How Can the Shoulder Joint Become Damaged?
In order for the shoulder joint to move smoothly and free from pain, the covering of cartilage on the head of the humerus and the glenoid cavity must be intact. Various factors can cause the protective layer of cartilage to become worn or damaged, this is referred to as shoulder arthrosis (omarthritis):
In a healthy shoulder joint, the joint cartilage forms a smooth surface, which protects the joint surfaces against friction. In the case of shoulder arthrosis, however, the joint cartilage initially loses its elasticity although the sufferer is unaware of this. The surface of the cartilage becomes rough in the areas subject to the greatest loads and, over time, is completely worn away. The bony surfaces of the joint now rub against each other which can ultimately lead to deformation of the humeral head and glenoid cavity.
If the joint surfaces rub against each other without the protective layer of cartilage, the person affected experiences pain. At first, the patient only experiences pain when the joint is under stress, but, over time, increasingly also when at rest, above all at night. Patients often complain of sensitivity to cold and scraping and rubbing inside the shoulder. The shoulder joint also increasingly loses mobility, ultimately becoming completely stiff. As a result of this, patients adopt a protective posture, which in turn causes muscle tension and pain in other regions of the body, such as the neck or back. As the shoulder joint plays a key role – particularly in everyday activities like lifting and carrying – patients become increasingly restricted in their day-to-day lives and their quality of life can suffer. Even putting on and taking off a jacket, pouring a drink or cleaning your teeth can become a problem.
Depending on the nature of the pain experienced, the attending doctor may explore conservative methods for reducing the pain. These include pain relief and anti-inflammatory medications, physiotherapy, baths and packs. Injections into the shoulder joint can also provide relief. These can help to reduce pain and improve mobility in the joint. Shoulder arthroscopy with irrigation of the joint cavity can also be performed.
However, there are currently no guaranteed methods for healing arthrosis permanently. If all conservative methods have been exhausted, joint-replacement surgery should be performed.