Prof. Ockert in an interview with MEDPERTISE on the topic of shoulder arthrosis - regaining quality of life with one intervention
- 10 hours ago
- 8 min read
Interview with Prof. Dr. Ockert on the treatment of shoulder arthrosis
1. What symptoms indicate shoulder arthrosis?
Prof. Ockert: Typical symptoms of shoulder arthrosis are persistent pain and limited mobility in the shoulder joint. Many sufferers initially notice that certain everyday movements, such as raising the arm or reaching for objects at head height, become increasingly uncomfortable or even cause pain. Often, the pain is not immediately severe but increases gradually over weeks or months. A stiff, immobile feeling in the shoulder, especially in the morning or after prolonged sitting, can also indicate arthrosis. indicate.
Another typical sign is a grinding or rubbing sensation in the joint, which can sometimes be felt when making circular movements. As osteoarthritis progresses, pain can become more severe, even during rest or at night, which can disrupt sleep. Overall, symptoms usually appear gradually and become more frequent and intense over time.
2. How can shoulder arthrosis be differentiated from other shoulder problems?
Prof. Ockert: Shoulder arthrosis is the wear and tear of the articular cartilage in the shoulder joint. While other shoulder problems are often triggered by injuries such as tendonitis, a rotator cuff tear , or bursitis , osteoarthritis usually manifests itself as gradually increasing, persistent pain and restricted movement. A "stiff" feeling in the shoulder is also typical, especially after prolonged periods of rest, such as after getting up in the morning. While acute tendon problems are often strongly associated with certain movements or stresses, the pain in osteoarthritis develops more slowly and also occurs at rest or at night. Another indication is a grinding or rubbing noise when moving the arm.
Shoulder arthrosis is a wear and tear of the articular cartilage in the shoulder joint.
3. Is it possible that shoulder arthrosis also affects the neck or back muscles?
Prof. Ockert: Yes, that's certainly possible. Many sufferers of shoulder arthrosis automatically adopt a protective posture to avoid shoulder pain. This protective posture can lead to increased strain on other muscles—for example, in the neck or back area. This can lead to tension and pain in these areas. The symptoms thus "migrate" indirectly because the body tries to relieve pressure on the painful joint.
4. What tests and examinations are performed to diagnose shoulder osteoarthritis?
Prof. Ockert: First, I conduct a detailed interview (anamnesis) to determine the patient's symptoms, their progression, and previous treatments. This is followed by a manual examination: I check the shoulder's mobility, whether certain movements trigger pain, or whether a grinding sensation is noticeable. Imaging techniques such as X-rays are then used to detect changes in the joint space and bone.
If necessary, an ultrasound or an MRI scan may follow to assess soft tissues such as tendons and muscles. In rare cases, an arthroscopy may be performed to examine the joint directly. However, this is only advisable if the osteoarthritis is not yet advanced and the procedure can repair damage that could potentially lead to pain relief or improved mobility.
I check how mobile the shoulder is, whether certain movements cause pain, or whether a crunching sensation can be felt.
5. Are there different stages of shoulder osteoarthritis and how do they differ?
Prof. Ockert: Yes, shoulder arthrosis can be divided into different degrees of severity:
In the early stages, the cartilage is still largely intact, and initial signs of wear are minimal. Symptoms occur only occasionally, usually under stress.
The middle stage involves significantly worn cartilage, resulting in a narrower joint space. Pain occurs more frequently, even during everyday movements. Grinding and restricted movement may occur.
In the late stage , the cartilage has largely disappeared, and bone rubs against bone. Severe pain, even at rest and at night, and pronounced restricted movement are typical. Bone growths ( osteophytes ) may form .
6. What conservative treatment options are there for shoulder osteoarthritis?
Prof. Ockert: Conservative, non-surgical methods include pain medications (such as ibuprofen or diclofenac), anti-inflammatory gels and ointments, as well as heat or cooling. Special nutritional supplements, such as glucosamine or chondroitin, are also sometimes used to support cartilage, although their effectiveness is controversial. Physiotherapy , targeted strengthening and stretching exercises, and minor daily adjustments can also help. It's also important to avoid excessive strain and awkward movements.
Conservative, non-surgical methods include pain medications (such as ibuprofen or diclofenac), anti-inflammatory gels and ointments, as well as heat applications or cooling.
7. What role does physiotherapy play in shoulder osteoarthritis and how often should it be used?
Prof. Ockert: Physiotherapy can help strengthen the muscles around the shoulder joint to relieve pressure on the joint. Targeted exercises also improve mobility and can reduce pain in the long term. Initially, one or two sessions per week are often recommended; later, the learned exercises can be continued independently at home. Physiotherapy is intended to provide greater stability, less pain, and greater freedom of movement in the long term.
8: Can a change in lifestyle (e.g. diet) have a positive effect on the symptoms?
Prof. Ockert: Yes, a healthy lifestyle can indeed help. A balanced diet rich in fruits, vegetables, healthy fats (e.g., from fish or avocado), and whole grains can have an anti-inflammatory effect. Maintaining a normal body weight is also important to avoid unnecessary pressure on the joints. Regular, but gentle exercise—such as walking, cycling, or swimming—can also help. Avoid excessive alcohol and sugar consumption, as these can promote inflammatory processes in the body.
9: What should you avoid to prevent osteoarthritis from worsening?
Prof. Ockert: Avoid excessive strain or repetitive, one-sided movements that place a great deal of stress on the shoulder joint. This includes heavy lifting above shoulder height or sudden, unfamiliar movements. Immobilization for too long is also not beneficial, as the cartilage is supplied with nutrients through movement. A balanced, moderate amount of gentle activity is ideal.
Avoid overloading or repetitive, one-sided movements that place a lot of strain on the shoulder joint.
10: Are there alternative therapies that can help with shoulder arthrosis?
Prof. Ockert: Yes, some patients report positive effects from alternative methods such as acupuncture or manual therapy. Osteopathy , massage , or heat treatments such as fango packs can also loosen muscles, relieve pain, and improve general well-being. It's important to choose reputable providers and not expect miracles. Often, a combination of conventional medicine and complementary treatments is most successful.
11: How useful are injections, e.g. with hyaluronic acid or cortisone, for shoulder arthrosis?
Prof. Ockert: Injections can provide short-term relief. Cortisone injections have an anti-inflammatory effect and can reduce pain for several weeks or even months. Hyaluronic acid injections are said to make joint cartilage more lubricated, thus reducing frictional pain. However, these effects do not last forever, and the response varies from patient to patient. They can provide temporary relief, but are not a permanent solution to the underlying problem.
Injections can provide short-term relief.
12: When does shoulder arthrosis need to be treated surgically?
Prof. Ockert: Surgery is usually considered when conservative measures (medication, physical therapy, injections) have been exhausted and the pain and limited mobility severely impact daily life. For example, if it becomes impossible to raise the arm, dress, or perform everyday activities without pain, surgery can help improve quality of life.
13: What are the advantages and disadvantages of surgery for advanced shoulder arthrosis?
Prof. Ockert: One advantage is that surgery—such as an artificial joint replacement—can provide long-term relief from severe pain and significantly improve shoulder function. This allows for greater independence in everyday life. Disadvantages include the risks associated with any surgery: infections, impaired wound healing , or complications from anesthesia. However, these risks are statistically low these days with careful planning and a high level of routine. Furthermore, rehabilitation after shoulder surgery requires patience and consistent practice.
14: What different surgical methods are there and how do they differ?
Prof. Ockert: There are different procedures, depending on the severity and the exact situation:
During an arthroscopic procedure, small cameras and instruments are used to loosen adhesions, remove inflamed tissue, or perform minimally invasive corrections, e.g. of the long biceps tendon.
In a partial prosthesis (hemiprosthesis), only the humeral head is replaced by an artificial component.
A full prosthesis (anatomical shoulder prosthesis) replaces both the joint socket and the humeral head in order to restore the most natural movement pattern possible.
In the reverse shoulder prosthesis, the natural anatomy of the joint is reversed (the socket and head are swapped), which is used primarily in cases of severely damaged rotator cuff in order to enable pain-free arm lifting again.
15: How long does recovery take after shoulder surgery?
Prof. Ockert: The recovery time depends on the type of surgery and your personal circumstances. It can generally take several weeks to months. After a prosthetic implantation, several weeks of immobilization of the arm are often necessary, followed by intensive physical therapy. With a reverse shoulder arthroplasty, several weeks of immobilization are not necessary. After about three to six months, many everyday activities can be performed again without pain, but the complete healing process can take up to a year.
After about 3 to 6 months, many everyday activities can be performed again without pain...
16: What are your tips for better coping with everyday life with shoulder arthrosis?
Prof. Ockert: Make sure you plan your daily routine so that you don't perform too many one-sided or strenuous movements in a row. Take regular breaks and use aids (e.g., longer grips or special bottle openers) to relieve pressure on your shoulder.
Good posture is important: Try not to sit or stand with your shoulders hunched. Supportive exercises to strengthen your shoulder and back muscles also help. And most importantly, take your time, listen to your body, and don't constantly push yourself to the limit.
17: Can you continue to exercise despite osteoarthritis and which sports do you specifically recommend?
Prof. Ockert: Generally, you can still exercise, but you should focus on low-impact sports. Swimming (especially backstroke), light cycling, or gymnastics exercises that gently mobilize the shoulder girdle are recommended. Yoga or Pilates can also help, as long as the exercises are adapted to your individual abilities. Avoid sports that place strong impacts on the shoulder, such as handball, martial arts, or intensive overhead weightlifting.
Sport is still possible, but you should focus on gentle sports.
18: What innovations have there been in the field of shoulder arthrosis in recent years?
Prof. Ockert: In recent years, there have been advances in materials for shoulder prostheses (e.g., more durable, better-tolerated implants) and improved surgical techniques, such as minimally invasive procedures. Imaging diagnostics have also advanced, allowing problems to be detected earlier and assessed more accurately. Furthermore, patient-specific implants and navigation technology offer options for even more precise implantation of an artificial joint.
19: What topics does current research on shoulder osteoarthritis include?
Prof. Ockert: Research is focusing, among other things, on how cartilage degradation can be better halted or even reversed in the future. New biomimetic materials and regenerative therapies are being tested, for example, using stem cells to repair damaged cartilage. The focus is also on the further development of surgical techniques, implants, and physiotherapy concepts. Furthermore, research is being conducted into how digital technologies (apps, online training programs, telerehab) can support patients in the healing process.
Thanks for the interview!
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