The Agony Of Shoulder Arthritis… Treatment Options

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The Agony Of Shoulder Arthritis… Treatment Options



Osteoarthritis (OA) is the most common form of arthritis. It is a disease of articular cartilage, the gristle that caps the ends of long bones .Cartilage consists of a mixture of proteins, sugars, and collagen. Interspersed in this matrix of substances are chondrocytes, cartilage cells. The purpose of the chondrocytes is to manufacture new healthy matrix and keep it healthy. In the picture to your right you can see that osteoarthritic cartilage has cracks in it. These are called “fissures.”
Osteoarthritis starts when chondrocytes begin to manufacture destructive enzymes.
In addition, there is a complex interplay of events that leads to bone spur formation and inflammation of the synovium (the lining of the joint), which causes further joint destruction.
There are multiple factors that predispose to OA of the shoulder. These include: rheumatoid arthritis,previous surgery, instability, rotator cuff disease, and trauma.
Trauma can come from recreational activities such as weightlifting… or from occupation.
There are two endpoints that effective arthritis treatment must meet. The first is adequate control of symptoms. The second is possible slowing down or reversal of cartilage loss.
So… what can be done? Unfortunately, many treatments have been tried but they all seem to fall short. The usual approaches to OA consist of non-steroidal anti-inflammatory drugs, analgesics, physical therapy, glucocorticoid injections, and exercises.
Results are generally disappointing
Most patients end up with a shoulder arthroplasty (shoulder replacement). While this is OK for many people, it is not a good option for the younger, healthy active person who wishes to continue to be active.
Recent advances from standard to reverse procedures may be better.
However, the most exciting news may be the use of mesenchymal stem cells combined with growth factors, administered after fenestration and scarification of the exposed bony. Symptomatic relief as well as what appears to be reversal of cartilage damage has been noted.
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