Shoulder osteoarthritis

At night, when you lie on your side, pain wakes you from sleep. In the morning, before you loosen up, the shoulder is stiff and clearly grinds during movement. This is not ordinary ‘stiffness with age’ that you only need to wait out. These are probably degenerative changes of the shoulder joint.

What is actually happening?

In a healthy shoulder, the round humeral head rotates in the socket, a hollow in the shoulder blade. Both surfaces are covered with cartilage, a smooth layer that lets the bones glide without friction. As cartilage wears away, the glide disappears and the bones rub against each other. Bony growths—osteophytes, small accumulations of bone—develop at the joint edges and can block movement.

It is most often the result of years of wear. Sometimes it appears earlier, after a fracture or dislocation of the shoulder joint, after damage to the shoulder tendons, or with inflammatory disease. In some people the joint wears out without an obvious cause.

How can you recognize it?

• you hear and feel ‘grinding’ in the shoulder during movement,
• pain in the joint that increases throughout the day or during work,
• everyday household activities become increasingly difficult because of pain or restricted movement,
• you transfer your bag and phone to the healthy arm so as not to burden the affected shoulder.

Why you should not wait

The body does not rebuild worn cartilage. The longer bare bone rubs against bone, the more cartilage is lost and the smaller the range of motion becomes. This process goes in one direction and will not resolve on its own.

At an early stage, wear can be slowed, symptoms controlled, and good function maintained without surgery. Later, as cartilage is lost, pain and restricted movement increase and conservative treatment no longer helps in the long term; minimally invasive treatment such as shoulder arthroscopy may provide support. With advanced degenerative changes, only replacement of the destroyed joint with an artificial implant helps, requiring a much more serious and extensive operation.

How we help

We begin with a consultation and imaging studies. An X-ray shows how much the joint space has narrowed, how much cartilage has been lost, and whether bony growths have appeared. Magnetic resonance imaging may help with further decisions by showing additional damage within the shoulder joint. When joint replacement is considered, computed tomography precisely maps wear of the socket and helps select the implant. We assess the rotator cuff, the tendons that lift the shoulder, with ultrasound because the implant choice depends on their condition.

When the degeneration is early, we begin with non-surgical treatment: rehabilitation, medication, and injections directly into the joint. The aim is less pain and slower cartilage damage.

When this is no longer enough, we consider surgery. For less advanced changes, we clean the joint arthroscopically: through several millimeter-sized incisions, using a camera and instruments, we remove bony growths, loose bone or cartilage fragments, and inflamed tissue. In advanced degeneration, we replace the worn joint surfaces with an implant that takes over their role.

There is one goal: a shoulder that does not hurt.

Book a consultation

If you recognize these symptoms, do not wait until your shoulder lets you down during everyday activities. Make an appointment for a consultation. We will assess the condition of your joint and tell you whether conservative treatment is enough or a procedure will be needed.