Todd P. Stitik, MD

Exercises that help strengthen themuscles that support the spinemay be especially helpful duringthe postmenopausal years. Theback extension series illustratedin Figures 1 through 5 is anexample of progressively moredifficult exercises that can beperformed several times perweek. These exercises can alsobe performed individually inconjunction with resistance andweight-bearing routines.

In addition to the extensive body of literaturethat supports medical therapiesfor osteoporosis and for preventionof postmenopausal fractures, numerousstudies have explored thebenefits of exercise in both premenopausaland postmenopausal women.1The results of these studies indicatethat weight-bearing exercise and resistancetraining may play a role in preventingbone loss and increasing bonemass.

For patients with osteoarthritis, nonpharmacologic treatment can be an effective adjunct to drug therapy. Patient education is essential; both community-based and independent self-care programs are available. Weight loss can improve function and alleviate symptoms; however, it is more effective when dietary modification is accompanied by increased physical activity.

ABSTRACT: Glenohumeral joint osteoarthritis may result from trauma, concomitant shoulder pathology, or crystal deposition disease, or it may have no discernible cause. The physical examination reveals muscular atrophy, abnormalities during palpation, and limited range of motion, particularly in external rotation and flexion. Treatment includes both nonpharmacologic and pharmacologic interventions. Nonpharmacologic strategies include patient education, activity modification, and structured rehabilitation followed by transition to a long-term home exercise program. Pharmacologic treatment may involve progressively potent oral analgesics and perhaps corticosteroid injections. Surgical procedures, such as shoulder arthroplasty and arthroscopic debridement, are indicated for intractable pain and loss of function.