Overview of shoulder arthritis

Shoulder arthritis can be a painful and debilitating condition, but there are several treatment options available that can help reduce pain and improve function in the shoulder joint. Here are some of the most common treatments for shoulder arthritis:

1. Non-surgical treatments:
   
   • Pain medication: Over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation in the shoulder joint.
   • Physical therapy: A physical therapist (Physiotherapist, Osteopath, Chiropractor) can help improve range of motion, strength, and overall function in the affected joint through exercises and other techniques.
   • Corticosteroid injections: Corticosteroid injections can help reduce pain and inflammation in the shoulder joint.
   • Suprascapular nerve blocks: are a type of regional anesthesia that involves injecting a local anesthetic around the suprascapular nerve. The suprascapular nerve is located in the shoulder and provides sensation to the shoulder blade and rotator cuff muscles.

2. Surgical treatments:

• Arthroscopy: A minimally invasive procedure in which a surgeon uses a small camera and instruments to clean out the joint and remove damaged tissue.
• Shoulder joint replacement: A surgical procedure in which the damaged joint is replaced with a prosthetic joint.

Shoulder injections can be effective in reducing pain and improving function in the shoulder joint. There are several different types of injections that can be used to treat shoulder pain, including:

1. Corticosteroid injections: Corticosteroids are powerful anti-inflammatory drugs that can be used to reduce pain and inflammation in the shoulder joint.
2. Hyaluronic acid injections: Hyaluronic acid is a naturally occurring substance that is used to lubricate and cushion joints. Injections of hyaluronic acid can help reduce pain and improve function in the shoulder joint.
3. Platelet-rich plasma (PRP) injections: PRP injections use a concentrated mixture of platelets from the patient's own blood to promote healing and reduce pain in the shoulder joint.

The effectiveness of shoulder injections will depend on several factors, including the underlying cause of the pain, the type of injection used, and the individual patient's response to the treatment. 

In general, shoulder injections can be a useful tool for reducing pain and improving function in the shoulder joint, but they are not a cure for all shoulder conditions and may need to be repeated over time to maintain their effectiveness.

It is important to discuss the risks and benefits of shoulder injections with your doctor and to have a clear understanding of the procedure and what to expect before undergoing any type of injection treatment for shoulder pain.

There is no specific maximum number of shoulder steroid injections that a person can have, but the number and frequency of injections is typically limited to minimize the risk of side effects. Here are some factors that can impact the number of injections a person can receive:

1. The type of steroid used: Different steroids can have different risks and side effects, so the type of steroid used can impact the number of injections a person can receive.
2. The underlying condition: Some conditions may require more frequent injections, while others may be well-managed with fewer injections.
3. The patient's response to the injection: Some patients may respond well to a single injection and not need any more, while others may need several injections over time to manage their symptoms.
4. The risks of repeated injections: Repeated injections of corticosteroids can increase the risk of local tissue damage, weakening of bones (osteoporosis), and systemic side effects, such as weight gain, high blood pressure, and weakened immunity.

Yes, physiotherapy can help manage shoulder arthritis. Physiotherapy can help improve joint mobility, strength, and flexibility in the shoulder, which can reduce pain and improve function in the affected joint. Here are some specific ways physiotherapy can help with shoulder arthritis:

1. Stretching and range of motion exercises: Physiotherapy can help improve flexibility and range of motion in the affected joint, which can reduce pain and stiffness and help improve function.
2. Strengthening exercises: Physiotherapy can help improve strength in the muscles surrounding the affected joint, which can reduce stress on the joint and improve function.
3. Pain management: Physiotherapy can also help manage pain through techniques such as ice and heat therapy, transcutaneous electrical nerve stimulation (TENS), and joint mobilization.
4. Education: Physiotherapists can also provide education on proper posture, body mechanics, and activities of daily living to help reduce stress on the affected joint and prevent further injury.

It is important to discuss the goals and expectations for physiotherapy with your doctor and to have a clear understanding of the treatment plan before beginning physiotherapy for shoulder arthritis. Physiotherapy is typically a safe and effective treatment for shoulder arthritis, but like any medical procedure, it carries some risks and side effects, and may not be appropriate for all patients.  The biggest risk is that it doesn't help or makes the pain worse.  This occurs in some patients and means a different plan is required.