Arthrosis of the shoulder joint

arthrosis of the shoulder joint

Arthrosis of the shoulder joint is a dystrophic lesion of the cartilaginous plate covering the articular surfaces of the joint, with subsequent involvement of the underlying bone.

About the disease

With this disease, not only the cartilaginous layer and subchondral bone are affected. The pathological process gradually also involves the articular capsule and ligamentous apparatus, synovium, musculotendinous compartment, as well as the subacromial region.

Arthrosis of the shoulder joint at a certain stage can lead to the development of osteoarthritis. This condition is characterized by the following symptoms: chronic pain, decreased range of motion in the joint, intra-articular crunch during rotation. Most often, people over 40 years of age are subject to this transformation.

The main symptoms of arthrosis of the shoulder joint are pain and limited mobility of the arm. To verify the diagnosis, imaging examination methods are informative - ultrasound and X-ray scanning, computed tomography and magnetic resonance imaging.

In accordance with clinical recommendations, treatment of the disease in the initial stages is carried out using conservative methods, and in the later stages, when there is significant damage to the cartilage layer and the patient’s self-care is impaired, joint replacement is indicated.

Types of arthrosis of the shoulder joint

According to the classification, the following types of arthrosis of the shoulder joint are distinguished:

  • primary arthrosis, in the development of which genetics play a large role, and even the most thorough examination does not allow us to identify the most significant cause of the disease;
  • secondary arthrosis, which is a consequence of the action of unfavorable factors on the joint (trauma, endocrine diseases, impaired joint anatomy).

Doctors judge the rate of progression of the pathological process by the degree of the disease. The more aggressive the process, the faster the destruction of articular cartilage and involvement of the underlying bone occurs. From a morphological point of view, there are 6 degrees of arthrosis of the shoulder joint:

  • first degree - the cartilage matrix becomes swollen and disintegrated, but the integrity of the superficial zone of the cartilage is not yet compromised;
  • second degree – the cells of cartilage tissue located in the deep layers are affected, the surface plate of the cartilage is damaged;
  • third degree - vertical cracks appear on the cartilage plate;
  • fourth degree - the superficial zone of the cartilaginous plate gradually exfoliates, erosive defects are formed, and cystic cavities appear in the underlying bone;
  • fifth degree - at this stage the underlying bone is exposed;
  • sixth degree - the subchondral zone thickens significantly, the cysts become more pronounced, and marginal bone growths appear.

Symptoms of arthrosis of the shoulder joint

The main clinical signs of shoulder arthrosis are pain, stiffness in the joint to the point of complete loss of mobility, as well as deformation of the joint.

Distinctive features of pain with deforming arthrosis are:

  • appearance at the beginning of flexion, extension or rotation;
  • increased during physical activity;
  • nocturnal character due to stagnation of venous blood in intraosseous canals;
  • the presence of blockades - sudden jamming in the joint due to separation of separated osteochondral fragments getting between the articular surfaces;
  • weather dependence - pain intensifies when the weather changes (in humid and cold climates, pain becomes more intense).

Arthrosis is a chronic pathology. At the initial stage of the disease, pain appears periodically (at the time of exacerbation of the disease). The rate of progression of the pathology is determined by the timeliness of the start of treatment and the adequacy of lifestyle modification. Shoulder pain becomes chronic if it persists for 6 months or more. The change from acute to chronic pain indicates the progression of the pathological process.

Causes of arthrosis of the shoulder joint

The causes of arthrosis of the shoulder joint are classified into 2 groups:

  1. modifiable – correction is possible;
  2. non-modifiable - it is not possible to influence their action.

Non-modifiable factors that may increase the risk of developing arthrosis changes in the shoulder joint include:

  • gender - up to the age of 50, women are less susceptible to the disease than men; after approximately 50 years, the prevalence of pathology among representatives of both sexes becomes approximately the same;
  • the age of the person - the older the patient, the higher the risks (and from about 30 years of age in cartilage tissue, the degeneration process proceeds faster than the regeneration process, which creates the preconditions for the development of the disease);
  • congenital abnormalities of the structure of the shoulder - excessively increased mobility (hypermobility), connective tissue dysplasia (normally, articular cartilage is represented by type 2 collagen fibers, with dysplasia, replacement with less durable types of collagen occurs), instability of the articulation;
  • genetic features - hereditarily determined predominance of type 2 collagen, polymorphism of the interleukin-1 and interleukin-2 genes.

Modifiable risk factors for deforming arthrosis of the right or left shoulder joint are:

  • traumatic joint damage;
  • excessive physical activity (strength sports and martial arts, including barbell bench press);
  • obesity – for shoulder arthrosis, the important factor is not the increase in mechanical load, but the metabolic changes that occur in the connective tissue, incl. a state of chronic inflammation accompanying obesity;
  • weakness of the muscle corset of the shoulder joint, especially in those people who perform precise activities with their hands (jewelers, dentists, secretaries, writers);
  • deficiency of vitamin D, which is actively involved in maintaining the health of the musculoskeletal system;
  • a diet low in vitamin C, which is an important link in the body’s calcium-phosphorus metabolism;
  • hormonal imbalance – thyroid disease, diabetes, etc. ;
  • smoking – both active and passive.

In shoulder arthrosis, the main targets of the pathological process are articular cartilage, subchondral bone and synovium. In the affected cartilage, the synthesis of proteoglycans decreases, fragmentation and cracking of the plate is observed, exposing the underlying bone. Increasing non-physiological load on the bone leads to its compaction, the appearance of cysts and osteophytes (marginal growths).


The examination of a patient with pain in the shoulder joint should begin with x-rays. It is important to scan in several projections to examine the joint in detail. Images can be taken in direct projection, in the position of internal and external rotation. To assess the soft tissue formations of the joint, especially at the early stage of arthrosis, ultrasound scanning of the joint is most informative. If the diagnosis remains unclear, magnetic resonance imaging/computed tomography of the joint is recommended. At the next stage, the preservation of the functions of the articulation is assessed.

Expert opinion

All morphological formations of the joint are involved in the pathological process. The main symptom of osteoarthritis is pain in the joint area, caused not only by synovitis, but also by bone damage (osteitis, periostitis), involvement of the periarticular soft tissues (tendinitis, tenosynovitis, myalgia, enthesopathies, stretching of the joint capsule), degeneration of the menisci and involvement of the neurosensory system (for example, irritation of nerve trunks by large osteophytes). Therefore, the sooner treatment begins, incl. modification of lifestyle, the more effective control over the occurrence of pain will be.


At the initial stage of the pathological process, treatment of arthrosis of the shoulder joint is carried out using conservative methods, and with severe degeneration of the articular cartilage, surgical intervention (endoprosthetics) is indicated.

Conservative treatment

During the period of exacerbation of the process, the first priority is pain relief. Non-steroidal anti-inflammatory drugs are most often used for pain relief. They can be applied topically (in the form of creams and ointments), injected into the joint cavity, or used systemically (tablets, intramuscular injections). In some patients, the pain may be so severe that a short course of corticosteroid medications may be used to relieve it.

Intra-articular injection of hyaluronic acid or plasma, incl. enriched with platelets, can have a stimulating effect on the cartilage plate and promote its renewal (this treatment is considered pathogenetic). These injections help accelerate the synthesis of collagen and elastin fibers that form the basis of cartilage. As a result, the structure of the cartilage layer and synovial membrane improves, which helps to increase the congruence of the articular surfaces. These intra-articular injections help optimize the production of synovial fluid, which not only absorbs shock and moisturizes cartilage, but also improves metabolic processes in chondrocytes, increasing their internal potential.

After the acute process has subsided, physiotherapeutic rehabilitation methods (pulsed currents, ultrasound and laser treatment) can be used as part of complex treatment. These procedures have a complex positive effect on joint structures.


The operation is indicated for significant destruction of the cartilage plate, which is accompanied by persistent pain and dysfunction of the joint, leading to the inability to self-care and perform professional tasks. A modern method of surgical intervention for shoulder arthrosis is the implantation of an endoprosthesis. At SM-Clinic, the operation is carried out in accordance with strict adherence to the methodology using the latest generation endoprostheses. This is the key to achieving the best therapeutic results.

Prevention of arthrosis of the shoulder joint

Primary prevention of arthrosis of the shoulder joint is aimed at maintaining optimal metabolism in the osteochondral compartment. For this it is recommended:

  • maintain normal body weight;
  • adequately compensate for endocrine disorders in the body (consultation and dynamic monitoring by an endocrinologist is required);
  • dosed strengthen the muscle corset of the shoulder girdle;
  • Warm up regularly if your professional activity involves performing similar movements in the shoulder.

To prevent the progression of developed shoulder arthrosis, the following recommendations are important:

  • avoid lifting heavy objects, incl. barbell push-ups;
  • conduct repeated courses of therapeutic massage;
  • regularly engage in health-improving gymnastics (under the supervision of a physical therapy specialist).


After endoprosthetics, a plaster cast is applied, which provides the necessary degree of immobilization. After the cast is removed, the period of restoration of the functional activity of the joint begins. For this, courses of therapeutic massage, physiotherapy and health-improving gymnastics under the supervision of a physical therapy specialist are recommended.

Questions and answers

Which doctor treats arthrosis of the shoulder joint?

The diagnosis and treatment of the disease is carried out by a traumatologist-orthopedist.

Representatives of which professions most often develop arthrosis of the shoulder joint?

Athletes involved in volleyball, tennis, basketball, projectile throwers, and loaders are at greatest risk of degenerative-dystrophic destruction of the cartilage layer of the shoulder joint.

Does shoulder pain indicate the development of arthrosis?

Indeed, pain is the leading sign of arthrosis. However, pain can also be a manifestation of other diseases - adhesive capsulitis, osteoarthritis, damage to the rotator cuff muscles, etc. A qualified orthopedic traumatologist will help you establish the correct diagnosis and select treatment.