Shoulder Osteoarthritis: Understanding It and How to Keep Your Shoulder Moving

The outlook for shoulder arthritis is hopeful and not the bleak diagnosis you may have presumed it to be and there is a good deal you can do that is within your control.  You may have interpreted a diagnosis of arthritis  as the end of the road for your shoulder and that you’ll have to learn to live with the discomfort and degeneration. There is more you can do than you may initially think.

Shoulder osteoarthritis is common and what appears on a scan often bears little relation to how much pain or restriction a person actually has. Symptoms usually fluctuate rather than decline in a straight line. National guidance places movement and structured exercise at the centre of care, long before surgical options come need to be considered.

That is why chiropractic assessment matters. Most of the people I see with an arthritic shoulder are not necessarily destined to an operation. What they are at risk of is having the shoulder stiffen and becoming  more cautious with it. By protecting the joint the surrounding muscles will weaken and the range of movement will shrink. I work out what the shoulder can safely do, address the movement that has been lost and give you the exercises and daily habits that keep it mobile. Keeping the joint moving is prevention as much as it is treatment. Movement is key.

“He has a very sympathetic and understanding approach to his patients.”

“Leslie has been treating to control pain and build muscle strength as I have severe arthritis. His understanding and knowledge of the human body and how it functions is very impressive. He is able to locate sources of pain and treat them quickly and effectively. He has a very sympathetic and understanding approach to his patients. I cannot recommend Leslie too highly.”

David H

What is shoulder osteoarthritis?

 

Osteoarthritis of the shoulder affects the main ball and socket joint, where the head of the arm bone meets the shallow socket of the shoulder blade (the glenohumeral joint). Over years, the smooth cartilage lining thins, the joint space narrows and the bone beneath remodels, sometimes forming small spurs. The result is a shoulder that aches deep in the joint, grinds or clicks and gradually stiffens, particularly when rotating the arm outward. It is a disease of time and load: population studies suggest roughly one in six adults over the age of 65 shows arthritis of this joint on X-ray.[1]

Here is an encouraging fact though: X-ray changes and symptoms are only loosely related. Plenty of people with striking scans have only modest pain and mild scans can accompany troublesome shoulders. You are not always what your X-ray says and management is guided more by how the shoulder behaves.

what causes it

Mostly, accumulated life and time. Cartilage has limited ability to repair itself and decades of reaching, lifting and load gradually tell, which is why shoulder arthritis typically presents from the age of sixty onward. Some shoulders get there sooner: a fracture or dislocation years earlier, previous shoulder surgery, a long-standing large rotator cuff tear that changes how the joint loads, inflammatory arthritis such as rheumatoid disease or simply the genetics and family medical history. Heavy manual work and certain sports add to this.

What does not cause it is staying active. Sensible use of a joint does not wear it out and the fear of “wearing it down further” leads people to rest an arthritic shoulder into deeper stiffness, which is precisely the wrong direction. An arthritic joint dislikes two things: being pushed violently and avoiding use.

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Symptoms of shoulder osteoarthritis

 

The signature symptom is a deep ache in the shoulder joint itself, often felt at the back of the shoulder, with stiffness that makes rotating the arm outward, reaching behind your back or combing your hair progressively harder. Grinding, catching or clicking with movement is common and a bad spell of pain often follows a busy week of using your arm. Night aching happens, though it is usually less painful than the night pain of a rotator cuff problem.

Telling it apart from its neighbours is key, because the shoulder has several ways of hurting. A frozen shoulder stiffens faster, over months rather than years and usually in someone in their forties or fifties. Rotator cuff pain aches over the outer arm and catches on the way up rather than grinding deep in the joint. Pain at the very top of the shoulder points to the AC joint and pain with pins and needles down the arm suggests the neck. Where the pain is located and how the stiffness arrived usually leads to an accurate diagnosis.

shoulder osteoarthritis and the pain area on the shoulder that is affected by the condition

The area of the shoulder most commonly affected by shoulder osteoarthritis

how chiropractic may help

My part as a chiropractor is practical. Gentle hands-on care can ease the muscle guarding and stiffness that gather around an arthritic joint and mobilisation helps maintain the movement the joint still has, particularly that stubborn outward rotation. Around it I build a simple strengthening programme, with the rotator cuff and shoulder blade muscles doing the protective work the guidelines describe,[1][2] and we adjust how you load the shoulder in daily use so flares become rarer and shorter. Progress in arthritis is measured in what you regain: the overhead cupboard, the backstroke, the garden tools. Care is paced to your shoulder’s response, flares are managed rather than feared and if your pain and function deteriorate despite good conservative care, I will say so and support the surgical conversation with your GP.

Medical evidence is positive. Remembering that nothing reverses the cartilage change. But that is not the fact that matters. The question is whether a person with an arthritic shoulder can hurt less and do more. Reviews of conservative care for shoulder arthritis support active, non-surgical management as the first line.[3][4] Current physical therapy guidelines describe multimodal programmes, movement, targeted strengthening and education, improving pain, function and quality of life with gains reported out to three years in long-term follow-up and suggest a proper twelve months of conservative care before decisions about joint replacement are made.[2] Most arthritic shoulders never need an operation and for the minority that eventually do, arriving stronger and more mobile is an advantage.

Headshot of Leslie Budzynski DC, BCA registered Bournemouth Chiropractor at Bournemouth Chiropractic

If arthritis in your shoulder is getting in the way of things you would rather be doing, come and talk it through. I offer a free 15-minute consultation, you can come in for a short no-obligation chat with no examination or treatment.

Book a free consultation

Or call for a chat on 01202 937568

red flags

Shoulder arthritis itself develops slowly and is not dangerous. A few situations alongside a stiff, aching shoulder need a doctor first. See your GP promptly if the shoulder becomes hot, swollen and acutely painful, especially with fever, a joint that flares like that needs infection and crystal arthritis ruled out; if pain is constant, unrelated to movement or waking you every night despite sensible management; if you have a history of cancer with new, unexplained shoulder pain; or if the arm is rapidly losing strength. A shoulder that suddenly cannot lift after a fall needs assessment for a fracture or tendon tear rather than an arthritis label. And pain spreading into the chest with breathlessness or sweating call 999.

your first visit to Bournemouth Chiropractic 

 

Your first appointment starts with the complete story of your pain and discomfort: how long you’ve had it, what has changed, what the shoulder is stopping you doing and your wider health. The examination will show me which movements are stiff and which are painful, distinguishes the deep grind of the joint from cuff, AC joint and referred neck pain and checks the strength you already have which you can build on. If you bring X-ray or scan reports, we will go through them. You leave with an informed picture and an agreed plan. There is more on the your first chiropractic visit page and lots of questions answered on my FAQ page.

Frequently Asked Questions

I cannot reverse arthritis and no practitioner can. What conservative care may do for shoulder arthritis, per current guidelines, is ease pain, maintain movement and improve function with active multimodal programmes showing benefits lasting years in follow-up studies.[2][3] My role is keeping your shoulder usable and knowing exactly when a surgical opinion may be called for.

Most people with shoulder arthritis do not end up needing surgery. Guidelines suggest a full twelve months of good conservative care before replacement is even decided upon and many shoulders settle into a manageable pattern long before that question arises.[2] Replacement remains an effective option for the small minority whose pain and function keep deteriorating despite efforts.

Exercise is safe and it is part of the treatment. Appropriate movement and strengthening are first-line care in every current guideline, protecting the joint by keeping the muscles around it doing their share.[1][2] Resting an arthritic shoulder stiffens it. The skill is how much exercise, which is exactly what we work out together.

X-ray severity and symptoms of arthritis correlate surprisingly loosely: dramatic images can sit alongside modest pain. Management follows your pain, movement and function. An X-ray is one piece of information and is not definitive.

A corticosteroid injection for shoulder arthritis, arranged through your GP, can calm a stubborn flare though relief is typically temporary and repeated injections carry their own concerns for the joint’s soft tissues.[1] They are a tool for the difficult moment, not a long-term plan. The long-term plan is movement, strength and sensible pacing.

Whatever may be behind your shoulder arthritis, come and find out

Shoulder arthritis can develop gradually and the stiffness or ache that comes with it is often what brings people in to see me for a proper chiropractic assessment. If it's affecting your movement or your day-to-day habits and activities, I'd happily see you to find out what's going on in your shoulder. During your consultation I'll give you an honest opinion on what's happening and how it's best managed.

Shoulder arthritis is often a reason people come to see me from Bournemouth and nearby Westbourne.

For some people, chiropractic care alongside the wider management of shoulder arthritis is a well-tolerated option worth exploring and I'll explain clearly what I think may help in your particular case, focusing on keeping the joint moving well. If I think you'd be better served by your GP, a specialist or another practitioner, I'll help point you in the right direction.

Call or message me, whatever's easiest and we'll take it from there.

References

[1] Harada Y, Yokoya S, Sumimoto Y, Adachi N. Non-operative management of shoulder osteoarthritis: current concepts. J ISAKOS. 2023;8(5):289-295. https://doi.org/10.1016/j.jisako.2023.06.002

[2] Brindisino F, et al. Physical therapist management of glenohumeral joint osteoarthritis: a clinical practice guideline from the American Physical Therapy Association. Phys Ther. 2023;103(6):pzad041. https://doi.org/10.1093/ptj/pzad041

[3] The role of conservative treatment of glenohumeral joint osteoarthritis: a systematic review. Semin Arthroplasty JSES. 2023. https://doi.org/10.1053/j.sart.2023.07.012

[4] Armstrong A. Evaluation and management of adult shoulder pain: a focus on rotator cuff disorders, acromioclavicular joint arthritis, and glenohumeral arthritis. Med Clin North Am. 2014;98(4):755-775. https://doi.org/10.1016/j.mcna.2014.03.004

Medical Disclaimer: The information on this website is for general informational purposes only and does not constitute medical advice, nor is it a substitute for diagnosis, treatment, or guidance from a qualified healthcare practitioner. If you have any health concern, please consult your GP or another appropriately qualified clinician. Chiropractic treatment isn’t suitable for everyone. Suitability is assessed at your initial consultation, with referral to another healthcare professional made where appropriate. Treatment outcomes vary between individuals, and no guarantee of results is made or implied.

Practitioner: Leslie Budzynski D.C. | Doctor of Chiropractic | GCC registration: 00043 | BCA membership number: 0072

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