Shoulder osteoarthritis

Symptoms

Pain is the most common symptom of shoulder arthritis. Pain is aggravated by activity and gets worse over time. As the disease progresses the pain may continue when at rest and can begin to affect sleep. The affected joint will dictate where the pain is felt in the shoulder girdle.

If the glenohumeral shoulder joint is affected, the pain can felt at the front and back of the shoulder and may feel like a deep ache.
If the AC joint is affected, pain will be focused on the top of the shoulder. This pain may radiate up the side of the neck.

Other common symptoms include:

Limited motion and stiffness
Crepitus

Who to refer, who not to refer, how to refer

Who to Refer

Those who have failed primary care management

Urgent Referral Criteria

Avascular necrosis or bone death

Who Not to Refer

Those who have not tried Primary care management

Additional Info

X-Ray to rule out Sinister causes (should be done pre-injection)

Imaging

Shoulder X-ray (Ideally xray is < 1yr old)

How to refer

We accept referrals through SCI gateway for those who are based in Scotland.

We also accept e referrals through the below email address using the attached form for those who are based just on the other side of the border.

E- Referral Email address - bor.orthoreferrals@borders.scot.nhs.uk

Referral form - E-Referral to Orthopaedics (Non Sci-Gateway)

Primary care management

Physio rehab- strengthening over extended period
Regular maximum multimodal analgesia
CSI X 2-3 as you see fit

Resources and links

Primary care shoulder pathway - developed by First Contact Practitioners (To be confirmed, will update when available

Local service details

orthopaedics@borders.scot.nhs.uk

bor.orthoreferrals@borders.scot.nhs.uk

Last reviewed: 31/07/2025

Next review date: 31/07/2027

Author(s): Mr Roshan Raghavan, Mr Rehan Siddiqi.

Author email(s): Roshan.Raghavan@nhs.scot.