When the shoulder joint wears out

When shoulder pain persists, the quality of life is massively limited. Not only does the pain burden the patients, but the resulting restriction of freedom of movement also reduces their well-being. Omarthrosis is often the cause of this problem. What exactly this is, how it can be treated and what needs to be taken into account in the treatment, you will learn in the further course of this article.

What is omarthrosis?

The term omarthrosis refers to the circumstance when arthrosis occurs in the shoulder (omos = Greek for shoulder). In the case of arthrosis, the joint shows wear and tear due to permanent stress, which manifests itself in the later stages in the form of pain in the affected joint. In principle, arthrosis can occur in all real joints. The knee joint (gonarthrosis) and hip joint (coxarthrosis) are affected much more frequently than the shoulder joint. The reason for this is that, unlike the other two joints mentioned, the shoulder joint does not have to bear the weight of the body parts above it.

Different causes for omarthrosis

Arthrosis can have a wide variety of causes. First of all, degenerative processes are physiological events that occur sooner or later in everyone. Through the use of the joint over the years, it loses its suppleness. This leads to remodelling processes in the joint which cause the individual parts of the joint to rub against each other and cause pain. In addition to the physiological forms, there are also omarthroses that occur as a result of injuries to the shoulder joint or in the context of rheumatoid arthritis. Unlike arthritis, however, osteoarthritis is not an inflammatory process. Anatomically caused instability of the shoulder joint can also lead to arthrosis.

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The leading symptoms of omarthrosis

The leading symptom of osteoarthritis is severe, stabbing pain in the shoulder that increases with weight-bearing and movement of the joint. However, this pain can also occur at night and at rest. A warning signal is when sufferers can no longer sleep on the painful side. Because of the severe pain, a protective posture is usually adopted for the joint. This leads to the muscles involved in the shoulder joint being used less and therefore atrophying, i.e. losing mass. In addition, in the advanced stages, there are audible noises caused by the structures in the shoulder rubbing against each other. Since osteoarthritis is not an inflammatory process, as described above, there is no redness or swelling of the joint. These are symptoms that are more likely to occur with arthritis.

The symptoms at a glance:

  • Increasing pain in the shoulder with exertion
  • Gentle posture of the shoulder joint
  • Muscular atrophy in the area of the shoulder joint
  • Friction noises in the shoulder joint
  • Night pain in the shoulder joint
  • Restricted movement of the shoulder joint

How can omarthrosis be diagnosed?

In order to ensure optimal treatment of osteoarthritis in the shoulder, the appropriate diagnosis must first be made. With the help of a physical examination and an imaging procedure, the diagnosis of osteoarthritis can be made beyond doubt if it is actually present. X-rays are usually used as an imaging procedure, as they can be used to assess the typical signs of arthrosis in the shoulder.

How can omarthrosis be treated?

Arthrosis in the shoulder joint can be treated in many ways. In order to stimulate the blood circulation and thus the metabolism in the affected joint, pulsed magnetic field therapy is very suitable. Pulsating magnetic field therapy. It has a very strong anti-inflammatory and decongestant effect and leads to a reduction of the inflammatory reaction associated with wear in the joint.

Acupuncture can also be used as a supportive pain therapy in the magnetic field. Its effect is positively enhanced by the magnetic field.

An essential component is also the treatment of osteoarthritis with medication. On the one hand, these are intended to relieve the pain and, on the other hand, to weaken an incipient inflammation. Even if arthrosis is not primarily an inflammatory disease, it can develop into arthritis. The drugs can be administered orally and applied superficially.

However, the most effective method of treatment is to inject the appropriate agents directly into the affected joint. In this way, the active substances reach their intended location directly. Cortisone and hyaluronic acid injections can usually be used. Especially intra-articular (into the joint) hyaluronic acid injections promise good treatment success for many forms of osteoarthritis. The hyaluronic acid is injected into the joint with a small needle.

Hyaluronic acid injections for the treatment of osteoarthritis

Hyaluronic acid is a natural component of the fluid that is in the joint space anyway (synovia). Under normal conditions, this acts as a kind of lubricant that allows the joint bones to interact smoothly with each other. Intra-articular hyaluronic acid injections therefore help the body to regain this natural function. Hyaluronic acid injections can significantly slow down the progression of the disease in its early stages. But even in advanced arthrosis, hyaluronic acid is a therapy that alleviates the patient's symptoms for a limited period of time, strengthening the remaining cartilage and restoring quality of life. However, destroyed cartilage cannot be restored by hyaluronic acid.

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Other treatment options for omarthrosis:

If the painful, highly acute phase of osteoarthritis is improved and alleviated by the treatment options described, physiotherapy can be carried out as a supportive measure. Here, the focus is not only on the shoulder joint itself, but also on the surrounding structures (e.g. the rotator cuff), as these can themselves be the cause of the existence of arthrosis in the shoulder joint in the case of dysfunctions.

As a last resort, it is still possible to replace the joint head of the upper arm bone (humerus) with a prosthesis.

Treatment methods summarised:

  • Drug treatment (painkillers / anti-inflammatory drugs)
  • Intra-articular injection treatment using corticosteroids or hyaluronic acid injections
  • Pulsating magnetic field therapy in combination with acupuncture
  • Physiotherapy
  • Surgical prosthesis insertion (total endoprosthesis)
Opportunities & Risks

What are the chances and risks of treatment with hyaluronic acid?

As already described above, hyaluronic acid is a substance that is produced by the body itself. Through an injection, the body is not supplied with a foreign substance that it has to break down in the liver and thus uses up important energy. Instead, you help the body by supplying it with hyaluronic acid so that it does not have to produce it itself.

In addition to its function as a lubricant, hyaluronic acid also has the advantages that it has an anti-inflammatory effect and helps the cartilage to regenerate. Degeneration of the articular cartilage is one of the central problems underlying osteoarthritis.

As hyaluronic acid is a product that is produced naturally in the body, allergic reactions rarely occur during treatment. However, these cannot be ruled out in principle. Injuries can also occur when the needle is inserted into the joint. However, on the one hand, these are rare, as this is a routine procedure, and on the other hand, they are not serious if they do occur.

Maximum hygiene is ensured during application. However, the penetration of germs into the joint and a resulting inflammation cannot always be prevented.

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Hyaluronic acid injections for symptom relief

Hyaluronic acid injection is a symptom-oriented form of treatment. It therefore does not fundamentally combat the causes of osteoarthritis, but only alleviates its symptoms. Furthermore, its effectiveness decreases with increasing damage to the joint cartilage. However, it is an excellent treatment for initial to moderate forms of osteoarthritis and promises significant symptom relief for a period of up to several months. In some cases, the effect even lasts for up to a year.

Preparation & Follow-up

What should be considered before and after the treatment of omarthrosis?

In order to be well prepared for the intra-articular hyaluronic acid injection, it is advisable to know a few things in advance. It is not enough to perform this type of treatment only once. Instead, several injections must be introduced into the affected joint to achieve the desired effect.

The interval between injections and the number of injections depend on the severity of the arthritis in the shoulder. In general, it can be said that the treatment takes place about weekly and three to five injections are administered each time.

Unfortunately, the costs for the treatment are not covered by the statutory health insurance. The prices for a hyaluronic acid injection vary and can therefore not be precisely quantified. Depending on the preparation, the total costs amount to about 400€.

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