Shoulder Osteoarthritis

 

Introduction

Shoulder osteoarthritis is a condition involving gradual wear and tear of the cartilage within the shoulder joint. Over time, this cartilage becomes thinner, potentially resulting in stiffness, discomfort, and a reduction in range of motion. Although often associated with ageing, shoulder osteoarthritis can also develop after injury, repetitive strain, or in relation to other underlying joint conditions.

At Alton Pain Clinic, we understand that shoulder osteoarthritis can impact daily activities such as lifting, dressing, driving, or even sleeping comfortably. Our approach includes offering ultrasound guided cortisone injections as part of a broader management plan to support patients in managing their symptoms.

Anatomy of the Shoulder

The shoulder is a ball-and-socket joint, formed by:

  • Humeral head — the ball at the top of the upper arm bone.
  • Glenoid cavity — a shallow socket in the shoulder blade.
  • Cartilage — smooth tissue that cushions and allows friction-free movement between bones.
  • Synovial membrane — produces fluid to lubricate the joint.
  • Ligaments and tendons — stabilise and move the joint.

The shoulder’s wide range of motion is possible because of its relatively shallow socket, but this flexibility also makes it more susceptible to wear and tear over time.

Pathology of Shoulder Osteoarthritis

In shoulder osteoarthritis, the cartilage covering the joint surfaces becomes progressively worn. Without sufficient cartilage, bone surfaces may rub together, which can alter joint shape and lead to the formation of bone spurs (osteophytes).

This degeneration can be caused by:

  • Age-related changes — cartilage naturally loses water and becomes less resilient.
  • Previous injury — fractures, dislocations, or rotator cuff injuries can accelerate wear.
  • Repetitive use — frequent overhead activities can contribute to cartilage breakdown.
  • Genetics — family history may play a role.

Common Symptoms

Symptoms can vary in severity but may include:

  • Persistent shoulder discomfort, particularly with movement.
  • Stiffness, especially after rest or in the morning.
  • Reduced range of motion, making daily activities harder.
  • Clicking, grinding, or catching sensations in the joint.
  • Weakness in the shoulder muscles.

Diagnosis

Diagnosis typically involves:

  1. Medical history — reviewing symptom onset, past injuries, and activity patterns
  2. Physical examination — assessing joint movement, tenderness, and muscle strength.

Management Approaches

There is no single method for managing shoulder osteoarthritis; the approach is often tailored to individual needs. Management may involve a combination of:

  • Activity modification — avoiding repetitive or heavy overhead movements.
  • Lifestyle adjustments — maintaining healthy weight, using supportive pillows at night.
  • Ultrasound guided cortisone injections — to target inflammation within the joint.

Ultrasound Guided Cortisone Injections at Alton Pain Clinic

At Alton Pain Clinic, we provide ultrasound guided cortisone injections for shoulder osteoarthritis as part of an individualised care plan.

What the Procedure Involves

  • Assessment — your clinician will review your history and examine your shoulder.
  • Ultrasound guidance — ensures precise needle placement into the affected joint.
  • Cortisone delivery — the injection is given directly into the joint space.
  • Post-procedure advice — guidance is provided on rest, gradual activity, and follow-up.

Benefits of Ultrasound Guidance

Ultrasound imaging allows clinicians to:

  • Visualise joint structures in real-time.
  • Ensure accurate delivery of cortisone to the targeted area.
  • Reduce the risk of injecting into surrounding tissues unnecessarily.

Mechanism of Cortisone in Shoulder Osteoarthritis

Cortisone is a type of corticosteroid that can help address inflammation in the joint. When injected into the shoulder:

  1. Anti-inflammatory action — cortisone acts on local tissues to reduce the production of inflammatory chemicals.
  2. Reduced swelling — less pressure in the joint space can support smoother movement.
  3. Nerve sensitivity modulation — by reducing inflammation, surrounding nerves may become less sensitive, easing discomfort perception.

Why Choose Alton Pain Clinic

  • Experienced clinicians skilled in musculoskeletal ultrasound.
  • Individualised treatment tailored to your lifestyle and activity goals.
  • Precision-focused care using ultrasound guidance for every injection.
  • Comprehensive approach combining procedural care with broader management advice.

Surgical Considerations

In some situations, if conservative management is not sufficient, referral to an orthopaedic specialist may be considered to discuss surgical options such as joint replacement. This is usually reserved for more advanced cases.

Outlook

While shoulder osteoarthritis is a long-term condition, many people find that a combination of lifestyle changes, targeted physiotherapy, and medical interventions can help them maintain mobility and continue daily activities with greater ease.

Conclusion

Shoulder osteoarthritis can affect everyday life, from reaching for a shelf to getting dressed. At Alton Pain Clinic, our aim is to work with you to find a management strategy that suits your needs, including ultrasound guided cortisone injections to help address inflammation and support function. By combining precision treatment with personalised advice, we can help you continue moving comfortably.

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