Do I need a shoulder replacement?

Not for most patients, at least not for a long time. Shoulder arthritis usually progresses slowly, and activity modification, therapy, and PRP injections manage many people well for years. Joint replacement is the definitive treatment when arthritis is advanced and pain limits daily life. When that point is reached, Dr. Lee performs shoulder replacement, including both anatomic and reverse total shoulder replacement, selecting the approach based on the arthritis and the condition of the rotator cuff.

Why does my shoulder grind and feel stiff?

As the cartilage that lines the ball and socket wears away, the bones begin to rub, which produces grinding, deep aching pain, and stiffness, especially reaching behind the back. X-rays confirm the diagnosis, and an MRI is added when the rotator cuff or cartilage needs closer evaluation.

Yes. Corticosteroid injections can relieve pain and, combined with activity modification and a therapy program, are a mainstay of non-surgical management. They do not reverse the arthritis, but they can keep the shoulder comfortable and functional, often for a long time.

Shoulder Arthritis (Glenohumeral), Steven J. Lee, MD

Glenohumeral arthritis is the loss of the smooth cartilage that lines the ball and socket of the shoulder. As the cartilage wears, the bones rub, which produces deep aching pain, stiffness, and a grinding sensation. It can come from age, prior injury, or inflammatory conditions.

Shoulder arthritis tends to progress slowly, and many people manage well for a long time with non-surgical care. The goal of treatment is to control pain and keep the shoulder functioning, with surgery considered when arthritis is advanced and quality of life is affected.

Symptoms

Common complaints include:

Deep, aching shoulder pain, often worse with activity and at night
Stiffness and loss of motion, especially reaching behind the back
Grinding or catching with movement
Pain that has built up gradually over months to years

How it is diagnosed

X-rays show the joint narrowing and bone changes of arthritis. An MRI is added when the cartilage, rotator cuff, or labrum needs closer evaluation, because the state of the rotator cuff influences which treatments are appropriate.

Dr. Lee's approach

Dr. Lee treats shoulder arthritis conservatively for as long as it controls symptoms, with activity modification, a therapy program to maintain motion and strength, anti-inflammatory measures, and injections such as PRP or Hyaluronic acid. Many patients do well with this approach for years.

When arthritis is advanced and pain limits daily life, Dr. Lee performs shoulder replacement, including both anatomic and reverse total shoulder replacement. He selects the approach based on the severity of the arthritis, the condition of the rotator cuff, and your goals, a reverse replacement is preferred when the rotator cuff is deficient.

Non-surgical treatment

Activity modification, a structured therapy program to maintain motion and strength, anti-inflammatory measures, and PRP or Hyaluronic Acid injections manage many patients well, often for years. The aim is to control pain and preserve function.

When arthritis is advanced

For advanced arthritis that limits daily life, joint replacement is the definitive treatment, and Dr. Lee performs both anatomic and reverse total shoulder replacement. The choice between them depends largely on the rotator cuff: a reverse replacement is used when the cuff is deficient. Dr. Lee weighs the arthritis, the cuff, and your goals in selecting the approach.

When performing shoulder replacements, Dr. Lee utilizes the most advanced techniques including a patient-specific preoperative planning system utilizing detailed CT scans to build a 3D digital model of the patient’s shoulder, enabling Dr. Lee to custom-design implant sizes and placement for both anatomic and reverse total shoulder replacements.

Recovery timeline

Recovery depends on the treatment and is guided individually:

Non-surgical
Ongoing activity modification, physical therapy, and periodic injections as needed to control symptoms.
After surgery, early
Protected motion in a sling for 4-6 weeks, with gentle guided range of motion as directed by a physical therapist.
After surgery, later
Progressive strengthening and a graded return to activity over several months. Full recovery can take 6 months.

What patients commonly misunderstand

Two things that reassure patients:

The rotator cuff matters. The condition of the rotator cuff strongly influences which treatments are appropriate for shoulder arthritis, which is why imaging looks at the cuff as well as the cartilage.
Many patients avoid surgery for years. Shoulder arthritis usually progresses slowly. With activity modification, therapy, and injections, many people manage well for a long time before any operation is considered.

This page is general educational content authored by Dr. Lee. It is not a substitute for individual medical advice. Every patient's case is different, book a consultation to discuss yours.

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Living with deep, stiff shoulder pain? There is a lot that can be done before surgery.

Shoulder arthritis usually progresses slowly, and many patients are managed well for years with activity modification, therapy, and injections. When arthritis is advanced, Dr. Lee performs the definitive treatment, anatomic and reverse total shoulder replacement, selecting the approach based on the condition of the rotator cuff.

Shoulder Arthritis: deep, stiff, aching shoulder pain.