Treatment for Shoulder Arthritis Birmingham and Warwickshire
- Adam Whatley
- 4 minutes ago
- 6 min read
Shoulder Arthritis: Glenohumeral and AC Joint Pain - Diagnosis, Treatment, and Advanced Injection Therapies
How Can We Help Improve Shoulder Pain and Function
Shoulder arthritis is a degenerative condition that affects one of the body’s most mobile and complex joints: the glenohumeral (GH) joint. In addition, many patients also develop pain at the acromioclavicular (AC) joint, the small joint located at the top of the shoulder where the collarbone meets the shoulder blade. Both types of arthritis can be painful, limit range of motion, and significantly interfere with everyday activities such as reaching overhead, lifting, or dressing.
At Dynamic Regenerative Medicine, we frequently assess shoulder arthritis and provide evidence-based treatment plans that integrate rehabilitation with advanced injection therapies particularly platelet-rich plasma (PRP) and hyaluronic acid (HA) viscosupplementation to help reduce pain, improve function, and potentially slow the progression of degenerative changes.
What Is Shoulder Arthritis?
Glenohumeral joint arthritis involves degeneration of the cartilage in the main shoulder joint - the ball-and-socket formed by the humeral head and glenoid. It can result from age-related wear and tear, previous injury, inflammatory conditions, or instability.
AC joint arthritis affects the smaller joint at the top of the shoulder. Because this joint bears a disproportionate amount of load during activities such as overhead lifting, it’s a common source of pain even when GH joint cartilage is relatively preserved.
Symptoms typically include:
Deep shoulder pain with movement or at rest
Stiffness and reduced range of motion
Pain with overhead activities
Pain at the AC joint (localized at the top of the shoulder)
Sleep disturbance due to discomfort
Accurate diagnosis is essential, often involving clinical assessment and imaging such as ultrasound or MRI to determine the extent of cartilage degeneration and involvement of surrounding soft tissues.
Conservative Management: The Foundation of Shoulder Arthritis Care
Before discussing injectable therapies, it’s important to understand the role of conventional, non-invasive treatments. These include:
✅ Physiotherapy and exercise programmes aimed at strengthening the rotator cuff and scapular stabilisers
✅ Activity modification to reduce pain-provoking movements
✅ Anti-inflammatory pain management
✅ Manual therapy to maintain joint mobility
These strategies form the basis of care and can often reduce pain and improve function when arthritis is mild.
Hyaluronic Acid (gel) Injections for Shoulder Arthritis
Hyaluronic acid (HA) is a naturally occurring component of joint synovial fluid that provides lubrication and nourishment to the articular cartilage. In osteoarthritis, the quality and quantity of HA decline, contributing to increased friction, pain, and cartilage wear.
Injecting HA into the glenohumeral joint, a process known as viscosupplementation can help restore joint lubrication, improve mechanics, reduce pain, and aid in slowing the progression of further degenerative changes that lead to advanced osteoarthritis. Evidence supports this approach:
While the evidence base is still evolving, HA injections are generally well tolerated and can provide intermediate-term symptom relief, especially for patients who have not responded to physiotherapy or are not surgical candidates. With joint osteoarthritis we always recommend tackling the condition sooner rather than later for the best clinical outcomes.
Platelet-Rich Plasma (PRP): Regenerative Injection Therapy
PRP injection therapy is an injection therapy is an extremely popular treatment we provide in clinical practice many times every day, and have been doing so well over 10 years now. This popular, natural, biological treatment uses a concentration of a patient’s own blood platelets, rich in growth factors and signalling proteins that can help modulate inflammation and support tissue healing.
Unlike hyaluronic acid, which primarily provides biomechanical lubrication, PRP targets the biological environment within the joint and may help:
✅ Reduce inflammation at the joint surface
✅ Modulate pain pathways
✅ Support a healthier intra-articular environment
✅ Encourage endogenous repair mechanisms
Clinical research exploring PRP in shoulder arthritis and related degenerative shoulder conditions shows promising outcomes:
Patients treated with PRP had greater reductions in pain on the Visual Analogue Scale (VAS) and larger gains in Constant-Murley functional scores than those receiving HA.
Observational studies and comparative trials in chronic shoulder degeneration also report higher responder rates and sustained improvement with PRP over HA in some patient groups.
Although systematic reviews note that the overall evidence is limited by study design variability, data suggest that both HA and PRP improve pain and function compared with baseline, and PRP may have additional biological benefits due to its regenerative potential.
It’s important to note that most high-quality studies involve ultrasound-guided intra-articular injections to ensure accurate delivery of the therapeutic agent into the joint space.
Evidence and Clinical Context
While both PRP and HA show promise, high-quality evidence in shoulder arthritis is still developing:
👉🏼 Systematic reviews summarise that injected therapies (HA, PRP, corticosteroids) can provide symptomatic relief and functional improvement in glenohumeral osteoarthritis, but head-to-head comparisons and long-term data are still emerging.
👉🏼 In the specific trial comparing PRP and HA, PRP demonstrated superior outcomes in mid-term follow-up, suggesting biological advantages in modulating joint inflammation and function.
Both therapies are generally safe when performed under ultrasound guidance, with transient post-injection soreness being the most commonly reported side effect.
AC Joint Arthritis: A Special Consideration
Acromioclavicular (AC) joint arthritis can occur alongside glenohumeral degeneration or as an isolated condition, often presenting as pain at the top of the shoulder, especially with cross-body movements or lifting objects. The AC joint deals with high amounts of compressive forces. It has a disk in the middle of the joint to deal with these compressive forces. Over a period of time compressive forces and repetitive overhead lifting along with poor posture can cause degenerative changes to the joint, articular surface and the disc.
While most research focuses on the glenohumeral joint, similar principles apply:
Corticosteroid injections into the AC joint can provide short-term relief for isolated pain.
Hyaluronic acid and PRP injections can be considered for chronic AC joint degeneration, particularly in patients seeking alternatives to surgery or corticosteroids, however, hyaluronic acid is not routinely done. It is generally applied for larger joints.
Emerging evidence from degenerative shoulder studies suggests that biologic therapies may provide longer-lasting benefits compared with steroids, although specific AC joint trials are limited. This being said, with clinical practice we have seen excellent results in comparison to corticosteroid, long-term.
Integrating Advanced Injection Therapy with Targeted Rehabilitation
Injection therapy should not be viewed in isolation. The most successful outcomes typically integrate:
✔️ Targeted shoulder rehabilitation to improve rotator cuff strength and scapular control
✔️ Post-injection guided therapy to maximise range of motion
✔️ Activity modification to reduce aggravating stresses
Combining physical therapy with PRP or HA injections often results in better pain control and functional recovery than either approach alone.
When to Seek Specialist Assessment
If shoulder pain is persistent, interferes with daily activities, or does not respond to conservative measures, specialist evaluation is recommended. Early assessment allows clinicians to determine:
Whether arthritis is the primary source of pain
The degree of cartilage degeneration
Appropriate treatment options ranging from rehabilitation to injection therapy
In some cases where the degenerative changes are two advanced, you may be referred for surgical opinion.
Specialist Care in Birmingham & Warwickshire
Dynamic Regenerative Medicine provides a comprehensive approach to shoulder arthritis, including:
✅ Detailed clinical and imaging assessment
✅ Ultrasound-guided injection therapies (corticosteroid, PRP, HA)
✅ Physiotherapy and rehabilitation planning
✅ Personalised treatment plans to reduce pain and improve function
Early intervention can help patients manage symptoms effectively and maintain quality of life without rushing to surgical options.
Book a Consultation
If you’re experiencing persistent shoulder pain due to glenohumeral or AC joint arthritis, specialist assessment can help determine the most appropriate treatment pathway, including advanced injection therapies such as PRP and hyaluronic acid.
Contact Dynamic Regenerative Medicine today to arrange an evaluation and discuss a personalised joint health plan.
Book a Consultation
If you are experiencing joint pain or injury, early assessment can prevent progression and speed recovery.
Dynamic Regenerative Medicine
Clinics in Birmingham and Warwickshire
Specialists in musculoskeletal medicine, rehabilitation, and regenerative therapies.
Contact us today to arrange an assessment.
01564 330773
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