What is it?
Shoulder osteoarthritis (OA) also called degenerative joint disease is a condition that occurs when the joint tissues of the shoulder wear down over time. This in turn produces friction in the joint, which may cause pain and slowly decrease your mobility.
It is classified into two categories, (primary OA and secondary OA.) Primary OA has no specific cause but can be related to your age, genes, and sex. It is typically seen in people over the age of 50 and it occurs more frequently in women than men. There are more cases seen with each advancing decade of life as people misuse or overuse of their joints over time. Secondary OA may be caused by an injury, dislocation of the shoulder, rotator cuff tears, or infection. However, shoulder OA can also develop in younger people after trauma or surgery to a joint.
It may result in the following symptoms:
- Pain or aching that increases with activities Can relieve with rest
- Decreased shoulder range of motion
- Stiffness that may result in difficulty using the arm
- “Clicking” or grinding noises as you move your shoulder
- Difficulty with everyday tasks (lifting arm)
- Difficulty sleeping with accompanied pain as the condition worsens
How Is It Diagnosed?
Your physical therapist will start by reviewing your medical history and symptoms with you. They will ask questions about your daily activities, exercise regimen, aggravating factors, and difficulties you currently are experiencing to identify other contributing factors. They will then perform a thorough examination of your shoulder to assess the following:
- Pain in certain positions and tenderness to the touch
- The available range of motion (as you move your arm and as your therapist moves it for you)
- Strength testing to both shoulders/arms
- Including the rotator cuff and the muscles that support the shoulder blade
- Crepitus (grinding sensation inside the joint) with movement
- Posture as well as how you perform certain activities
- Signs of arthritis in other joints
- Signs of old or new injuries.
How a Physical Therapist Can Help
Together as a team, your physical therapist will work with you to develop a plan and set goals customized for you and your specific case. Treatment for shoulder osteoarthritis will include:
- Education on the nature of OA and the use of heat/cold packs for pain/stiffness
- Passive and active range of motion to decrease tension and improve mobility
- Manual therapy and stretching of tight musculature for better flexibility
- Progressive strength training of the shoulder and arm muscles
- Functional task training to improve activities of daily living
- Postural control and endurance
Your physical therapist will also provide you with an individualized exercise program for you to continue at home in order to achieve your goals and to maintain your strength and function after completing your therapy. For some, aquatic (water) therapy may be advised to reduce pain levels, allow for pain-free motion, promote strengthening, and increase overall function. The resistance and friction provided by the water allows for strengthening, while the buoyancy (decreased weight) properties decrease joint stress and alleviate pain. The above techniques would be included by the physical therapist if deemed appropriate.
If you continue with unresolved pain, your doctor may prescribe medications such as steroids or nonsteroidal anti-inflammatory drugs (NSAIDs). The use of steroid or anesthetic medications through injections may also help. Depending on your specific circumstances, your doctor may order an x-ray to determine the amount of change in the joint such as joint-space narrowing, changes in the bone, and/or the formation of osteophytes (bone spurs). If there is suspected loss of bone, a CAT scan may be ordered to get a clearer picture of the area.
Individuals with shoulder osteoarthritis usually have very good relief of pain and improved function through physical therapy treatment.
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