What Causes Shoulder Arthritis, and When Should You See an Orthopedic Specialist?

Shoulder pain can make even simple activities uncomfortable. Reaching into a cabinet, putting on a shirt, lifting groceries, or finding a comfortable sleeping position may become increasingly difficult.

While shoulder pain can result from injuries, overuse, or tendon problems, another common cause is arthritis.

Shoulder arthritis often develops gradually. You might first notice occasional stiffness or discomfort that comes and goes. Over time, the pain may become more persistent, and activities that once felt easy may require more effort.

But how do you know whether your shoulder pain is caused by arthritis, and when should you see an orthopedic specialist?

Shoulder arthritis occurs when the cartilage that helps the shoulder joint move smoothly becomes damaged or worn. Common causes include age-related osteoarthritis, previous shoulder injuries, inflammatory conditions, and long-standing rotator cuff problems. An orthopedic specialist should evaluate persistent shoulder pain, stiffness, loss of motion, or symptoms that interfere with sleep and daily activities.

Understanding the causes and treatment options can help you take the right steps toward managing your symptoms and maintaining shoulder function.

What Is Shoulder Arthritis?

The shoulder is a complex joint that allows your arm to move in many directions.

The main shoulder joint, called the glenohumeral joint, is formed by the rounded head of the upper arm bone and the socket of the shoulder blade.

Normally, smooth cartilage covers the surfaces of these bones, allowing them to move against each other with minimal friction.

When cartilage becomes damaged or deteriorates, the joint may no longer move as smoothly.

This can lead to inflammation, pain, stiffness, and reduced range of motion.

Arthritis can affect the main shoulder joint or the acromioclavicular (AC) joint, which is located near the top of the shoulder where the collarbone meets the shoulder blade.

The location and type of arthritis can influence both symptoms and treatment.

What Are the Most Common Causes of Shoulder Arthritis?

Several conditions can lead to arthritis in the shoulder.

1. Osteoarthritis

Osteoarthritis is one of the most common forms of shoulder arthritis.

It develops as the cartilage covering the joint surfaces gradually deteriorates.

As the cartilage becomes thinner, the joint may become stiff and painful. Bone spurs and other structural changes can develop.

Although osteoarthritis becomes more common with age, it doesn’t affect everyone in the same way.

Some people have relatively mild symptoms, while others experience significant limitations.

2. Previous Shoulder Injuries

A previous fracture, dislocation, or other significant shoulder injury may increase the risk of developing arthritis later in life.

This is called post-traumatic arthritis.

Damage to the cartilage or changes in joint alignment can affect how forces are distributed across the shoulder.

Symptoms may not develop until years after the original injury.

3. Rheumatoid Arthritis and Other Inflammatory Conditions

Rheumatoid arthritis is an inflammatory disease in which the immune system attacks joint tissues.

Unlike osteoarthritis, which primarily involves degenerative joint changes, rheumatoid arthritis can cause inflammation that damages cartilage and other joint structures.

Other inflammatory conditions may also affect the shoulder.

These conditions often require coordinated treatment with a rheumatologist or other appropriate healthcare professional.

4. Rotator Cuff Tear Arthropathy

The rotator cuff is a group of muscles and tendons that helps stabilize and move the shoulder.

When a large rotator cuff tear remains untreated or cannot be repaired, the mechanics of the shoulder may change.

Over time, some patients develop a type of arthritis called rotator cuff tear arthropathy.

This condition may cause pain, weakness, and difficulty lifting the arm.

Treatment can differ from that used for conventional shoulder osteoarthritis.

5. Avascular Necrosis

Avascular necrosis occurs when the blood supply to part of a bone becomes disrupted, potentially causing bone tissue damage.

When it affects the head of the upper arm bone, the joint surface may eventually collapse and lead to secondary arthritis.

Although less common, this condition is another possible cause of shoulder joint deterioration.

What Are the Symptoms of Shoulder Arthritis?

Shoulder arthritis symptoms often develop gradually, although the pattern varies.

Common symptoms include:

• Deep aching pain in the shoulder
• Stiffness, especially after inactivity
• Difficulty raising or rotating the arm
• Pain when reaching overhead or behind the back
• Grinding, catching, or clicking sensations
• Reduced range of motion
• Pain that interferes with sleep
• Difficulty performing everyday activities

Some patients experience discomfort primarily during activity.

Others notice aching even while resting.

As arthritis progresses, the shoulder may become increasingly stiff, making activities such as dressing, bathing, or reaching into cabinets more challenging.

Why Does Shoulder Arthritis Hurt More at Night?

Nighttime shoulder pain is a common complaint among people with arthritis.

Inflammation, joint irritation, and pressure from certain sleeping positions can contribute to discomfort.

Lying directly on the affected shoulder may increase pain.

Some patients also find that their shoulder becomes uncomfortable when the arm remains in one position for an extended period.

However, nighttime pain isn’t specific to arthritis.

Rotator cuff injuries, bursitis, and other shoulder conditions can produce similar symptoms.

Persistent pain that disrupts sleep is a good reason to seek an orthopedic evaluation.

How Can You Tell the Difference Between Shoulder Arthritis and a Rotator Cuff Injury?

Shoulder arthritis and rotator cuff injuries can produce overlapping symptoms, but they affect different structures.

Arthritis primarily involves the joint surfaces and surrounding joint tissues.

A rotator cuff injury affects the tendons that help stabilize and move the shoulder.

Patients with arthritis often experience stiffness and restricted motion, including difficulty moving the arm even when someone else assists.

Rotator cuff problems may cause weakness, pain during certain movements, or difficulty lifting the arm.

However, these patterns aren’t always reliable enough to make a diagnosis without an examination.

Some patients have both arthritis and rotator cuff damage.

An orthopedic specialist can evaluate the shoulder and determine which structures are contributing to the symptoms.

When Should You See an Orthopedic Specialist for Shoulder Arthritis?

Occasional shoulder soreness doesn’t always require specialty care.

However, persistent or progressive symptoms shouldn’t be ignored.

Consider scheduling an orthopedic evaluation if:

• Shoulder pain continues for several weeks
• Stiffness makes everyday activities difficult
• You have trouble lifting or rotating your arm
• Shoulder pain regularly interrupts your sleep
• Symptoms are getting worse rather than improving
• Over-the-counter treatments provide little relief
• You have a history of significant shoulder injury
• Pain or weakness limits work, exercise, or recreation

Early evaluation can help identify the cause and determine whether nonsurgical treatment may be beneficial.

Are There Shoulder Symptoms That Require Immediate Medical Attention?

Yes.

Seek urgent medical evaluation after a serious injury, especially if the shoulder appears deformed or you cannot move the arm.

A shoulder that becomes suddenly very painful, hot, red, or swollen—particularly when accompanied by fever—may indicate an infection or another urgent condition.

Sudden shoulder or arm discomfort accompanied by chest pain, shortness of breath, sweating, or other symptoms of a possible heart attack requires emergency care.

How Is Shoulder Arthritis Diagnosed?

Diagnosis usually begins with a discussion of your symptoms and medical history.

The orthopedic specialist may ask when the pain started, which movements cause discomfort, whether you have experienced previous injuries, and how symptoms affect your daily activities.

A physical examination may assess:

• Shoulder range of motion
• Strength and stability
• Areas of tenderness
• Joint movement
• Rotator cuff function
• Possible nerve-related symptoms

Will You Need X-Rays or an MRI?

X-rays are commonly used to evaluate suspected shoulder arthritis.

They can reveal joint space narrowing, bone spurs, changes in joint alignment, and other signs of degeneration.

An MRI may be recommended when the specialist needs additional information about soft tissues, such as the rotator cuff, or when the diagnosis remains uncertain.

Not every patient needs an MRI.

The appropriate imaging depends on the examination findings and treatment considerations.

What Are the Best Nonsurgical Treatments for Shoulder Arthritis?

Many patients begin with conservative treatment.

The goal is to reduce discomfort, preserve motion, and help patients continue their daily activities.

Physical Therapy

Physical therapy can help improve shoulder mobility, strengthen surrounding muscles, and support joint function.

A therapist may develop a program involving gentle range-of-motion exercises, strengthening, and activity modifications.

Exercises should be individualized because aggressive movements can sometimes increase discomfort.

Activity Modification

Certain activities may place additional stress on an arthritic shoulder.

Adjusting repetitive overhead movements, heavy lifting, or other painful activities may help manage symptoms.

The goal is to remain active while reducing unnecessary irritation.

Medications

Depending on your medical history, a healthcare professional may recommend appropriate pain-relieving or anti-inflammatory medication.

These treatments may help manage symptoms but do not restore damaged cartilage.

Medication decisions should consider potential side effects and other health conditions.

Corticosteroid Injections

A corticosteroid injection may provide temporary relief for some patients by reducing inflammation and discomfort.

The degree and duration of relief vary.

Injections are not appropriate for everyone, and repeated use requires careful consideration.

Other Supportive Measures

Ice or heat may help some patients manage discomfort.

Maintaining general physical activity and following a prescribed exercise program may also support overall function.

Your orthopedic specialist can help determine which options are appropriate.

Can Physical Therapy Help Shoulder Arthritis?

Yes.

Physical therapy is often an important part of nonsurgical shoulder arthritis treatment.

Although it cannot reverse cartilage damage, therapy may improve mobility, strength, and comfort during daily activities.

A physical therapist can help patients learn how to move the shoulder without repeatedly aggravating symptoms.

Treatment may focus on maintaining range of motion, strengthening the muscles around the joint, and improving movement patterns.

For patients with mild to moderate symptoms, an individualized program may help maintain independence and function.

Physical therapy may also be recommended before or after certain surgical procedures.

When Is Shoulder Replacement Surgery Considered?

Shoulder replacement surgery may be considered when arthritis causes significant pain and functional limitations that do not respond adequately to nonsurgical treatment.

The decision depends on several factors, including the severity of arthritis, rotator cuff condition, bone quality, overall health, and patient goals.

What Is Total Shoulder Replacement?

In a traditional anatomic total shoulder replacement, damaged joint surfaces are replaced with artificial components.

This procedure is generally considered for selected patients whose rotator cuff is functioning adequately.

What Is Reverse Shoulder Replacement?

Reverse shoulder replacement uses a different arrangement of artificial joint components.

It may be appropriate for certain patients with advanced arthritis and substantial rotator cuff damage, among other indications.

Not every patient with shoulder arthritis needs surgery.

An orthopedic shoulder specialist can explain the available procedures and whether any are appropriate for your condition.

How Long Does Recovery Take After Shoulder Replacement?

Recovery varies depending on the procedure, individual health, and rehabilitation plan.

Patients generally need time for healing and a gradual return to movement and activity.

Physical therapy may be an important part of recovery, helping restore appropriate mobility and strength.

Some restrictions may remain in place during the early stages of healing.

Your surgeon and rehabilitation team will provide instructions based on the procedure performed.

Full functional recovery can take several months, and outcomes vary.

Can Shoulder Arthritis Be Prevented?

Not all cases of shoulder arthritis can be prevented.

Age, genetics, previous injuries, and inflammatory conditions may influence risk.

However, protecting the shoulder from avoidable injuries and maintaining appropriate strength and mobility can support long-term joint health.

If you participate in sports or activities involving repetitive overhead movement, proper technique and conditioning may help reduce certain injury risks.

Prompt evaluation of significant shoulder injuries can also help identify problems that need treatment.

For people already diagnosed with arthritis, managing symptoms and maintaining function are often more realistic goals than preventing every structural change.

Does Shoulder Arthritis Always Get Worse?

Not necessarily.

Arthritis is generally associated with structural changes that may progress over time, but symptoms don’t always worsen at a steady rate.

Some patients experience relatively stable symptoms for years.

Others develop increasing pain or stiffness.

Treatment decisions should be guided by how the condition affects daily life, not solely by the appearance of imaging studies.

Frequently Asked Questions About Shoulder Arthritis

What is the most common cause of shoulder arthritis?

Osteoarthritis is a common cause, particularly in older adults. Previous injuries, inflammatory conditions, and chronic rotator cuff problems can also contribute.

What does shoulder arthritis feel like?

It may cause deep aching pain, stiffness, grinding sensations, reduced motion, and discomfort during everyday activities.

Can shoulder arthritis cause pain down the arm?

Yes. Shoulder arthritis can cause discomfort that extends into the upper arm. However, pain traveling farther down the arm, especially with numbness or tingling, may indicate another condition that needs evaluation.

Can shoulder arthritis be treated without surgery?

Yes. Many patients manage symptoms with physical therapy, activity modification, appropriate medications, and selected injections.

Is shoulder arthritis the same as a rotator cuff tear?

No. Arthritis affects the joint surfaces, while a rotator cuff tear involves the tendons surrounding the shoulder. Both conditions can occur together.

Does shoulder arthritis show up on an X-ray?

Often, yes. X-rays can show joint space narrowing, bone spurs, and other changes associated with arthritis.

When should shoulder arthritis be evaluated by an orthopedic specialist?

Persistent pain, progressive stiffness, loss of motion, nighttime discomfort, or difficulty completing normal activities are reasons to seek evaluation.

Can physical therapy prevent shoulder replacement surgery?

Physical therapy may help some patients manage symptoms and maintain function without surgery. However, it cannot guarantee that surgery will be avoided.

Don’t Let Shoulder Arthritis Limit Your Everyday Activities

Shoulder arthritis can make routine tasks frustrating, especially when pain and stiffness interfere with work, sleep, or the activities you enjoy.

But a diagnosis of shoulder arthritis doesn’t automatically mean surgery is necessary.

Many patients benefit from nonsurgical treatment designed to manage symptoms and preserve function.

When symptoms become more severe or conservative treatments are no longer effective, an orthopedic specialist can discuss additional options.

The most important step is understanding what’s causing your pain and developing a treatment plan that fits your needs.

Schedule a Shoulder Evaluation at Plano Orthopedic & Sports Medicine Center

At Plano Orthopedic & Sports Medicine Center (POSMC), patients have access to orthopedic specialists experienced in diagnosing and treating shoulder conditions.

Whether you’re experiencing persistent shoulder pain, stiffness, limited motion, or difficulty sleeping because of discomfort, a professional evaluation can help determine whether arthritis or another shoulder condition is responsible.

Treatment options may include physical therapy, nonsurgical pain management, and surgical care when appropriate.

Don’t wait until shoulder pain begins affecting every part of your day.

Contact Plano Orthopedic & Sports Medicine Center to schedule an appointment and learn more about available shoulder treatment options.

Visit POSMC to learn more about orthopedic care in Plano, Texas, and surrounding communities.