Shoulder arthrosis

Finally free of pain thanks to customised treatments

Putting on a jacket, washing your hair, reaching up to a high shelf... when every arm movement causes a flash of pain through your body, everyday life becomes torturous. Wear and tear in the shoulder (arthrosis) are at fault.

There are a number of ways to effectively treat arthrosis in your shoulder. Our arthrosis specialists at Schoen Clinic have several years of experience and highly customised treatment concepts. We will get the pain under control with the help of medication, conservative measures, such as psychotherapists and, if necessary, by means of surgery.

Causes & symptoms

Shoulder arthrosis: What is damaged?

Your shoulder joint consists of two bones that are covered in cartilage tissue and is lubricated and protected by joint fluid. If the cartilage tissue is damaged or worn due to overuse, the two bones in the joint will rub together and the surrounding tissue will become inflamed. This causes pain in the shoulder and restricts mobility. A bit more cartilage and, later, bone tissue is abraded with every movement. The joint becomes more and more deformed.

Causes: How shoulder arthrosis occurs

Arthrosis is the medical term for chronic and slowly progressing wear and tear on a joint. Experts differentiate between primary and secondary arthrosis.

Primary is the most frequent. The cause of this form of shoulder arthrosis is damage to the joint cartilage. This causes cartilage-building and degrading processes to get out of balance which results in a loss of the protective cartilage layer. As a result, the wear and tear expands to the bone, the joint capsule and the surrounding tendons. This causes pain to develop. If left untreated, arthrosis results in bone deformation in the joint and, as a result, limitations to mechanical mobility. Usually, predisposition and/or overuse are responsible for arthrosis. In these cases arthrosis in shoulder often occur without a detectable cause.

The secondary form of arthrosis is not necessarily related to age. Most frequently, damage to the tendons (tears in the rotator cuff) or past accidents with broken bones in the shoulder are responsible.

Other forms of secondary arthrosis develop if there is a chronic instability in the shoulder joint due to recurring or constant dislocations. Chronic inflammatory diseases, for instance, rheumatism, can cause characteristic forms of arthrosis. In rarer forms, arthrosis is caused by a circulation problem in the humeral head (humeral head necrosis). This can also develop after accidents or due to taking certain medications, for instance, chemotherapy drugs.

Symptoms indicating shoulder arthrosis

Pain in shoulder and limited mobility in everyday life; these are the symptoms with which patients come to us at the Schoen Clinic. There is often no concrete trigger for the sudden and extreme pain. Sometimes, normal or slightly increased everyday strain reveal arthrosis. If arthrosis progresses, the pain will even occur when resting, in particular, at night. Constant pain cycles are typical for arthrosis.

Our patients often complain of rubbing or grinding when they stretch their arms out to the front or raise them above their head. They are often unable to fully rotate their shoulders outwards or behind their body. Depending on the stage and progression of arthrosis, limitations in general mobility and a loss of strength in the shoulder develop over time. All of this often affects the back and neck muscles.

Diagnostics

An examination with the specialists as the most important guidepost

To be able to start the right treatment for arthrosis in the shoulder, we first perform a comprehensive clinical exam of your shoulder joint. The shoulder joint and its tendons and muscles are examined to identify the major functional weaknesses.

X-rays are necessary to confirm the diagnosis. The x-ray provides information about the distance between the two joint bones: The more cartilage has already been lost due to friction in the joint, the smaller this spacing is. If there is chronic damage to the rotator cuff, the humeral head under the shoulder socket will be higher on the x-ray. This all confirms the suspicion of arthrosis in the shoulder.

By using ultrasound exams and magnetic resonance imaging (MRI), our specialists can also precisely determine the extent of the defects in the tendon cuff and secondary inflammatory reactions.

To plan a shoulder joint prosthesis, we also perform a computer tomography (CT) if there are larger bone defects and major changes in the original joint geometry. The CT allows our experts, with the help of special computer programs, to create a 3D simulation of your joint and the surgery to be performed. If necessary, in complex cases, individual, patient-specific implants (PSI) and target devices will be created.