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Understanding Shoulder Stiffness: Osteoarthritis of the Shoulder

Understanding Shoulder Stiffness: Osteoarthritis of the shoulder

In a previous article, we discussed the shoulder condition of adhesive capsulitis, commonly referred to as frozen shoulder, which presents with shoulder pain and stiffness. Today, we will discuss another shoulder condition that also presents with shoulder pain and stiffness: osteoarthritis of the shoulder.

What is shoulder osteoarthritis?

Osteoarthritis (OA) of the shoulder is one of the more common forms of osteoarthritis to affect the body, after knee osteoarthritis and hip osteoarthritis. Osteoarthritis is a joint condition that involves the breakdown of articular cartilage. Articular cartilage is the protective tissue that cushions the ends of bones within joints, allowing bones to glide together smoothly. With osteoarthritis, articular cartilage within the joint wears down faster than it is replaced, resulting in the gradual increase of friction and pain with movement. This increase in friction may result in the development of bone spurs and inflammation of the lining of the shoulder joint. Prolonged inflammation of the joint lining can lead to permanent changes within the shoulder, such as narrowing of the joint space and changes to the bones within the shoulder joint. This results in pain, and the gradual loss of shoulder flexibility.

There are many factors that can increase the chances of developing shoulder osteoarthritis, a few of which include:

· Trauma: a history of repetitive heavy lifting with the shoulders, or a fall onto the shoulder.

· Shoulder instability: a shoulder that dislocates repeatedly has an increased chance of developing shoulder OA.

· Previous shoulder surgery: the stress on the shoulder tissues and joints during a shoulder surgery can also be considered a form of trauma, thereby increasing the risk of developing shoulder OA.

Unlike frozen shoulder, which usually recovers after a period of time, shoulder osteoarthritis is a condition that requires long term management. With proper intervention, the symptoms can be well managed to enhance joint function, and improve quality of life.

Signs and symptoms of shoulder osteoarthritis

· Pain: The gradual onset of pain is usually one of the first signs noticed with shoulder osteoarthritis. Pain can be felt in movements such as reaching overhead, or reaching behind your back. In certain cases, the pain can be persistent, and may even disturb your sleep.

· Stiffness and lack of flexibility: Due to the changes of the tissues and bone in the shoulder joint, it is common for the shoulder to feel stiff and difficult to move. Avoiding movement of the shoulder, or excessive rest, will cause the shoulder to further stiffen up, making it harder to move the shoulder.

· Clicking or crackling sounds: Clicks, pops or crackling sounds are referred to as crepitus in medical terms. These can occur due to changes in the joints and bones of the shoulder joint, or stiff tendons and ligaments moving over bony structures in the joint. It’s important to note that although osteoarthritis can cause crepitus, not everyone with joint osteoarthritis will experience it.

What you can do about shoulder osteoarthritis

Shoulder osteoarthritis is a condition that requires long term management. There are a few physiotherapy management strategies that can help with the symptoms of shoulder osteoarthritis.

  • Joint protection and lifestyle modification

An important component of osteoarthritis management is reducing excessive joint strain and stress to protect the joint. Poor posture during activities can causes increased load and strain on the shoulder joint. A physiotherapist will be able guide you on how to maintain good posture, as well as how to modify or adjust your lifestyle or activities to reduce excessive joint strain.

  • Pain management

Pain is one of the key features of shoulder osteoarthritis, and can adversely affect one’s quality of life. Physiotherapy can help reduce pain and discomfort through a variety of techniques, which can include the use of modalities, such as heat or ultrasound, exercise rehabilitation, movement and postural correction, and manual therapy.

  • Manual therapy

Manual therapy works on the joints and soft tissues of the shoulder to reduce stiffness and immobility. The use of gentle hands-on therapy not only helps improve movement and flexibility of the shoulder, but also helps reduce pain and discomfort.

  • Customised exercise and rehabilitation

Exercise rehabilitation plays a pivotal role in the long-term management of shoulder osteoarthritis. Strengthening and flexibility exercises are important in maintaining good shoulder mobility and function. Specific exercises that target the muscles of the shoulder to improve stability and support of the shoulder joint will help with reducing shoulder strain. A physiotherapist will be able to tailor an exercise program to meet your current needs and capability.

Shoulder osteoarthritis is a frustrating condition that can significantly affect one’s use of the shoulder, independence, enjoyment of life, and one that usually requires long-term management. Physiotherapy provides an effective and non-surgical method of management that help

s with reducing the pain and discomfort, as well as improving shoulder function and quality of life. Seeking early help and assessment from a healthcare professional is important in ensuring the best possible outcome.

If you, or someone you know, is experiencing shoulder pain or stiffness, feel free to contact our team of dedicated therapists at or 6581 9688.


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