Shoulder Osteoarthritis

 

Introduction

The shoulder is one of the most mobile joints in the human body, enabling a wide range of movements that allow us to lift, reach, push, pull, and rotate the arm. Over time, this joint can be affected by degenerative changes that impact its smooth function. One such condition is shoulder osteoarthritis, a gradual wearing down of the cartilage within the joint.

For some individuals, the symptoms may remain mild and manageable, while for others, they may become more pronounced over time. Shoulder osteoarthritis can influence both daily activities and overall joint mobility, and it is often managed using a combination of lifestyle measures, clinical interventions, and targeted treatments.

At Joint Injections, our clinicians offer ultrasound-guided cortisone injections as one of the options that may assist in reducing inflammation in the shoulder joint and support more comfortable movement.

Understanding the Shoulder Joint

The shoulder is a complex ball-and-socket joint formed by three main bones:

• Humerus — the upper arm bone, whose rounded head fits into the socket.
• Scapula — the shoulder blade, which contains the glenoid cavity where the humeral head sits.
• Clavicle — the collarbone, which supports the shoulder and connects it to the chest.

The surfaces of the humeral head and the glenoid are covered by articular cartilage, a smooth, cushioning tissue that reduces friction and allows pain-free movement. Surrounding this joint is a fibrous capsule lined with synovial membrane, which produces synovial fluid to lubricate and nourish the cartilage.

Several muscles and tendons, collectively known as the rotator cuff, stabilise the joint and guide its motion. Ligaments further support the joint by connecting bones together.

What is Shoulder Osteoarthritis?

Shoulder osteoarthritis is a degenerative joint condition where the protective cartilage wears down over time. Without this cushioning layer, the bones may rub together, leading to stiffness and reduced mobility. In some cases, the body responds to the cartilage loss by forming osteophytes (bone spurs), which can further restrict movement.

The shoulder is less commonly affected by osteoarthritis than weight-bearing joints such as the hips and knees, but when it does occur, it can have a significant impact on upper limb function.

Causes and Risk Factors

There is no single cause for shoulder osteoarthritis; rather, it develops due to a combination of factors:

1. Age-related changes — Natural wear and tear over the years can gradually thin the cartilage.
2. Previous shoulder injuries — Fractures, dislocations, or severe sprains may alter the joint’s mechanics.
3. Repetitive use — Occupations or sports involving repeated overhead movements may place added strain on the joint.
4. Genetic predisposition — Family history can play a role in joint health.
5. Inflammatory conditions — Certain systemic conditions affecting joint tissues may contribute to cartilage breakdown.

Common Symptoms

While symptoms vary from person to person, common signs of shoulder osteoarthritis may include:

• Pain in the shoulder, often worse with movement.
• Stiffness, particularly after periods of inactivity.
• Reduced range of motion, making it harder to reach overhead or behind the back.
• Grinding or clicking sounds (crepitus) when moving the arm.
• Swelling around the joint in some cases.

These symptoms can develop gradually, sometimes over years, and may progress in severity over time.

Diagnosis

A clinician will typically assess shoulder osteoarthritis through:

1. Medical history — Reviewing symptoms, onset, and any past injuries.
2. Physical examination — Assessing movement, strength, and areas of tenderness.

Management of Shoulder Osteoarthritis

There is currently no way to reverse cartilage loss once it has occurred, but there are a variety of strategies that can help manage symptoms and maintain joint mobility.

Management plans are often tailored to the individual and may include:

• Activity modification — Reducing repetitive overhead movements.
• Heat or cold therapy — For easing stiffness or discomfort.
• Medications — Such as anti-inflammatory medicines recommended by a clinician.
• Targeted joint injections — Ultrasound-guided cortisone injections to help reduce inflammation.

Ultrasound-Guided Cortisone Injections at Joint Injections

At Joint Injections, our clinicians use ultrasound guidance to administer cortisone injections into the shoulder joint. This approach allows for precise placement of the medication, as the ultrasound provides a real-time image of the joint structures.

Cortisone is a corticosteroid that can assist in reducing inflammation within the joint. This may help in easing discomfort and improving mobility for a period of time.

Benefits of Ultrasound Guidance

Using ultrasound to guide the injection offers several potential advantages:

• Accuracy — The clinician can see exactly where the needle is placed.
• Reduced risk of misplacement — Ensuring the medication is delivered to the intended location.
• Real-time imaging — Adjustments can be made during the procedure for optimal results.
• Minimised tissue irritation — By avoiding unnecessary contact with nearby structures.

Why Choose Joint Injections?

When it comes to joint care, patients may value:

• Experienced clinicians — Skilled in administering ultrasound-guided injections.
• Specialised equipment — High-quality imaging technology.
• Personalised approach — Tailored management strategies based on each individual’s needs.
• Comfort-focused environment — Designed to make the procedure as straightforward as possible.

Mechanism of Action of Cortisone in the Shoulder Joint

Cortisone works by mimicking the effects of cortisol, a natural hormone produced by the adrenal glands that plays a role in regulating inflammation. When injected directly into the shoulder joint:

1. Anti-inflammatory effect — It reduces the activity of inflammatory cells and mediators within the joint lining.
2. Decreased swelling — This can help to improve joint space and mobility.
3. Potential relief of discomfort — With reduced inflammation, movement may become more comfortable.

The effects can vary between individuals and may last for different lengths of time depending on the condition and other factors.

Living with Shoulder Osteoarthritis

Adapting daily routines can make a difference in managing shoulder osteoarthritis. Some strategies include:

• Using ergonomic tools to minimise strain.
• Pacing activities to avoid overuse.
• Incorporating gentle stretches into the day.
• Maintaining good posture to reduce joint stress.

Many people find that combining several approaches works best in supporting their shoulder health over the long term.

Conclusion

Shoulder osteoarthritis is a progressive joint condition that can influence mobility and comfort. With a comprehensive management plan, it is often possible to adapt daily activities, maintain function, and explore targeted treatment options such as ultrasound-guided cortisone injections.

At Joint Injections, our clinicians aim to support each patient with tailored care and precise injection techniques, using ultrasound guidance to ensure accuracy. By combining joint-specific expertise with modern imaging technology, we provide an environment where individuals can explore appropriate options for their shoulder joint health.