Management of Shoulder OA
Cards (5)
- Shoulder OA - Education:
- provide a careful explanation to reassure the pt that no serious disease or injury has been found and they'll regain function in that shoulder
- pain relief/advice - heat, ice, NSAIDs, taping
- ROM - loss of abduction and external rotation ROM is common
- strengthening exercises to prevent loss of strength
- dynamic stabilisation drills
- neuromuscular training
- proprioception drills
- scapular muscle strengthening
- graded return to desired activities
- Shoulder OA - Treatment pt1:
- manual therapy - high grade mobilisations (grade 3 & 4) of the glenohumeral joint may be effective in increasing range and decreasing pain
- pain control medication: analgesics can be used to decrease pain
- lifestyle modifications: modifications to activities to avoid exacerbating the condition, consider relative rest and alternative activities that are not as irritable for the shoulder
- corticosteroid injection: may be used in conjunction with conservative treatments to reduce pain and inflammation
- Shoulder OA - Treatment pt2:
- conservative treatment approaches may be used in isolation or in combination and the specific approach will depend on the pts needs and goals
- Shoulder OA - Surgery pt1:
- hemiarthroplasty
- total shoulder arthroplasty (TSA)
- reverse total shoulder arthroplasty (rTSA) - can reverse shoulder arthrokinematics, where the ball is attached to the acetabulum and the stem becomes more concave
- resurfacing hemiarthroplasty
- shoulder resurfacing arthroplasty
- subacromial decompression
- Shoulder OA - Surgery pt2:
- injections: can help with pain relief and decrease inflammation
- there may be structural compromise to the joint and a steroid injection may help with the short term symptom relief and help pts regain the quality of life
- with shoulder OA, pain and decrease ROM are the most prevalent, it is possible to make changes to the quantity and quality of ROM, but you may already have structural changes to the joint, so this is where surgery may be helpful e.g. you may have a joint replacement or resurfacing of the joint using an implant to the head of humerus