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How physical therapy can help shoulder arthritis
The shoulder (glenohumeral) joint is the third most common joint for arthritis, with the knee and hip being one and two, respectively. Many people with shoulder arthritis have a past history of trauma, although the injury may have occurred several years prior to the onset of arthritis symptoms. The anatomical features of shoulder arthritis include wearing down of the articular cartilage and bony erosions. Since these findings are common even in folks without shoulder pain, I view cartilage loss as a “wrinkle on the inside of the body.” We prefer to monitor the clinical features of arthritis, which includes a loss of range of motion and morning stiffness that improves with activity. This is something physical therapy can treat. If we can reduce your pain, improve your shoulder range of motion and strength so you can do all the activities you enjoy, does it matter that your MRI shows “cartilage loss?”
Physical therapy includes joint mobilizations of the shoulder, dry needling and soft tissue work to reduce muscle tension, stretching/strengthening exercise and exercises/hands on treatments to improve the flexibility of the upper back (which will help overall shoulder range of motion).
References:
- Seitz, PT, PhD, DPT, OCS;, A., Christain, PT, DPT, OCS, SCS, H., Lutz, PT, DPT, PhD, A. and Shanley, PT, PhD, OCS, E., 2021. Current Concepts of Physical Therapy, 5th Edition-The Shoulder: Evidence-Informed Physical Therapy Patient Management. 5th ed. Academy of Orthopaedic Physical Therapy.
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How do we track your progress?
We define patient-centered goals as what you hope to accomplish from physical therapy. While these are typically activity-specific goals, often patients report they just wish to experience less pain.
When do I need an MRI and how will this guide treatment?
Medical imaging such as X-rays, MRIs, Ultrasound, and others can be a great tool when worried about a medical emergency or planning for surgery. Unfortunately, outside of this, they often do more harm than good.
When is someone with shoulder pain not a candidate for PT?
Like many parts of the body, non- neuro-muscular-skeletal conditions can refer pain to the shoulder. These include heart, liver, stomach, pancreas, Pancoast’s tumor and spleen.