Cartilage damage to the shoulder - information and specialists

Many people experience pain in the shoulder area. It often leads to limited mobility as the condition progresses. Cartilage damage in the shoulder can occur in everyday life or as a result of sporting activities. The orthopaedic specialist is the specialist in this field.

Below you will find further information on symptoms, causes and treatment options as well as selected specialists for treatment.

What is cartilage damage in the shoulder

Cartilage damage is caused by wear and tear or injury to the body's own cartilage tissue in the shoulder. The shoulder is covered with cartilage on the inside of the glenoid cavity and on the heads of the humerus. This articular cartilage is the gliding layer of the joint and ensures low-friction movements. It is itself insensitive to pain.

If this cartilage surface breaks open or a part splinters off, cartilage damage occurs. If the damage is limited, it is referred to as focal cartilage damage.

If left untreated, there is a risk that this limited defect will expand further over time and with continued strain. The result is generalized cartilage damage. Doctors then speak of shoulder osteoarthritis.

In the case of untreated cartilage damage, pieces of cartilage that have broken off can also float in the joint and cause further damage and pain.

Symptoms of cartilage damage in the shoulder

The main symptom of damage to the cartilage in the shoulder is pain in the shoulder joint or shoulder. It is usually deep-seated and is noticeable as a cracking sound. If the injuries to your joint cartilage are minor, you may not feel any pain at first. This is because the shoulder joint has no load-bearing function.

Cartilage damage and free-floating parts can also cause irritation of the shoulder mucosa. These can be painful and severely restrict mobility. This is referred to as a "frozen shoulder".

If the injury spreads, the pain becomes increasingly severe. Mobility is also significantly restricted. It is therefore advisable to take the onset of shoulder pain seriously. So that it does not develop into omarthrosis (shoulder osteoarthritis) in the long term.

Causes of cartilage damage

The reasons for the development of cartilage damage in the shoulder cannot usually be clearly determined. It is often caused by micro-injuries in everyday life that you may not even notice. For example, minor accidents or bruises to the shoulder. Cartilage damage can also be caused by strength training. Sports that put a lot of strain on the shoulder are among the most common triggers.

Being overweight and old age are also risk factors. People who have jobs that require them to lift and carry heavy loads are also affected. Permanent mechanical stress on bones and joints leads to a cartilage defect over time.

The diagnosis

The orthopaedic specialist is an expert in the examination of diseases in the shoulder area. In a medical history interview, he will ask you in detail about the type and duration of the pain. He will inquire whether there is a connection with an accident or other event. Your doctor will then examine your shoulder movements to determine when the pain occurs.

Depending on the initial situation, he will use different methods of examination:

1. The first step is an X-ray examination. This shows whether there are any problems with the bones. The cartilage cannot be imaged.
2. The second step is a magnetic resonance imaging (MRI) scan. This makes injuries to the tissue visible.
3. An arthroscopy (shoulder endoscopy) is usually required to make a final diagnosis.

If your doctor diagnoses cartilage damage, this can be divided into four degrees of severity.

Therapy & treatment

Possible forms of therapy are conservative treatment or surgery. Your doctor will decide which procedure to use based on the findings.

• Conservative therapy

Conservative therapy is suitable for minor damage. It includes medication and physiotherapy. Nutritional supplements that stimulate and support cartilage metabolism are also an option. The aim of the therapy is to improve the mobility of the joint.

Physiotherapy helps to maintain or improve mobility in the shoulder joint @ Studio Romantic / AdobeStock

Infiltration is also becoming increasingly popular. During infiltration, bioactive substances are injected into the shoulder.

• Surgery

There are two options for surgical treatment:

1. Repair or regeneration of the cartilage joint: these are particularly interesting for young patients and people with limited damage. Cartilage transplantation is one of the most modern and recognized procedures. The orthopaedic surgeon breaks open the defect (microfracturing) in order to achieve a haemorrhage. The bleeding stimulates the body to form new replacement cartilage. As a rule, these procedures are minimally invasive and are performed as part of an arthroscopy (shoulder endoscopy).
2. Replacing the cartilage joint: In addition to repairing the joint, doctors can also replace it. The insertion of a shoulder prosthesis is particularly useful for older patients or people with shoulder osteoarthritis. The shoulder surgeon replaces the damaged areas of the glenoid cavity and humeral head with an artificial replacement.

Progression and prognosis

The wear and tear of the cartilage itself cannot be cured. However, it can be significantly delayed or stopped if you recognize it early. With the right treatment, the quality of life of the cartilage increases considerably.

Existing pain can often be completely treated. Restore full mobility. The earlier you consult an orthopaedic specialist or shoulder surgeon, the better the treatment results.

However, if you ignore your shoulder pain, you run the risk of developing osteoarthritis later on. Targeted muscle training for the shoulder and neck is helpful for a good prognosis.

This includes light strength exercises as well as stretching the chest muscle to center the shoulder joint. A great deal of discipline is required in the long term to prevent the disease from progressing.

Conclusion

Pain in the shoulders is part of everyday life for many people. Signs of cartilage wear are often responsible for this. The earlier a specialist recognizes this, the greater the chances of maintaining the full functionality of your shoulders.

The aim is to minimize the risk of osteoarthritis and avoid or delay surgery if possible. A healthy lifestyle, caution during sporting activities and regular strength training and stretching are important to keep your shoulder healthy.