A wearing out of the ‘ball and socket’ joint of the shoulder. Progressive cartilage wear leads to bone rubbing on bone.
Most cases have no obvious cause. There is probably a genetic predisposition. Occasionally there is a history of an old injury.
Increasing aching pain in the shoulder, radiating down the arm. Aggravated with activity or motion of the shoulder, and relieved with rest. Sleeping on the involved side is usually very uncomfortable. Patients may report a grinding sensation.
Tenderness along the glenohumeral joint of the shoulder. Decreased range of motion, with pain at the extremes of motion.
Physical examination and special x-rays are diagnostic.
Anti-inflammatory medication may reduce symptoms. A well-placed corticosteroid injection can bring substantial relief to some patients, for a long time.
Either a shoulder arthroscopy and debridement, or Total Shoulder Replacement.
Most patients can be managed non-operatively. A shoulder arthroscopy is a straight forward outpatient procedure that only washes out the joint; it doesn’t replace the worn-out cartilage, and is of variable success. A shoulder replacement is a much more substantial procedure, but reliably improves pain relief and function.