Shoulder Arthritis

Shoulder arthritis occurs when the cartilage that cushions the joint surfaces of the shoulder wears down over time. As cartilage deteriorates, bones begin to rub against each other, leading to pain, stiffness, and reduced shoulder function. The condition may affect either of the two joints in the shoulder—the glenohumeral joint (ball-and-socket) or the acromioclavicular (AC) joint at the top of the shoulder.

Arthritis in the shoulder can develop gradually with age or result from prior injury, inflammation, or joint degeneration.

Types of Shoulder Arthritis

There are several forms of shoulder arthritis:

• Osteoarthritis (degenerative joint disease): The most common type, often age-related, due to gradual wear and tear.

• Rheumatoid arthritis: An autoimmune condition that causes chronic joint inflammation.

• Post-traumatic arthritis: Results from a previous shoulder injury, such as fractures or dislocations.

• Rotator cuff arthropathy: A form of arthritis associated with massive rotator cuff tears.

• Avascular necrosis: Caused by disrupted blood supply to the humeral head, leading to bone collapse and joint damage.

Symptoms

Common symptoms of shoulder arthritis include:

• Deep, aching shoulder pain, especially with activity or at night

• Stiffness and reduced range of motion

• Grinding, clicking, or catching with movement

• Difficulty with overhead activities or reaching behind the back

• Shoulder weakness or fatigue

Symptoms tend to worsen gradually but can flare with overuse or changes in weather.

Diagnosis

Diagnosis is based on:

• History and physical exam: Evaluates range of motion, tenderness, and joint mechanics

• X-rays: Show joint space narrowing, bone spurs (osteophytes), and changes in joint alignment

• MRI or CT scan: May be used in complex cases to assess soft tissue status and bone integrity

Treatment Options

Treatment depends on the severity of arthritis, activity level, and response to initial care.

Non-Surgical Management:

• Anti-inflammatory medications (NSAIDs)

• Activity modification

• Physical therapy to maintain motion and strengthen surrounding muscles

• Corticosteroid injections for temporary symptom relief

These measures can be effective in early stages or for low-demand patients.

Surgical Management:

Surgery is typically considered when conservative treatments fail to control pain and functional loss:

• Shoulder Arthroscopy: Minimally invasive procedure to remove loose bodies or inflamed tissue in mild cases

• Hemiarthroplasty: Replacement of only the humeral head (ball)

• Total Shoulder Arthroplasty (TSA): Replacement of both the humeral head and glenoid (socket) for advanced arthritis with intact rotator cuff

• Reverse Shoulder Arthroplasty: For patients with arthritis and significant rotator cuff deficiency

These procedures aim to relieve pain and restore mobility and function.

Recovery and Outlook

• Most patients experience significant pain relief and improved range of motion after surgery

• Recovery timelines vary based on procedure:

  • TSA: Sling for 4–6 weeks; full recovery in 4–6 months

  • Reverse TSA: Similar timeline, with quicker early pain relief in many cases

• Physical therapy is critical to maximize outcomes

• Long-term implant survival is excellent with modern techniques and implant designs

Conclusion

Shoulder arthritis can significantly impact daily life and limit upper extremity function. Fortunately, a range of non-surgical and surgical treatments can help manage symptoms and restore mobility. Early evaluation and tailored treatment planning are key to maintaining shoulder health and staying active.

If shoulder pain is interfering with your life or activities, we’re here to help guide you through your options and determine the best path forward.