Shoulder Osteoarthritis in Vienna
Shoulder osteoarthritis usually announces itself quietly: putting on a jacket takes longer, reaching into the top shelf pulls, and lying on the affected side becomes uncomfortable. At my practice at the Orthozentrum Döbling I establish how far the wear has progressed and which treatment fits your everyday life.
In short
In shoulder osteoarthritis (omarthrosis) the cartilage between the humeral head and the shoulder socket is worn down. Typical signs are pain seated deep in the joint under load, grinding when the arm is rotated and mobility that decreases — usually outward rotation first. I make the diagnosis from the conversation, the clinical examination and ultrasound; the X-ray image shows the narrowed joint space. Treatment starts conservatively, with physiotherapy, an ultrasound-guided injection and PRP therapy. I consider an operation only once these routes have been exhausted.
What is shoulder osteoarthritis?
The shoulder joint consists of the ball-shaped humeral head and a flat socket on the shoulder blade. Both surfaces carry a smooth covering of cartilage. In osteoarthritis it becomes thinner and rougher, outgrowths form at the edge of the bone, and the joint capsule becomes tougher and shrinks. Because the shoulder is guided not by bone but by muscles and capsule, the rotational movements suffer early on.
There are two routes that lead there. Primary omarthrosis develops over years without a recognisable cause. The secondary form follows a history: a shoulder dislocation or recurrent instability, a fracture of the humeral head, a previous inflammation, or old tendon damage through which the humeral head no longer runs cleanly centred.
Not every shoulder pain comes from the joint itself. Tendon disorders such as a rotator cuff tear or an inflammation of the capsule such as frozen shoulder produce a similar picture and are treated differently. The acromioclavicular joint (AC joint) also wears; the pain then sits on top of the shoulder. I set out further causes under shoulder pain and its assessment.
Typical symptoms
- Deep pain under load — in the joint, often at the side and radiating into the upper arm.
- Grinding and crunching — audible or palpable when the arm is rotated and lifted.
- Stiffness after rest — the first movements in the morning are hard.
- Loss of outward rotation — putting on a jacket or reaching behind the back becomes laborious.
- Night pain when lying on the side — lying on the affected shoulder interrupts sleep.
- Loss of strength — lifting and carrying heavy things works less well than before.
How I make the diagnosis
It starts with a detailed conversation: since when the symptoms have been there, what brings them on, which injuries went before. Then I examine the shoulder clinically: active and passive mobility, rotation, strength and the painful points. Ultrasound is available in the practice; with it I assess tendons, bursa and a possible effusion. For the osteoarthritis itself the X-ray image is informative, because it shows the joint space and bony outgrowths. X-ray and MRI are not in the building; where they are needed, I arrange them.
Treatment: conservative first
With shoulder osteoarthritis I begin without an operation. The aim is to ease the pain, preserve mobility and strengthen the muscles that guide the joint.
- Movement and physiotherapy — work on mobility against the shrinking capsule, strengthening for the rotator cuff. Physiotherapy and exercise therapy are available in-house at the Orthozentrum Döbling.
- Ultrasound-guided injection — where the irritation is pronounced, I place the medication under visual control exactly where it is meant to act.
- PRP therapy — treatment with your own blood (PRP) can be an option while the wear is not yet far advanced.
- Magnetic field therapy — accompanying, to ease pain and irritation.
- Shockwave — if a tendon insertion is irritated as well, shockwave therapy can address that part of the symptoms.
- Adapted loading — we replace movements that irritate with alternatives you tolerate. Sparing the shoulder permanently is not a solution.
When an operation is necessary
If the symptoms persist despite consistent conservative treatment, I examine the surgical options. Through small approaches with the camera, loose bodies and inflamed tissue can be removed, disturbing bony outgrowths taken down and a shrunken capsule released — that can improve pain and blocked movement. The limit is clear: a shoulder arthroscopy does not create new cartilage. With far advanced osteoarthritis I therefore honestly advise against it. If a joint replacement is under consideration, I place the findings in context and discuss with you which route makes sense.
I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare. For an operation, direct settlement with a supplementary private insurance is possible; the details on billing in a private practice are set out on a separate page. We decide together whether an operation goes ahead, once all the findings are in.
Frequently asked
Common questions about shoulder osteoarthritis
Worn cartilage does not grow back. The aim of treatment is therefore not to reverse the wear, but to ease the pain, preserve mobility and make the shoulder able to cope with everyday life again. How far that succeeds depends on the findings, on the demands you place on the shoulder and on the muscles that guide it.
From the symptoms alone the two often cannot be separated with certainty, and both can be present at the same time. Pain seated deep in the joint, with grinding on rotation and a limit to movement that remains even when I guide the arm passively, points to osteoarthritis. Tendon problems tend to hurt when lifting overhead.
It starts with a conversation and a clinical examination. In the practice I use ultrasound to assess tendons, bursa and a possible effusion. For the osteoarthritis itself the X-ray is informative, because it shows the joint space and bony outgrowths; I arrange it where needed. I order an MRI when the tendons have to be assessed more closely.
Movement is an essential part of the treatment. If the shoulder is spared, the capsule shortens and mobility is lost on top of that. What makes sense is movement in the range that causes little pain, together with targeted strengthening of the muscles that guide the joint. After the examination, I work out what is good for you together with you and your physiotherapist.
PRP therapy can be an option when the wear is not yet far advanced and the symptoms persist despite physiotherapy. I take blood, prepare it and inject the concentrate into the joint under ultrasound guidance. The evidence is less clear for the shoulder than for other joints; I say that openly.
Arthroscopically, loose bodies can be removed, disturbing bony outgrowths taken down, inflamed tissue removed and a shrunken capsule released. That can improve pain and blocked movement. The procedure does not create new cartilage. With advanced osteoarthritis the benefit is therefore limited, and I advise against it when the findings speak against it.
No, a referral is not necessary. Bring to your first consultation whatever you have: your e-card, previous reports, doctors' letters and images. My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
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Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.