Shoulder condition

Shoulder arthritis

Arthritis of the shoulder means the smooth cartilage that lets the joint glide has worn or been damaged, so that bone rubs against bone more directly. It usually causes pain and stiffness that build over time. Treatment depends on how much the arthritis affects you — your symptoms, your examination and imaging, how your shoulder functions, and your goals — and there is a range of options, from managing symptoms to, in some cases, joint replacement. This page explains what shoulder arthritis is, how it is evaluated, and how treatment decisions are approached.

General orthopedic education — not medical advice. Decisions about your care should be made with a qualified clinician.

What shoulder arthritis is

Arthritis is loss of the smooth cartilage surface of the joint.

The main shoulder joint (the glenohumeral joint) is a ball-and-socket joint: the rounded top of the upper arm bone sits against a shallow socket on the shoulder blade. Both surfaces are normally covered by smooth cartilage that lets the joint glide with very little friction. In arthritis, that cartilage wears thin or is damaged, so the surfaces no longer glide smoothly and bone comes into more direct contact with bone.

As the cartilage is lost, the joint can become painful and stiff, and the bone around it can change shape over time. Arthritis of the shoulder is generally a gradual process rather than a sudden injury.

Different causes of shoulder arthritis

Several different processes can lead to a worn shoulder joint.

Shoulder arthritis can come from more than one underlying cause, including:

Osteoarthritis — gradual, wear-related loss of cartilage, often with age
Inflammatory arthritis, such as rheumatoid arthritis, in which the joint lining is affected
Arthritis after an old injury or fracture (post-traumatic arthritis)
Cuff-tear arthropathy — arthritis that develops when a large, long-standing rotator-cuff tear changes how the joint works over time
Loss of blood supply to the ball of the joint (osteonecrosis), which can damage the surface

Why the underlying cause matters

The cause matters because it shapes both how the shoulder behaves and how it is treated. In particular, the condition of the rotator cuff — whether it is intact or torn — is an important part of the picture, because the cuff helps center and power the joint. Whether the cuff is working affects which treatments are sensible, and it is one of the things assessed during evaluation.

Symptoms

Symptoms usually build gradually and affect both comfort and use of the arm.

Shoulder arthritis commonly causes:

Pain deep in the shoulder, often worse with activity and sometimes at night
Stiffness and gradual loss of motion
A grinding, catching, or clicking sensation with movement
Difficulty with everyday tasks such as reaching overhead, behind the back, or across the body
Aching that can persist at rest as the arthritis advances

How shoulder arthritis is evaluated

Evaluation combines your history, an examination, and imaging.

Evaluation usually begins with the history of your symptoms and a physical examination that assesses your motion, strength, and the function of the rotator cuff. X-rays are central to diagnosing arthritis — they show the loss of joint space, changes in the bone, and the overall shape and alignment of the joint.

Additional imaging, such as a CT scan or an MRI, is used selectively — for example, to assess the bone of the socket in more detail, or to evaluate the rotator cuff — when that information would help with planning. The findings are always interpreted alongside your symptoms and how the shoulder is affecting your life, not in isolation.

Nonsurgical care

Many people with shoulder arthritis are helped by nonsurgical measures.

Treatment for shoulder arthritis usually begins with nonsurgical care, which aims to reduce pain and keep the shoulder as functional and comfortable as possible. Depending on your situation, this may include:

Activity modification — adjusting demanding or provoking activities
Rehabilitation to maintain motion and support strength around the shoulder
Medication for pain and, when relevant, treatment directed at an inflammatory condition, as advised by your clinician
In selected situations, an injection into the joint may be considered; whether one is used, and of what kind, is an individual decision made with your clinician
Managing the demands you place on the shoulder as symptoms change over time

When surgery may be discussed

Surgery is considered when arthritis is advanced and nonsurgical care is no longer enough.

A conversation about surgery generally comes up when the arthritis is advanced and pain or loss of function is limiting your life despite an appropriate course of nonsurgical care. The most common surgical option for advanced shoulder arthritis is shoulder replacement, in which the worn surfaces are replaced with an implant.

Whether replacement is a good option, and which type, is highly individual. It depends on your symptoms and examination, your imaging, how the shoulder is functioning, your goals and activity expectations, your age, the anatomy of the joint, the condition of the rotator cuff, the quality of the bone, and any prior surgery. Because so many factors matter, the decision is made together, and the treatment page explains the options — including anatomic and reverse shoulder replacement — in more detail.

Preparing for your visit

Questions worth discussing at your evaluation

Bringing a few questions can make the first conversation more useful. You might ask:

How advanced is the arthritis in my shoulder, and what is causing it?
Is my rotator cuff intact, and how does that affect my options?
What can nonsurgical care realistically do for me right now?
If surgery came up, what type of replacement would fit my anatomy and goals — and why?
How do my age, activity expectations, and bone quality factor into the decision?

Common questions