Shoulder osteoarthritis is classified according to cause and severity:

1. Primary omarthrosis: Age-related, idiopathic wear without identifiable external causes.
2. Secondary omarthrosis: Osteoarthritis resulting from injuries, inflammatory diseases, or mechanical misalignments.
3. Post-traumatic omarthrosis: Following fractures, dislocations, or injuries of the shoulder joint.
4. Rheumatic omarthrosis: As a result of inflammatory diseases such as rheumatoid arthritis.
5. Partial osteoarthritis: Affects only parts of the joint, for example, the shoulder socket.
6. Complete omarthrosis: Complete wear of the entire shoulder joint.

The causes of shoulder osteoarthritis are diverse and can be divided into mechanical, inflammatory, and traumatic factors:

• Mechanical stress:
  • Repeated movements or overuse, e.g., in professional activities or sports such as tennis or handball.
  • Misalignments or instabilities in the shoulder joint, leading to uneven stress.
• Traumatic causes:
  • Injuries such as dislocations or fractures that cause long-term joint damage.
  • Injuries to the rotator cuff, leading to uneven joint stress.
• Inflammatory diseases:
  • Rheumatoid arthritis, which leads to chronic inflammation and cartilage damage.
• Degenerative processes:
  • Age-related wear of cartilage tissue due to natural wear and tear.
• Risk factors:
  • Overweight, which increases joint stress.
  • Genetic predisposition to cartilage diseases.

The symptoms of shoulder osteoarthritis vary depending on the progression of the disease, but typically include:

- **Pain:** Sharp or pulling pain, initially during movement, later also at rest.

- **Movement restrictions:** Difficulty lifting the arm, especially above shoulder height.

- **Loss of strength:** Reduced muscle strength in the shoulder and arm.

- **Grinding and rubbing:** Perception of grinding noises (crepitus) in the joint.

- **Swelling:** Rare, but possible with inflammatory involvement.

- **Night pain:** Pain that affects sleep, especially when lying on the affected side.

The diagnosis is made through a thorough medical history, clinical examination, and imaging techniques:

- Medical history:

- The doctor inquires about the duration and intensity of the symptoms, possible injuries, and occupational stresses.

- Physical examination:

- Checking the mobility and strength in the shoulder joint.

- Palpating for pain points and possible swelling.

- Imaging:

- X-ray: Visualization of the joint space, osteophytes, and bony changes.

- MRI: Detailed assessment of cartilage, soft tissues, and accompanying injuries.

- Ultrasound: Evaluation of soft tissues, especially the rotator cuff.

Conservative Therapy

In the early stages, non-surgical treatment is often sufficient to alleviate symptoms and maintain joint function:

• Medication Therapy:
  • NSAIDs: For pain relief and anti-inflammatory effects.
  • Hyaluronic acid injections to improve joint function.
  • Corticosteroid injections for acute inflammation.
• Physiotherapy:
  • Exercises to strengthen shoulder muscles and improve mobility.
  • Manual therapy to relieve joint stress.
• Pain Management:
  • Heat or cold therapy to relieve pain and inflammation.
• Alternative Therapies:
  • Shockwave therapy or acupuncture for pain relief.

Surgical Therapy

In cases of advanced osteoarthritis or persistent symptoms despite conservative measures, surgery may be necessary:

• Arthroscopy: Minimally invasive joint cleaning to remove cartilage debris and osteophytes.
• Joint Replacement (Endoprosthesis):
  • Hemiarthroplasty: Replacement of the humeral head.
  • Total Endoprosthesis: Replacement of the entire joint.
  • Reverse Prosthesis: For rotator cuff damage.
• Osteotomies: Correction of misalignments to relieve joint stress.

To prevent shoulder osteoarthritis and support joint health, the following measures are recommended:

1. Ergonomic movements: Avoiding unilateral strain and incorrect posture.
2. Regular exercise: Promoting joint mobility through moderate sports like swimming.
3. Muscle strengthening: Targeted training of the shoulder muscles to stabilize the joint.
4. Weight control: Reducing joint strain through a healthy body weight.
5. Early detection and treatment: Seeking medical advice promptly at the first signs of pain or stiffness.