What it is
Glenohumeral osteoarthritis is the most common type of shoulder arthritis. It occurs when the smooth cartilage that lines the ball-and-socket shoulder joint gradually wears away, causing the bones to rub against one another. This can lead to pain, stiffness, grinding and a gradual loss of movement.
How it usually presents
- A deep aching pain that becomes worse with activity
- Increasing stiffness and gradual loss of movement
- Grinding or crunching through the arc of movement
- Difficulty with everyday tasks such as reaching overhead or fastening a seatbelt
- Pain at night and disturbed sleep, which as the arthritis progresses often has the greatest impact on quality of life
Why does it happen?
For many people, shoulder arthritis develops naturally with age and there is no obvious cause. In others, it may occur following a previous injury to the shoulder, even one that happened many years earlier and seemed relatively minor at the time. Less commonly, arthritis can develop following an infection within the joint earlier in life. Symptoms usually begin gradually and build over months or years rather than appearing suddenly.
How it is assessed
The diagnosis can usually be made with a careful assessment and simple X-rays, which often provide all the information needed to understand the condition and discuss treatment options.
Do I need a scan or surgery?
Initial treatment is usually aimed at managing symptoms and maintaining movement. This may include pain relief, activity modification, physiotherapy and, in some cases, an ultrasound-guided injection. When pain becomes persistent, affects your sleep, or begins to limit the activities that are important to you, it may be the right time to discuss shoulder replacement surgery. Unlike some other shoulder conditions, keyhole (arthroscopic) surgery is rarely beneficial once established arthritis is present, even if there is an associated rotator cuff tear. The focus instead becomes replacing the damaged joint surfaces to relieve pain and restore function.
Treatment options
- Pain relief and activity modification
- Physiotherapy to maintain movement and shoulder blade control
- Ultrasound-guided injection in selected cases
- Anatomic shoulder replacement where the rotator cuff is working well
- Reverse shoulder replacement where the rotator cuff is not functioning, or in more complex cases
The two main types of shoulder replacement
Anatomic shoulder replacement is used when the rotator cuff tendons are functioning well. The worn joint surfaces are replaced whilst preserving the normal anatomy of the shoulder, allowing the rotator cuff to continue controlling movement.
Reverse shoulder replacement is used when arthritis is associated with a non-functioning rotator cuff, or in certain more complex situations. The design of the replacement changes the mechanics of the shoulder so that the deltoid muscle can lift the arm more effectively, often providing excellent pain relief and improved function.
Getting you back to the things you want
Hobbies with friends
Jobs around the house
Every shoulder is different. My role is to understand not only what your X-rays show, but how your symptoms affect your life. Together, we can decide whether non-surgical treatment remains appropriate or whether shoulder replacement is likely to provide the greatest improvement in pain, movement and quality of life.
Patient FAQs
Related conditions
Rotator cuff tears
Partial or full-thickness tears of the tendons that lift the arm.
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Pain right on the top of the shoulder, over the collarbone joint.
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