"Bone on bone" implies that the joint space and protective cartilage of the joint has completely deteriorated. This end-stage of arthritis is at a point of management with conservative (non-invasive) care or surgical joint replacement.

Conservative care would entail the avoidance of overhead activities and frequent loading of the joint with reaching, pushing and pulling. Additionally, re-balancing the shoulder joint can be helpful in minimizing the pain. As the body ages, the shoulder (the humerus in particular) is often pulled into a forward position by the strong pectoralis muscles which overpower the rhomboids. Re-balancing and re-positioning the shoulder into a more natural, normal "start" position can be accomplished by a body "tune-up" with a well-trained physical therapist. Sometimes people have to resort to medications as well if surgery is to be avoided.

Surgery may be a good option depending on your health and circumstances. Shoulder joint replacements are not a common as knee or hip replacements, but are available.

If you find a good shoulder (upper extermity) orthopedic specialist, this person should be able to help you find the best option for you.

Dr. Christina Lasich, MD