Shoulder Osteoarthritis
Shoulder osteoarthritis is the progressive degeneration of the cartilage that lines the glenohumeral joint — the ball-and-socket articulation between the humeral head and the glenoid. As cartilage wears away, bone-on-bone contact causes pain, stiffness, and loss of shoulder function. While less common than knee or hip arthritis, shoulder OA is a significant source of disability, particularly in patients over 60.
Causes and Risk Factors
Primary glenohumeral osteoarthritis is most often idiopathic, developing gradually with age. Secondary OA can result from prior shoulder injuries — including shoulder dislocations, rotator cuff tears, fractures, or previous surgeries — as well as inflammatory arthritis conditions such as rheumatoid arthritis. Individuals with a history of chronic shoulder instability are at elevated risk for early cartilage loss.
Symptoms
Patients describe a deep, aching pain in the shoulder that worsens with activity — particularly overhead movements, lifting, or reaching behind the back. Morning stiffness is common, and the shoulder may feel progressively tighter as arthritis advances. A grinding, grating, or crunching sensation with movement (crepitus) is frequently reported. In advanced cases, pain may persist at rest and at night, significantly disrupting sleep.
Diagnosis
Dr. Cooper evaluates shoulder arthritis with weight-bearing X-rays (standing or in specific positions to stress the joint), which reveal joint space narrowing, osteophyte formation, and glenoid bone loss. MRI provides additional information about the rotator cuff and soft tissue envelope, which influences surgical planning if joint replacement becomes necessary.
Treatment
Conservative management includes activity modification, physical therapy focused on maintaining motion and strengthening the rotator cuff musculature, anti-inflammatory medications, and corticosteroid injections. Viscosupplementation and biologic injections may provide relief in select patients.
When non-operative treatment no longer controls symptoms adequately, total shoulder arthroplasty (TSA) — replacing the worn joint surfaces with a prosthetic ball and socket — provides excellent, long-lasting pain relief and functional restoration. In patients with irreparable rotator cuff damage alongside arthritis, reverse total shoulder arthroplasty is the preferred surgical option. Dr. Cooper discusses all available options to help each patient determine the right timing and approach for their situation.
