Shoulder Arthritis (osteoarthritis)

SHOULDER ARTHRITIS (OSTEOARTHRITIS) Shoulder arthritis can be extremely painful and make everyday activities such as, lifting a heavy dish into a cupboard, hanging clothes on a washing line, or even steering a car difficult. The shoulder is engaged in almost all arm movements, so painful movement of the shoulder joint affects many everyday activities.



Typically, a gradual onset of pain is felt, with local tenderness and limited mobility. Osteoarthritis is the most common type of shoulder arthritis, followed by forms of inflammatory arthritis, such as rheumatoid arthritis or gout.

Shoulder osteoarthritis is an age related degenerative joint disease that involves the cartilage in the joints to break down and degredate. Consequently bony growths called osteophytes or bone spurs can develop in the joint, further effecting the shoulder joint.



Causes


We may think that only weight-bearing joints such as the knee and hips are subject to arthritis, but this is wrong unfortunately. Genetics play a key role for one, and two - shoulder cartilage degeneration is often preceded by an injury or ongoing repetitive trauma / overuse. The degeneration eventually leads to abnormal joint function, pain and inflexibility.




Symptoms


  • Shoulder pain and tenderness intermittently,

  • Limited mobility

  • Pain with certain activities, such as golfing, throwing a ball, lifting items overhead, putting on a seat belt, or brushing teeth.


Treatment

  • Painkillers and anti-inflammatory medications only provide short term relief.

  • Osteopathic Treatment and physical rehabilitation aims to keep your shoulder mobile and strong, with further aims to reduce pain and weakness.

  • If conservative treatment fails then you may be offered a Cortisone steroid injection into the area to help reduce inflammation and control the pain. However, it should be noted that these in most cases only offer short term relief and I’m not a solution long-term. Furthermore, It is advisable to avoid repeated steroid injections in the presence of a tendon tear, as this has been shown to further damage the tendon further.

  • Platelet rich plasma (PRP) Treatment - a natural non-surgical treatment aiming to restore function and reduce pain. Also, a popular form of regenerative medicine which is used to preserve and restore cartilage health

  • Surgery is required may be required in the form of a shoulder replacement if the shoulder arthritis is servre and has not responded to conservative management and rehabilitation. It is important to note that surgery requires a long period of rehabilitation following.




- REGENERATIVE MEDICINE. PLATELET RICH PLASMA (PRP) TREATMENT:


Platelet-rich plasma (PRP) is a very popular ortho-biologic treatment use in regenerative medicine. Ortho-biologics are substances that occur naturally in the human body. When extracted, concentrated and injected back into the body, these substances activate the body’s own healing mechanisms. PRP treatment is performed by taking a small sample of the patient’s blood, extracting the platelets are then further contacting them before they are used to speed up healing and recovery.


PRP injections are very commonly used to facilitate the body’s self-healing mechanisms, and the clinical outcomes are very good. Furthermore, it is completely natural and associated with minimal downtime.

PRP has been shown in scientific research to be very effective for treating mild to moderate osteoarthritis, without the risks and expense of surgery.


Most patients here at Dynamic Osteopaths & Regenerative Medicine report minimal discomfort associated with the injection. Also, go on to report significant improvement that occurs in the subsequent weeks. The study below demonstrates that single injection of PRP is effective and better than corticosteroid injection or ultrasonic therapy in treatment of shoulder arthritis (link).




- HYALURONIC ACID (HA) INJECTION TREATMENT:


Two types of injections are normally used for treatment of pain from shoulder osteoarthritis: steroid injections and hyaluronic acid (HA) injections.


  • The goal of steroid injections is to reduce inflammation, however, these are only sort lived and can be damaging to the tissue.

  • The goal of hyaluronic acid injections is to provide nourishment and lubrication for the shoulder joint and to protect the joint cartilage. As hyaluronic acid mimics our normal joint fluid that naturally lubricates joints. Hyaluronic acid injections are a type of treatment called viscosupplementation. As we age, we lose the fluid with inside our joints gradually, this then results in friction and slow degradation of the joint cartilage - causing inflammation and arthritis. Hyaluronic acid injections replace the normal fluid loss.


Ideally, when injections are used they can be used in combination with a structured physical therapy program. The study here shown that the combination of intra-articular injection of hyaluronic acid with physical therapy program was more effective in comparison with the only physical therapy in reducing pain in patients affected by glenohumeral arthritis (link).



PLEASE FOLLOW THIS LINK HERE FOR FURTHER SPECIFIC INFORMATION ON PRP & HA TREATMENT




Exercises for Shoulder Arthritis


It is important that the stabilising muscles are working to their best ability during the treatment of shoulder arthritis, and rehabilitation. The shoulder joint relies heavily on dynamic synergistic control while moving and if this is out, the shoulder biomechanics will be affected and the rotator cuff can also be susceptible to damage So, it is important to do some corrective stabilisation and strengthening exercises under the guidance of your osteopath, such as:


  • Rear scapular (shoulder blade) control

  • Rotator cuff strengthening

  • Postural control

  • Shoulder mobility exercises


Further specific exercises (below) can be adopted when tolerated

  • Therapy ball can be used to strengthen the core muscles

  • Rear shoulder strengthening (when tolerated)

  • Preventive exercise

PLEASE FOLLOW LINK HERE FOR SPECIFIC SHOULDER REHABILITATION FOR SHOULDER ARTHRITIS

www.dynamicosteopaths.com



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