The shoulder joint consists of the humerus head (Caput humeri) and the shoulder joint socket (Glenoid cavities), both of which are covered with cartilage. The cartilage structure and synovial fluid ensure that there is no friction or pain when moving. If there is cartilage damage, i.e. a kind of tear in the cartilage tissue, pain can occur, which may need to be treated. This can be a small crack, but under certain circumstances it can also take on significantly larger dimensions.

The problem with cartilage damage is that the cartilage does not have its own blood supply, like most other structures in our body, but is largely supplied by other structures. If cartilage tissue is damaged, the body's own regeneration is usually only possible to a very limited extent for this reason.

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Bald cartilage describes the condition when there is no more cartilage. For more information, read the article at: Bald cartilage - is it dangerous?

causes

The reasons for cartilage damage cannot always be clearly diagnosed. Damage can have several causes. A previous accident is typical for such abrasion of the cartilage tissue, but incorrect, excessive loads can also cause such damage as a result. If the joint is subjected to sudden, very high stress, for example in a car accident or playing sports, the cartilage can be damaged.
The occurrence of cartilage damage on the shoulder can typically be favored by certain sports. These include tennis, American football, wrestling, bodybuilding and the shot put. Often, a piece of cartilage splintered off, which in turn could lead to pain and restricted mobility.

Long-term mechanical stress on the joint also results in cartilage damage in the joints. Risk factors for developing a chronic disease of the joints, such as arthritis, are typically overweight and certain occupational groups, who therefore expose their joints to high levels of stress. Damage caused by that cause is often more extensive than damage after an accident or a sports injury.
In the development of these diseases, factors such as age and individual stress on the joint also play a decisive role.

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Symptoms

The symptoms of cartilage damage to the shoulder are very similar to other shoulder injuries. These include:

  • Pain, which is often associated with "over-head" work, a "cracking" in the joint, with or without associated pain
  • Pain at night
  • a feeling of instability in the shoulder joint
  • Movement restrictions in the joint
  • Loss of strength
  • Swelling and
  • other signs of inflammation such as warming and redness

Appointment with a shoulder specialist

I would be happy to advise you!

Who am I?
My name is Carmen Heinz. I am a specialist in orthopedics and trauma surgery in the specialist team of .

The shoulder joint is one of the most complicated joints in the human body.

The treatment of the shoulder (rotator cuff, impingement syndrome, calcified shoulder (tendinosis calcarea, biceps tendon, etc.) therefore requires a lot of experience.
I treat a wide variety of shoulder diseases in a conservative way.
The aim of any therapy is treatment with full recovery without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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You can find me in:

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  • Lumedis - your orthopedic surgeon
    Kaiserstrasse 14
    60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
You can find more information about myself at Carmen Heinz.

diagnosis

The experts in injuries to the joints, and therefore also in diseases associated with cartilage damage in the shoulder joint, are specialists in orthopedics or general medicine. For the diagnosis, it is important whether the pain is directly related to an accident, how long it has existed and with which movements pain occurs. To find out, the attending physician will carry out a few tests to examine, among other things, stability and freedom of movement.
In order to rule out other problems, x-rays can be taken, whereby cartilage tissue cannot be examined in them. In order to be able to assess this, an MRI of the shoulder joint (Magnetic resonance topography) arranged. A contrast agent may be injected here in order to better assess the damage. However, in most cases, the final diagnosis cannot be established until an arthroscopy is performed.
The International Cartilage Repair Society has created different degrees of severity for the classification of cartilage damage:

Grade 0: (normal) healthy cartilage tissue
Grade 1: The cartilage has soft spots or blisters
Grade 2: Small damage to the cartilage is visible
Grade 3: damage with gap formation (in more than 50% of the cartilage tissue in the joint)
Grade 4: The damage to the cartilage extends to the underlying bone and exposes it.

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The cartilage damage in the shoulder joint can best be assessed on an MRI.

Read more about this: MRI of the shoulder joint

therapy

There are two specifically different therapeutic approaches for cartilage damage in the shoulder joint. On the one hand, there is conservative therapy, to which many patients respond well, depending on the size and type of cartilage damage.
This therapy includes the use of pain relievers and anti-inflammatory drugs (NSAIDs), and exercises for the joint with physiotherapy or at home.
In addition, conservative therapy is advisable in order to alleviate the symptoms and subject the joint to as little stress as possible. Unless the damage is excessive, this treatment may well meet all of the patient's needs.

However, if this conservative method proves to be inadequate, the attending physician may consider surgery. For the most part, cartilage damage to the shoulder joint is treated using arthroscopy. This is a minimally invasive operation in which the cartilage tissue can be restored using different methods.
Most of the time, a technique called microfracturing is used. This is supposed to result in bleeding that stimulates the tissue to form cartilage. The process of cartilage transplantation, in which cartilage is removed from other joints and inserted into the affected joint, has not yet established itself in the treatment of cartilage damage in the shoulder joint.

Conservative therapy options

Can hyaluronic acid help?

Hyaluronic acid as an important component of the connective tissue and also the synovial fluid, can be used in the context of osteoarthritis therapy. Because especially in patients with cartilage damage, the availability of hyaluronic acid in the joint is significantly reduced.

The preparation obtained from animal raw material is injected into the damaged joint in several sessions (1-5 injections), where it then serves as a kind of "synovial fluid" and shock absorber. Especially in the early stages of cartilage damage, this procedure can lead to a significant reduction in shoulder joint pain, so that better stress is possible.

Find out more about the topic here: Hyaluronic acid used to treat joint diseases.

Can Chondroitin / Glucosamine Help?

In addition to injecting hyaluronic acid into the shoulder joint, some also speak of the possibility of taking certain dietary supplements (chondroitin sulfate and glucosamine) that are supposed to counteract osteoarthritis.

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Chondroitin sulfate is a natural molecule, which is formed by cartilage-forming cells in the body and is involved in the development and strengthening of the joint cartilage. The sugar derivative glucosamine is also an important component of cartilage tissue. However, initial medical studies on the therapeutic effect of the orally taken preparations are contradictory. A significant improvement in symptoms or a decrease in cartilage damage has not yet been recorded with certainty.

Read more on the subject here Chondroprotectives.

Can Homeopathy Help?

Alternatively, or even in addition, a homeopathic approach can be followed. A wide variety of homeopathic medicines are available for degenerative diseases such as cartilage damage.

The common remedies include: Acidum formicicum, Acidum sulfuricum, Aranin (obtained from the black night spider), Aristolochia (pipe flower), Calcium sulfuricum, Formica rufa (obtained from the red wood ant), Harpagophytum (devil's claw), Kalium sulfuricum.

Can Acupuncture Help?

Acupuncture can be considered as an alternative or supplementary therapy attempt in the case of cartilage damage in the shoulder joint. According to traditional Chinese medicine, the fine needle pricks in very specific, selected points on the body irritate these areas. This allows you to influence certain body regulations.

However, the exact mechanism of action has not yet been clarified. Some patients report that regular acupuncture and osteoarthritis therapy reduced the pain in the affected joint and improved mobility. First medical studies to investigate the effectiveness of acupuncture for knee osteoarthritis show a positive result.

Find out more about the topic here Acupuncture.

Can Osteopathy Help?

Osteopathy, as an area of ‚Äč‚Äčalternative medicine, diagnoses and treats certain functional disorders of the human musculoskeletal system. Especially with painful cartilage damage in joints, relieving postures can quickly occur unconsciously, which not only lead to muscular tension, but also further promote the onset of osteoarthritis.

With certain manual techniques, osteopathy can reveal and correct these relieving postures. In addition, the osteopathic therapeutic approach can take care of restoring and maintaining mobility in the shoulder joint in parallel to the orthopedic and physiotherapeutic treatment methods.

more on the subject Osteopathy you'll find here.

What home remedies can I take to help?

In most cases, drug therapy against the symptoms of cartilage damage in the shoulder joint or osteoarthritis in general is unavoidable. However, various home remedies can also be used in addition.

Who will benefit from shoulder surgery?

Surgical treatment of the cartilage damage to the shoulder joint should only be discussed when all conservative therapy options have been tried and exhausted.
This means that an artificial joint replacement should only be considered when medical, orthopedic, physiotherapeutic and / or alternative medical treatment no longer leads to a reduction in symptoms.

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The reason why the surgical procedure should be delayed for as long as possible is not necessarily due to the associated surgical risks. Rather, it is due to the fact that an artificial joint replacement does not have an unlimited lifespan (approx. 10 years), so that a joint replacement at a young age can possibly also involve one or even several operations for material replacement in the course of life.


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