Understanding Osteoarthritis and Rheumatoid Arthritis in the Shoulder Joint

Understanding Shoulder Arthritis: Osteoarthritis and Rheumatoid Arthritis Affecting the Shoulder Joint

Shoulder injuries can lead to various complications, including arthritis. Two common forms of shoulder arthritis are osteoarthritis and rheumatoid arthritis. In this blog, we will explore the causes, symptoms, and treatment options for these conditions, shedding light on how they affect the shoulder joint.

Osteoarthritis is the most prevalent form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of bones gradually wears down over time, leading to joint pain and stiffness. The shoulder joint is no exception to this degenerative process.

Common causes of shoulder osteoarthritis include ageing, repetitive stress on the joint, previous shoulder injuries, and genetic factors. Over time, the cartilage within the shoulder joint becomes thin, resulting in bone-on-bone contact. This friction causes inflammation, pain, and limited range of motion.

Symptoms of shoulder osteoarthritis include persistent pain, tenderness, stiffness, decreased range of motion, and a clicking or grinding sensation during movement. These symptoms can significantly impact daily activities and quality of life.

While there is no cure for osteoarthritis, several treatment options can help manage symptoms and improve shoulder function. Non-surgical approaches include physical therapy exercises to strengthen the surrounding muscles, pain management techniques like heat or cold therapy, and medications such as nonsteroidal anti-inflammatory drugs (NSAIDs).

In severe cases, when conservative measures no longer provide relief, surgical intervention may be necessary. Procedures like arthroscopy, joint resurfacing, or joint replacement surgery can be considered based on the patient’s condition and the severity of the arthritis.

Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation, primarily affecting the joints. While it commonly affects the smaller joints, such as the hands and feet, it can also impact the shoulder joint.

In RA, the immune system mistakenly attacks the synovium, which is the lining of the joint capsule. This leads to inflammation, thickening of the synovium, and eventual destruction of the joint cartilage. The shoulder joint becomes painful, swollen, and may lose its normal range of motion.

Symptoms of shoulder rheumatoid arthritis include joint pain, swelling, stiffness, fatigue, and general malaise. These symptoms often appear symmetrically, affecting both shoulders simultaneously.

Early diagnosis and treatment are crucial in managing rheumatoid arthritis. Medications such as disease-modifying antirheumatic drugs (DMARDs) and biologic agents are commonly prescribed to slow the progression of the disease, reduce inflammation, and alleviate symptoms.

In addition to medications, physical therapy and occupational therapy play a vital role in maintaining joint function and range of motion. Exercises that focus on strengthening the shoulder muscles and maintaining flexibility can be beneficial.

In severe cases, surgical options like synovectomy (removal of the inflamed joint lining) or joint replacement surgery may be considered to alleviate pain and restore function.

An exercise to safely recruit your rhomboid muscles courtesy of Royal City Physio (Read the caption)

Understanding how a Physiotherapist can help with shoulder injuries

Shoulder injuries can be debilitating, impacting daily activities and overall quality of life. When it comes to recovering from a shoulder injury, a physiotherapist plays a crucial role in the rehabilitation process. In this blog, we will explore how a physiotherapist can help individuals with shoulder injuries regain strength, mobility, and functionality.

1.) Assessment and Diagnosis:

A physiotherapist specialising in shoulder injuries will begin by conducting a thorough assessment and diagnosis. They will evaluate the individual’s medical history, perform a physical examination, and assess the range of motion, strength, and stability of the injured shoulder. This step is crucial in understanding the nature and extent of the injury, allowing the physiotherapist to tailor a personalised treatment plan.

2.) Pain Management:

Shoulder injuries often come with pain and discomfort. A physiotherapist can employ various techniques to help manage pain effectively. They may use manual therapy techniques such as soft tissue mobilisation, joint mobilisation, or massage to reduce muscle tension and alleviate pain. Additionally, they can educate the individual on pain management strategies, such as applying ice or heat therapy and recommending specific exercises to promote pain relief.

3.) Restoring Range of Motion:

One of the primary goals of physiotherapy for shoulder injuries is to restore the range of motion in the affected shoulder. Physiotherapists will design a comprehensive range of motion exercise programs that focus on stretching and flexibility exercises specific to the shoulder joint. These exercises aim to gradually increase the joint’s mobility, reduce stiffness, and improve overall shoulder function.

4.) Strengthening Exercises:

To regain strength in the shoulder and surrounding muscles, physiotherapists prescribe specific strengthening exercises. These exercises target the muscles that support and stabilise the shoulder joint. Through a progressive and customised exercise program, physiotherapists can help individuals rebuild muscle strength, enhance stability, and prevent further injury. They may incorporate resistance bands, weights, or bodyweight exercises to gradually challenge the muscles and promote optimal recovery.

5.) Proprioception and Balance Training:

Shoulder injuries can disrupt the body’s sense of proprioception (awareness of body position) and balance. Physiotherapists employ specific exercises and techniques to restore proprioception and enhance balance. These exercises focus on improving coordination, control, and stability of the shoulder joint. By retraining the proprioceptive system, individuals can regain confidence in their shoulder’s movements and reduce the risk of re-injury.

6.) Functional Rehabilitation:

Physiotherapists understand the importance of restoring functional abilities for individuals with shoulder injuries. They tailor rehabilitation programs that specifically address the individual’s functional goals, whether it’s reaching overhead, lifting objects, or participating in sports. Through task-specific exercises and functional movements, physiotherapists guide individuals to regain their shoulder’s functionality in real-life situations.

7.) Education and Prevention:

A vital aspect of physiotherapy for shoulder injuries is educating individuals on injury prevention strategies. Physiotherapists provide guidance on proper posture, body mechanics, and techniques to avoid excessive stress on the shoulder joint. They also educate individuals on appropriate warm-up and cool-down exercises, as well as techniques for stretching and strengthening the shoulder muscles. By equipping individuals with knowledge and skills, physiotherapists empower them to take an active role in preventing future shoulder injuries.

Physiotherapy plays a significant role in the recovery process for shoulder injuries. Through assessment, pain management, range of motion exercises, strengthening programs, balance training, functional rehabilitation, and education, physiotherapists provide individuals with comprehensive care to regain strength, mobility, and functionality in their injured shoulder. Collaborating with a physiotherapist can significantly enhance the healing process and improve long-term outcomes.

Shoulder stability and strength courtesy of Royal City Physio (Read the caption)


This appointment is your opportunity to tell us what hurts and discover whether physiotherapy or chiropractic care is a good fit for you! During this session, you will talk with a physiotherapist or chiropractor on a phone call (or online) and create the right care plan specifically for your pain. There is no obligation on this session is to find out whether physiotherapy or chiropractic care can help you getting back to doing the things you love in life.

Frequently Asked Questions

Shoulder arthritis can be triggered by various factors. The primary causes include age-related wear and tear of the joint, known as osteoarthritis. Repetitive stress on the shoulder joint, previous shoulder injuries, and genetic predisposition can also contribute to the development of shoulder arthritis. Additionally, certain inflammatory conditions like rheumatoid arthritis can affect the shoulder joint and lead to arthritis.

If you suspect you may have arthritis in your shoulder, it’s important to consult with a healthcare professional for an accurate diagnosis. Common symptoms of shoulder arthritis include persistent pain in the shoulder joint, tenderness, stiffness, decreased range of motion, and a clicking or grinding sensation during movement. An evaluation by a medical expert, such as a rheumatologist or orthopaedic specialist, may involve physical examinations, imaging tests (such as X-rays or MRI scans), and a review of your medical history.

While shoulder arthritis is often associated with the natural wear and tear of the joint over time (osteoarthritis), it can also be caused or accelerated by shoulder injuries. Traumatic injuries, such as fractures or dislocations of the shoulder joint, can lead to post-traumatic arthritis. Repetitive use or overuse of the shoulder joint, commonly seen in athletes or individuals with physically demanding occupations, can contribute to the development of arthritis. It’s important to seek appropriate medical attention if you have experienced a shoulder injury, as early intervention and management can help minimise the risk of developing arthritis in the future.

About Karen Nichol

Karen Nichol graduated from the University of British Columbia with a Bachelor of Science in Physiotherapy. For over two decades, Karen’s practice has been centered around the rehabilitation of active individuals with a focus on athletes, utilizing manual therapy and sport-specific exercise as her main treatment approach.

Being the primary therapist for many high-level sports teams, Karen has gained a vast knowledge for the distinct demands and movement patterns a sport requires. In clinic, Karen tailors each program to match the needs of both the athlete and their sport to ensure these individuals not only return to sport at a high level but minimize their chance of further injuries. 

Medical Disclaimer:

The information presented in this blog post is for educational purposes and should not be interpreted as medical advice. If you are seeking medical advice, treatment or a diagnosis, consult with a medical professional such as one suggested on this website. The Clinic Accelerator Inc. and the author of this page are not liable for the associated risks of using or acting upon the information contained in this article.

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