Shoulder arthritis is wear of the cartilage covering the ball of the arm bone and the socket of the shoulder blade, so bone rubs on bone and causes deep pain, stiffness and grinding. Most cases improve with non-surgical treatment — activity changes, pain relief, physiotherapy and injections — and shoulder replacement is considered only when pain and function stay poor despite this.
Symptoms of shoulder arthritis
- Deep shoulder pain that worsens with movement and over time.
- Night pain that stops you sleeping on that side.
- Stiffness and difficulty lifting the arm or reaching behind your back.
- Grinding or clicking inside the joint.
- Gradual difficulty with daily tasks such as combing hair or dressing.
Causes and types
| Type | Cause | Note |
|---|---|---|
| Primary osteoarthritis | Cartilage wear with age | Tendons usually intact |
| Rotator cuff tear arthropathy | A large long-standing tendon tear changes joint mechanics | Usually suits a reverse replacement |
| Rheumatoid arthritis | Autoimmune inflammation damages cartilage and tendons | Needs rheumatology follow-up |
| Post-traumatic arthritis | Previous fracture or dislocation | May come with bone deformity |
| Avascular necrosis | Loss of blood supply (steroids, injury) | The head collapses and the joint wears |
Diagnosis
Diagnosis relies on examining range of motion and tendon strength, then X-rays showing joint-space narrowing and bone spurs. MRI may assess the tendons, and CT the shoulder-blade bone when surgery is planned.
Treatment step by step
- Activity changes: avoid painful movements and heavy overhead lifting.
- Medication: short courses of pain relief and anti-inflammatories as your doctor advises.
- Physiotherapy: exercises to keep motion and strengthen the shoulder and shoulder-blade muscles.
- Injections: steroid injections can ease flare-ups temporarily.
- Surgery: joint replacement when the above fails — anatomic with healthy tendons, reverse when the tendons are damaged.
Video: a simple home test for frozen shoulder
Frequently asked questions about shoulder arthritis
What are the symptoms of shoulder arthritis?
Deep pain that worsens with movement and at night, stiffness, difficulty lifting the arm, and grinding inside the joint.
Does shoulder arthritis need surgery?
Not usually. Treatment starts with activity changes, medication, physiotherapy and injections; surgery is for advanced cases that do not respond.
What is the difference between shoulder arthritis and frozen shoulder?
Frozen shoulder is inflammation and tightening of the joint capsule that usually improves with time and physiotherapy; arthritis is permanent cartilage wear visible on X-ray.
Do exercises help shoulder arthritis?
Yes. Gradual, pain-free range-of-motion and strengthening exercises help maintain function and reduce pain.
When do I need a shoulder replacement?
When pain disturbs sleep and daily life despite non-surgical treatment, with advanced arthritis on X-ray.
To have your shoulder assessed, book a consultation, call +20 155 240 4488 or message us on WhatsApp at +20 155 554 7181.
Medically reviewed by Prof. Dr. Ibrahim Shaarawi, Professor of Orthopaedic Surgery. This article is general medical education and does not replace an examination or the plan your surgeon sets for you. See our medical disclaimer.
Related shoulder replacement guides
Advanced arthritis is one of the reasons for reverse shoulder replacement. Read also:
- Reverse shoulder replacement
- Rotator cuff tear arthropathy
- Proximal humerus fractures in older adults
- Shoulder impingement syndrome
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Arthritis of the Shoulder.
- Izquierdo R, et al. Treatment of glenohumeral osteoarthritis. J Am Acad Orthop Surg. 2010;18(6):375-82.
- Craig RS, et al. Shoulder replacement surgery for osteoarthritis and rotator cuff tear arthropathy. Cochrane Database Syst Rev. 2020;4(4):CD012879.