subsequently developing arthritis
3. Heavy manual occupation. It is thought heavy repetatative work may be a factor in recurrent tear, flair and repair cycles
4. Genetics. Osteoarthritis can run in families
5. Obesity. Having a higher than normal body mass index (BMI) is associated with osteoarthritis in the shoulder. This is thought to be due to the 'switching on' of inflammation by a group of chemical messengers called adipokines. These chemicals are secreted by fat tissue (which we tend to have more of in our jont soft tissues if we are overweight).
6. Smoking. Smoking is linked to poor joint health.
What can i do about the problem
Osteoarthritis is a long term condition- it usually develops and evolves very slowly (there are some more aggressive types that tend to affect younger people where the osteoarthritis develops quickly, but these are the exceptions not the rule).
Just as with other long term conditions like asthma or diabetes there are steps that can be taken to manage existing symptoms, and lifestyle changes that can be made which will generally improve symptoms.
From time to time people with osteoarthritis can experience flair up of their symptoms and may require additional help or treatment at these times to setle things back down.
Managing existing symptoms
The main ways of managing existing symptoms are looking at medication useage, maintenance exercises, and activity pacing techniques.
The aim of medication in osteoarthritis is to minimise your experience of pain symptoms. For some people dipping in and out of pain relief as required is sufficient to do this, for others a more formal regime of taking medication regularly is required to acheive this aim. National guidance for the use of medication in osteoarthritis suggests that people should try and use paracetamol or a NSAID in the first instance. Because both sets of drugs are unsuitable for some people you should speak to your GP about which approach is right for you.
Maintenance exercises are designed to keep your shoulder moving well, the following exercises are likely to be useful.
Actvity pacing techniques are useful to consider if either:
you are not able to to complete activities you enjoy because of pain
you can complete activities but you suffer for doing so for a few days afterwards.
Pacing involves breaking bigger activities down into smaller chunks to acheive you goal. The short video below explains how to pace your activities.
Improving existing symptoms
Employing the above management strategies for your existing symptoms should have the net effect of improving your existing symptoms.
Symptoms may also be improved by thinking about lifestyle factors. The key areas where changing lifestyle can be beneficial to joint health are:
stopping smoking, loosing weight, and exercising regularly.
Exercising regularly has been shown to have a strong effect on peoples self reported ability to function with arthritis.
If you are overweight, using a calorie controlled diet t otry and reduce this has also been shown to reduce arthritis symptoms.
Smoking cessation improves not only joint health but will have a positive impact on almost every system in the body.
To find out more about the positive effect that managing your lifestyle can have on your pain visit our lifestyle page.
Managing flare ups
If you experience a flare of symptoms this is usually linked to an episode of inflammation within the joint. It is therefore usual for a flare up to last between 6 and 12 weeks. If you are struggling with a flare it is worth considering your medication based option for managing this. Your GP may prescribe you a short course of medication to help with the flare up or alternatively a corticosteroid injection into the joint can be helpful to settle things down. We are happy to see people on a one to one basis for consideration of an injection during a flare up period. Please speak to your GP to arrange an MSK referral.
I'm struggling to manage the problem what should i do?
You can ask your GP for a referral to the MSK service or you can refer yourself here.