Facing a diagnosis of bone-on-bone shoulder arthritis can be daunting, with many patients questioning what alternatives exist beyond the recommendation of shoulder replacement surgery. In this blog, we will explore the possibilities offered by regenerative injections such as stem cells and exosomes, as well as the potential benefits and limitations of these treatments. We’ll also delve into the role of cortisone shots and evaluate their risks and benefits. Led by insights from Dr. David Guyer, a triple board-certified orthopedic surgeon, sports medicine specialist, and expert in anti-aging and regenerative medicine, this discussion will provide a comprehensive look at how regenerative medicine might offer pain relief and potentially delay the need for invasive surgery. Whether you are in search of alternative solutions for osteoarthritis or simply want to understand more about your treatment options, this exploration aims to empower you with knowledge to make informed choices about your osteoarthritis management plan.

Cortisone Shots: A Double-Edged Sword

Bone-on-bone shoulder arthritis represents a severe form of degenerative joint disease where the cartilage cushioning between the bones has severely deteriorated. This loss of cartilage leads to an increase in pain and a decrease in joint function, often leaving patients considering various treatment avenues to improve their quality of life.

Cortisone shots are commonly prescribed to reduce inflammation and pain in arthritic joints, providing temporary relief. However, repeated cortisone injections carry significant risks:

• Cartilage and Bone Damage: Over time, cortisone can speed up the degeneration of cartilage and bone, potentially worsening the arthritis.
• Tendon Weakening: Specifically in the shoulder, repeated cortisone shots may weaken the rotator cuff tendons, complicating future surgical procedures if they become necessary.

While cortisone can offer temporary pain relief, especially when surgery is not immediately feasible, it is often not favored as a long-term solution due to these potential adverse effects.

Regenerative Injections: Stem Cells and Exosomes

In the realm of alternatives, regenerative medicine has sparked interest for its potential to alleviate symptoms without the side effects associated with traditional treatments.

1. Stem Cells

These are undifferentiated cells that have the capacity to develop into different types of cells, potentially aiding in the repair and regeneration of damaged tissues.

• Functionality: In theory, stem cells may help regenerate cartilage; however, in severe cases like bone-on-bone arthritis, the regrowth of significant amounts of cartilage is unlikely.
• Pain and Function Improvement: Despite limitations in cartilage regeneration, stem cells might still contribute to reductions in pain and improvements in joint function, offering patients additional time before requiring surgery.

2. Exosomes

Tiny vesicles that facilitate cell communication and regenerative processes.

• Advantages: Exosomes might promote healing and modulate inflammation more efficiently than stem cells, offering a promising alternative.
• Current Research: As with stem cells, exosomes remain under study, and while initial findings are promising, they are still considered experimental by the FDA.

Weighing the Options

When deciding between regenerative treatments and cortisone shots, several factors should be considered:

• Extent of Cartilage Loss: In cases where cartilage is severely diminished, regenerative treatments might offer limited benefits in terms of cartilage regeneration but could still enhance joint health to some extent.
• Patient Goals: Those looking to delay surgery and manage pain with non-invasive options might find regenerative treatments appealing despite their experimental status.

Beyond Injections: Holistic Considerations

In addition to these interventions, exploring other therapeutic avenues can be beneficial for comprehensive joint health:

• Physical Therapy: Tailored exercises can improve mobility and strengthen surrounding muscles, providing better support to the joint.
• Nutritional Support: A diet rich in anti-inflammatory foods can aid in reducing overall inflammation.
• Supplements: Glucosamine and chondroitin sulfate supplements may also provide benefit in managing arthritis symptoms.

Consult Your Healthcare Provider

It is crucial to emphasize that while these treatments provide potential alternatives, they are not replacements for personalized medical advice. Engaging in a thorough discussion with a healthcare provider, particularly one versed in both traditional and regenerative approaches, is essential to tailoring a treatment plan to your specific needs and medical history.

Having detailed discussions around expectations, potential outcomes, and the experimental nature of regenerative treatments can guide better decision-making. Additionally, for those contemplating these treatments, it may be beneficial to seek out clinical trials or research studies to access the latest advancements in these therapies.

Bone-on-bone arthritis inevitably presents challenges, but with a growing array of treatment options, patients have a better opportunity than ever to find a path forward that aligns with their health goals and lifestyle aspirations. By staying informed and working closely with medical professionals, you can explore these innovative possibilities to potentially enhance your quality of life.