Shoulder arthritis
in Rockhampton

About the condition

What is shoulder arthritis

Shoulder arthritis is the loss of the smooth cartilage that lines the joint, so that bone moves against bone. Most often it affects the main ball-and-socket (glenohumeral) joint, but it can also affect the smaller AC joint at the top of the shoulder. The result is a deep, aching pain on movement, grinding or catching, stiffness, difficulty sleeping on the affected side, and a slow loss of reach — particularly overhead and behind the back.

Arthritis is generally progressive and worn cartilage does not grow back, but the rate varies widely and symptoms often respond to non-operative treatment for a long time. The aim of the consult is to confirm the diagnosis on examination and X-ray, work out which sub-type is present and whether the rotator cuff is involved, and set out a pathway that runs from physiotherapy and injection through to shoulder replacement when — and only when — symptoms justify it. The shoulder arthritis education page covers the underlying condition in more detail.

When to see a specialist

The threshold for referral

Shoulder arthritis is usually managed first by the GP and physiotherapist. A specialist opinion is worth seeking when:

• Pain disturbs your sleep or wakes you on the affected side.
• Everyday tasks — dressing, reaching a shelf, the seatbelt — are limited.
• Stiffness and loss of reach are progressing.
• An X-ray has confirmed established arthritis of the shoulder.
• Physiotherapy, analgesia and injection are no longer giving acceptable relief.
• There is weakness and loss of overhead function, suggesting the cuff is also involved.

A GP referral is needed for a Medicare rebate, and seeing a specialist does not commit you to surgery — much of the value is confirming the diagnosis and mapping the non-operative and operative options. Where the arthritis follows an old injury, the shoulder injury page covers the post-trauma pathway.

Frequently asked

Patient questions we hear most

• Can shoulder arthritis be treated without surgery?

  Yes — most shoulder arthritis is managed without surgery for a long time, and surgery is never the first step. Activity modification, analgesia, a structured physiotherapy program to maintain range and strengthen the muscles around the joint, and an occasional corticosteroid injection all help. These measures don't regrow worn cartilage, but they control symptoms and preserve function. Replacement is reserved for established arthritis where pain dominates daily life and non-operative measures are no longer enough.

• How is shoulder arthritis diagnosed?

  A plain X-ray of the shoulder is the key test — it shows loss of joint space, bony spurs and, in cuff-tear arthropathy, upward migration of the humeral head. History and examination establish how much the arthritis is affecting function and the state of the rotator cuff. A CT or MRI is added when replacement is being planned, to assess the glenoid bone stock and the cuff, which together determine whether an anatomic or reverse replacement is appropriate.

• What's the difference between shoulder arthritis and a rotator cuff problem?

  Arthritis is wear of the joint surfaces (cartilage and bone); rotator cuff problems involve the tendons that move and stabilise the shoulder. They produce overlapping symptoms — pain, weakness, night pain — and frequently co-exist, because a long-standing cuff tear can lead to a particular kind of arthritis (cuff-tear arthropathy). Sorting out which is driving the symptoms, and whether both are present, is what determines treatment, and is established at the consult with examination and imaging.

• Does shoulder arthritis always get worse?

  Arthritis is generally progressive, but the rate varies enormously between people and is hard to predict — some have stable symptoms for years. Worn cartilage does not regrow, so the changes seen on X-ray don't reverse, but pain and function fluctuate and often respond well to non-operative treatment for a long period. The aim is to keep the shoulder comfortable and functional, and to consider replacement only when symptoms — not the X-ray alone — justify it.

• When should I see a specialist about shoulder arthritis?

  Reasonable triggers are: pain that disturbs sleep or wakes you on that side, pain that limits everyday tasks like dressing or reaching a shelf, stiffness that is progressing, or arthritis confirmed on an X-ray that your GP and physiotherapist have been managing without enough relief. A GP referral is needed for a Medicare rebate. Seeing a specialist does not commit you to surgery — much of the value is confirming the diagnosis and mapping out the non-operative and operative options.

• Is shoulder replacement the only surgical option for shoulder arthritis?

  For established arthritis of the main (glenohumeral) joint, replacement — anatomic or reverse — is the reliable surgical option, because the worn surfaces need resurfacing. Arthroscopic 'tidy-up' procedures have a limited role and a short-lived benefit in true arthritis. Arthritis of the smaller AC joint is different and is treated with arthroscopic distal clavicle excision rather than replacement. The right operation depends on which joint is affected and the state of the rotator cuff.