Shoulder Arthritis Treatment Adelaide
Dr Arthur Turow, Shoulder SurgeonShoulder arthritis can cause persistent pain, stiffness and difficulty with everyday activities, including reaching overhead, dressing and sleeping comfortably. Dr Arthur Turow is an Adelaide-based orthopaedic surgeon specialising in shoulder and upper limb conditions. He provides assessment and treatment for shoulder arthritis, including non-surgical management and shoulder replacement surgery when appropriate. Treatment is tailored to your symptoms, shoulder function and individual needs.
Shoulder arthritis can lead to shoulder pain, stiffness and clicking
What is Shoulder Arthritis?
Shoulder arthritis describes conditions that damage the joint surfaces of your shoulder. The most common form is osteoarthritis, in which the smooth cartilage covering the ball and socket gradually wears. With this, movement can become painful and restricted. Other forms of arthritis may develop following a significant rotator cuff tear, previous injury or inflammatory joint disease.
Find out more about shoulder arthritis at OrthoInfo or Healthdirect.
What are the most common causes for shoulder arthritis?
There are different causes of shoulder arthritis. The most common ones include:
Primary osteoarthritis: This is the most common form of shoulder arthritis. Primary shoulder osteoarthritis occurs when the smooth cartilage covering the joint gradually wears. This can cause pain, stiffness, grinding and reduced shoulder movement. It becomes more common with age, although previous injuries, e.g. shoulder dislocations, and other factors may contribute.
X-rays are the first step to assess the joint and usually show joint space narrowing, bone spurs and bone cysts. Many patients can manage their arthritis without surgery, while those with advanced arthritis may benefit from a shoulder replacement.
Rotator cuff tear arthropathy: Sometimes called cuff-tear arthritis; this can develop after a large, longstanding rotator cuff tear. The torn cuff tendons change how your shoulder joint moves and this can lead to arthritis over time. If you symptoms are severe, a reverse reverse shoulder replacement may be considered.
Post-traumatic arthritis: This type of arthritis can develop after a shoulder injury or fracture. The trauma can damage the joint structures, leading to cartilage degeneration and subsequent arthritis.
AC joint arthritis: Arthritis can also affect the acromioclavicular (AC) joint, where the collarbone meets the shoulder blade. This usually causes pain over the top of the shoulder, particularly when reaching across your body. Treatment differs from arthritis of the main ball-and-socket shoulder joint, so identifying which joint is affected is important.
Shoulder Arthritis Symptoms
The symptoms of shoulder arthritis can vary but most frequently include:
Pain: Pain is the most common symptom and often feels like a deep ache. It can be in different areas of the shoulder depending on the type of arthritis and may worsen with activity or at night.
Stiffness: Stiffness is another common symptom. It is a common shoulder problem and can occur in several other conditions, such as frozen shoulder. You may find that you cannot lift your arm above your head or it may be difficult to reach out to the side. As your shoulder joint gets stiff with arthritis, your shoulder blade may hitch and move instead of the shoulder joint as a way to compensate for the shoulder joint stiffness.
Clicking: Mechanical symptoms can occur with shoulder arthritis. This may include locking, grinding or popping of your shoulder.
Weakness: Depending on why you have shoulder arthritis, you may feel that your shoulder is weak, particularly as you try to raise your arm above your head.
X-ray of a normal shoulder
In a normal shoulder X-ray, the shoulder joint has a smooth outline with a symmetrical outline of the joint.
X-ray of an arthritic shoulder
In shoulder arthritis (arrow), the shoulder joint is narrow leading to joint stiffness and pain.
Diagnosis and When to Seek Help
Shoulder arthritis is diagnosed with physical examination and imaging such as an X-ray. X-rays assess for joint space narrowing and bone changes. Further imaging such as ultrasound, MRI and CT may sometimes be needed for further treatment guidance. You should see a shoulder specialist if you have not responded to non-operative treatments, your pain is worsening and is affecting your daily activities and sleep.
If you are looking for shoulder arthritis treatment in Adelaide, an assessment can help determine whether your symptoms are caused by osteoarthritis, rotator cuff disease or another shoulder condition.
Shoulder Arthritis Treatment Options
Non-surgical Treatment
Rest and activity modification: Avoid activities that aggravate your shoulder and allow your shoulder to rest. Using a sling on occasion may help you with pain.
Pain management: It is best to stick to simple pain relief, such as Paracetamol (Panadol) or nonsteroidal anti-inflammatories (NSAIDs; Nurofen). Strong opioid painkillers are generally not recommended for routine management of chronic shoulder arthritis because of their risks and limited long-term benefit.
Physical therapy: Specific exercises and stretching of your shoulder may be helpful. Your physiotherapist can guide you through specific strengthening and stretching.
Heat/ cold: Your shoulder may respond to heating or cooling, especially if you have a spike of pain. Heating tends to work better in the colder months and cooling in summer; it’s best to try what works best for you.
Steroid injections: If you are considering shoulder replacement surgery, it is important to consider the timing of any injections. Injections given close to shoulder surgery may increase the risk of postoperative infection.
Shoulder Replacement Surgery
Shoulder replacement surgery, also known as shoulder arthroplasty, may be needed when your arthritis causes persistent pain and loss of function despite maximal non-surgical treatment. Depending on the condition of your rotator cuff and the shape/ anatomy of your shoulder joint, an anatomic or reverse shoulder replacement may be recommended. The main aim is to reduce pain and improve your everyday function. A shoulder replacement is a major operation. You will need time to heal and recover. After surgery, you will have follow-up with a physiotherapist, who will guide you through your rehabilitation and work on your range of motion and shoulder strength.
Anatomic vs Reverse Shoulder Replacement
There are two main types of total shoulder replacement used to treat shoulder arthritis: anatomic and reverse shoulder replacement. Which shoulder replacement is best for you? This depends on several factors, such as previous surgery, any rotator cuff tears, your bone shape and size and your individual goals for surgery.
Anatomic Shoulder Replacement
An anatomic shoulder replacement is a like-for-like replacement. It aims to restore the normal anatomy of your shoulder. The damaged ball of your shoulder (humeral head) is replaced with an artificial ball, while the socket (glenoid) is resurfaced with a matching implant. This is generally suitable for patients with shoulder arthritis who have a functioning rotator cuff.
Reverse Shoulder Replacement
In a reverse shoulder replacement, the ball-and-socket shape is reversed. This means the socket of your shoulder (glenoid) gets a ball implant and the ball of your shoulder (humeral head) gets a socket implant. This may seem like a strange thing to do, but it is a very reliable way to treat very complex shoulder problems. This changes the mechanics of the shoulder, allowing the deltoid muscle to compensate for a deficient rotator cuff. A reverse shoulder replacement can also be used if you have a severe fracture of your shoulder, if you have severe bone deformity or if you had a previous shoulder replacement that did not work.
Shoulder Replacement
With a shoulder replacement the ball and socket joint is replaced with an implant to reduce your pain and improve your shoulder function.
Why Choose Dr Arthur Turow for Shoulder Arthritis in Adelaide
Dr Arthur Turow is a fellowship-trained orthopaedic surgeon with a subspecialty focus on shoulder and upper limb surgery. His practice includes the management of shoulder osteoarthritis, rotator cuff tear arthropathy and complex shoulder conditions.
Treatment begins with an assessment of your symptoms, examination and imaging. Dr Turow will discuss with you non-surgical options. If you need a shoulder replacement, Dr Turow assesses the condition of your rotator cuff and the anatomy of your shoulder joint to help determine whether an anatomic or reverse replacement is more appropriate.
Consultations are available in Adelaide CBD and at regional locations across South Australia, including Yorke Peninsula, Gawler and Mt Barker.
Frequently Asked Questions
What causes shoulder arthritis?
Common causes include primary osteoarthritis from wear and tear of your shoulder joint, post-traumatic arthritis, rotator cuff disease and inflammatory conditions.
Do alternative treatments work for shoulder arthritis?
Alternative treatments for shoulder arthritis include acupuncture/dry needling, platelet rich plasma (PRP) injections, joint fluid supplements (e.g. Durolane and Monovisc) or manipulation. None of these measures have been shown to provide any long-term, beneficial effects for shoulder arthritis. In some cases, however, you may find some benefits with alternative treatments. If you would like to explore non-surgical, alternative treatments for your shoulder it is best to get guidance with this from your GP or from a dedicated musculoskeletal physician. The Wakefield Sports Clinic has a dedicated team of musculoskeletal physicians that can help you.
What not to do with shoulder arthritis?
There are usually no specific restrictions with shoulder arthritis. You can and are encouraged to stay active. You may need to reduce or adapt activities that repeatedly aggravate your shoulder pain. Avoid forcing painful movements.
It is important to maintain good shoulder health by maintaining range of motion and strength of your shoulder muscles. Your physioo can help you to maintain shoulder movement & strength while adjusting your exercises.
Can worn shoulder cartilage grow back?
No. Our current treatments do not reliably regrow cartilage lost through shoulder osteoarthritis. Treatment focuses on reducing your pain and improving movement and function. Shoulder replacement may be considered when your symptoms remain troublesome despite nonsurgical care.
When is surgery needed?
Shoulder replacement surgery may be considered when arthritis causes persistent pain, stiffness, disturbed sleep or difficulty with daily activities despite appropriate non-surgical treatment. The decision depends on your symptoms, examination findings, imaging and personal goals. Not everyone with shoulder arthritis needs surgery.
For Patients
Everyone responds differently to shoulder arthritis and your specific symptoms can vary. If you are experiencing shoulder pain, limited mobility, or other concerning symptoms, book your appointment with Dr Arthur Turow at one of his clinic locations in Adelaide to discuss the right treatment for you.