Shoulder Arthritis

Shoulder arthritis is inflammation in your shoulder joint that causes pain and stiffness. It makes lifting your arm uncomfortable and performing daily tasks extremely difficult.

Arthritis in the shoulder most commonly affects the “ball and socket” joint of your shoulder (glenohumeral joint). This joint is where the “ball” of your upper arm bone (humerus) rests against the “socket,” or cup, on the edge of your shoulder blade (scapula).

Over time, shoulder arthritis leads to cartilage loss. Cartilage is the tissue that covers the humeral head and the “socket” of your shoulder joint. Cartilage allows your bone surfaces to glide within your joints. It also cushions your bones against impact.

In the end stage of shoulder arthritis, without protective cartilage, bones in your shoulder joints rub directly against each other. Bone spurs can form, which block normal motion and can break off and become loose bodies within your joint.

What are the stages of shoulder arthritis?

There are four main stages of arthritis in the shoulder:

• Stage 1. In the early stage, your cartilage starts to soften, but you don’t have any serious symptoms. It’s sometimes called the doubtful stage.
• Stage 2. In the mild stage, your cartilage develops cracks. Pain and stiffness start to develop with movement of your joint.
• Stage 3. In the moderate stage, your cartilage starts to weaken and flake off. Pain becomes more frequent with movement, and stiffness occurs during long periods of rest.
• Stage 4. In the end stage, your cartilage wears away completely and exposes the surface of your bone. Pain, swelling and stiffness may be severe with or without movement.

Symptoms of shoulder arthritis

Shoulder arthritis symptoms vary from person to person. Symptom severity doesn’t always align with the level of cartilage damage.

Signs and symptoms may include:

• Shoulder pain. This is the most common symptom. At first, you may feel pain only during activity. As time goes on, you may feel pain at any time, with or without arm movement.
• Stiffness and loss of range of motion. You may feel stiffness in your shoulder and lose range of motion. These symptoms may make everyday tasks — like bathing or dressing — difficult.
• Grinding, clicking, popping or cracking in your shoulder joint. Loss of cartilage, which leaves an unsmooth surface, causes these noises. The noises occur with or without pain.
• Loss of sleep. It’s difficult to find a comfortable sleeping position. Any shoulder movement may hurt.

What does arthritis in the shoulder feel like?

If you have shoulder arthritis, you’ll feel mild-to-severe pain and stiffness in your shoulder. The pain is commonly located at the side of your shoulder, and the ache feels like it’s deep in your joint. Over time, you’ll notice a loss in your range of motion in your shoulder joint.

Shoulder arthritis causes

Shoulder arthritis has many possible causes. They include:

• Osteoarthritis. The most common type of arthritis, this is the “wear and tear,” age-related type of joint disease. Cartilage gets soft, cracks, flakes or becomes frayed and eventually wears away.
• Rotator cuff tear arthropathy. This type of arthritis in the shoulder develops after a large rotator cuff tear causes the humeral head to rub up against your other bones.
• Rheumatoid arthritis and other inflammatory arthritis. These are autoimmune diseases, which means your body’s defense system attacks its own healthy tissues.
• Trauma to your shoulder. Any type of injury to the bones of your shoulder — including dislocation, fracture or severe impact — can damage the cartilage surface.
• Avascular necrosis. This condition, also called osteonecrosis, is the death of part of the “ball” of your shoulder. It happens when trauma or disease cut off blood flow to the bone.

Risk factors for shoulder arthritis

Shoulder arthritis is more likely to affect people:

• Over age 50
• Who have obesity
• With a biological family history of the condition

How doctors diagnose arthritis in the shoulder

Your healthcare provider will perform a physical exam of your shoulder, including checking your range of motion and strength. Your provider will also ask about your medical history and current symptoms.

Your provider may order imaging tests, including

• Shoulder X-ray. X-rays show the condition of your shoulder bones. They can’t directly show cartilage, but your provider can see the amount of space between your shoulder bones.
• CT scan. This test provides more detail of the bones of your shoulder joint than X-rays. Providers order it frequently for surgical planning.
• MRI scan. This test shows the surrounding soft tissues of your shoulder joint. Your provider may order it to look at the condition of your rotator cuff tendons.

How is shoulder arthritis treated?

Arthritis in the shoulder treatment options include home-based and lifestyle care, medications and surgery.

Home-based and lifestyle care for shoulder arthritis

Treatment for shoulder arthritis usually begins with nonoperative, home-based and lifestyle care. These methods keep your shoulder mobile and reduce pain. These treatments include:

• Activity and lifestyle adjustments. Let pain be your guide. Cut back or avoid everyday activities (for example, lifting heavy objects) or athletic activities that cause shoulder pain.
• Ice and heat. Apply ice or moist heat — whichever feels better — to reduce inflammation and ease your pain.
• Shoulder exercises. Stretching exercises help improve or retain your range of motion. Your provider may have you work with a physical therapist.

Shoulder arthritis medications

Medications relieve pain and reduce inflammation. Common options are:

• Over-the-counter medications. For short-term pain relief, common choices are acetaminophen (Tylenol®) or nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen (Advil®, Motrin®).
• Corticosteroid injections. Cortisone relieves pain by reducing inflammation in your joint. Your provider injects the medication into the joint space in your shoulder.

Shoulder arthritis surgery

If other treatment methods don’t relieve your pain and your arthritis is getting worse, surgery may be an option. Common surgical options include:

• Shoulder replacement. Your surgeon uses plastic and metal to replace the diseased sections of bones in your shoulder joint.
• Arthroscopic shoulder debridement. Your surgeon inserts small tools and a camera through small cuts (incisions) in your shoulder to remove loose fragments of damaged cartilage.

Your surgeon may consider variations of these main types of surgeries based on the type, location and severity of your arthritis. Your lifestyle, health history and personal preferences may also play a role.

Can shoulder arthritis be prevented?

You can lower your chances of developing arthritis in the shoulder by:

• Avoiding nicotine products, including vaping
• Focusing on a healthy eating plan, like the Mediterranean diet
• Reaching and maintaining a healthy weight for you
• Performing low-impact, non-weight-bearing physical activity
• Reducing your risk of joint injuries by avoiding or limiting certain activities

See your healthcare provider at the first sign of symptoms. If your shoulder problem is found early, you can learn ways to reduce pain, change or avoid certain activities, and reduce further cartilage damage.

Can shoulder arthritis be cured?

Although there’s no cure for shoulder arthritis, there are many ways to ease your pain. You can use ice, heat and exercises to keep your shoulder loose and comfortable. Also, limit or avoid activities that are causing you pain. If these simple methods don’t relieve your pain, ask your healthcare provider about surgical options.

What outcome can I expect if I have arthritis in the shoulder?

Your outcome depends on your age, activity level and the types and range of movements you make with your arm and shoulder. It also depends on the location, size and severity of your shoulder arthritis.

Because each person and shoulder situation is unique, ask your provider what outcome you can expect as you explore all treatment options.