Shoulder Arthritis: Early Symptoms, Non-Surgical Treatments and When Surgery Is Needed
- Dr. Kushalappa Subbiah
- Dec 17, 2025
- 7 min read
In Brief: Shoulder arthritis develops when cartilage inside the shoulder joint wears down, leading to pain, stiffness, and reduced movement. It progresses gradually and affects daily function. Early symptoms include deep shoulder pain, creaking sensations, and difficulty lifting the arm. Many patients improve with physiotherapy, medications, and lifestyle modifications, but severe cases may require surgical options like shoulder replacement. Early assessment by a shoulder specialist in Bangalore ensures accurate diagnosis and effective treatment.
Shoulder arthritis is a degenerative or inflammatory condition that results in chronic pain and limited mobility of the shoulder joint. Over time, the smooth, protective cartilage covering the bones wears away, causing friction, inflammation, and stiffness. This condition is especially common in middle-aged and older adults, and can also develop after previous injuries or due to autoimmune disease.
Because shoulder arthritis progresses slowly, many people attribute early symptoms to simple fatigue or ageing. The key to successful management is recognising symptoms early and starting appropriate treatment before stiffness becomes severe.
This blog explains the early signs, conservative treatments, and indicators for surgery—designed to help patients make informed decisions about shoulder care.
What Is Shoulder Arthritis?
Shoulder arthritis occurs when the protective cartilage in the shoulder joint gradually breaks down. As cartilage thins, bone surfaces begin to rub against each other, resulting in pain, inflammation, and increasing stiffness.
Types of Shoulder Arthritis
Understanding the type of arthritis helps in selecting the right treatment pathway:
1. Osteoarthritis (Degenerative Arthritis):
This is the most common type and occurs due to age-related wear and tear. The cartilage lining the joint becomes thin and rough, leading to pain, stiffness, and reduced mobility. It usually progresses slowly over the years and is more common in individuals above 50.
2. Rheumatoid Arthritis (Inflammatory Arthritis):
An autoimmune condition where the body’s immune system attacks the synovial lining of the joint. This leads to chronic inflammation, cartilage breakdown, and bone erosion. It often affects both shoulders and may progress more aggressively than osteoarthritis.
3. Post-Traumatic Arthritis:
Develops after previous injuries such as fractures, dislocations, or untreated rotator cuff tears. The joint may become misaligned or structurally altered, accelerating cartilage wear. Symptoms often begin earlier compared to age-related arthritis.
4. Rotator Cuff Tear Arthropathy:
Occurs when a long-standing rotator cuff tear causes abnormal movement in the shoulder joint, leading to accelerated wear and arthritis. These patients often require different surgical options, such as reverse shoulder replacement.
5. Avascular Necrosis (AVN)–Related Arthritis:
In AVN, the blood supply to the humeral head is compromised, causing bone death and eventual cartilage collapse. This leads to severe arthritis and shoulder dysfunction if untreated.
Early Symptoms of Shoulder Arthritis
Shoulder arthritis develops gradually, and early recognition is important.
1. Deep, Aching Shoulder Pain:
Pain is typically felt deep inside the joint rather than on the surface. It may start mildly but becomes more noticeable with activity. Over time, discomfort begins to occur even during rest.
2. Stiffness and Reduced Mobility:
Patients notice difficulty lifting the arm, rotating it outward, or reaching behind the back. Simple activities like dressing or reaching overhead may become restricted.
3. Grinding, Clicking, or Popping Sensation:
As cartilage wears away, the rough bone surfaces create a grinding or crackling feeling during movement. This is more noticeable during overhead or rotational movements.
4. Pain with Overhead or Repetitive Activities:
Tasks like lifting, throwing, or carrying objects may worsen pain. Athletes and manual workers often experience early symptoms during routine activities.
5. Night Pain:
Pain may intensify at night, especially when lying on the affected shoulder. This is often one of the first signs prompting patients to seek help.
6. Weakness and Fatigue:
As the joint becomes stiff, surrounding muscles weaken due to reduced use. Patients feel their shoulders tiring quickly or are unable to support their weight.
How Shoulder Arthritis Is Diagnosed
Diagnosis involves both clinical evaluation and imaging tests to determine the severity and type of arthritis.
1. Detailed Clinical Examination:
The specialist assesses:
Range of motion (active and passive)
Tenderness around the joint
Strength of the rotator cuff muscles
Crepitus (grinding sensation)
Painful arcs or specific movement limitations
A physical exam helps differentiate arthritis from rotator cuff tears, tendinitis, or frozen shoulder.
2. X-rays:
X-rays are the primary imaging tool and show:
Joint space narrowing (loss of cartilage)
Bone spurs (osteophytes)
Bone cysts or sclerosis
Changes in the shape of the humeral head or glenoid
These findings help determine the stage of arthritis.
3. MRI (When Needed):
MRI is used selectively to check for:
Rotator cuff tears
Labrum damage
Joint inflammation
Early-stage arthritis not visible on X-ray
4. CT Scan (Complex or Post-Traumatic Cases):
CT scans give a detailed view of the joint surface and are useful when planning shoulder replacement surgery or assessing deformity after previous injuries.
Non-Surgical Treatment Options for Shoulder Arthritis
Conservative treatment is the first line of management for most patients and can significantly reduce pain and maintain shoulder function.
1. Medications & Injections:
NSAIDs: Help reduce joint inflammation and pain during daily activities.
Corticosteroid Injections: A precise injection into the joint reduces inflammation, providing weeks to months of relief. Particularly useful during pain flare-ups.
Viscosupplementation: In selected cases, lubricating injections may improve movement and reduce friction inside the joint.
2. Physiotherapy & Exercise Therapy:
Physiotherapy remains one of the most effective non-surgical treatments. It focuses on:
Stretching to maintain mobility
Strengthening the rotator cuff and scapular muscles
Improving posture
Restoring coordinated movement patterns
Reducing mechanical stress on the joint
A consistent, guided program helps prevent further stiffness.
3. Activity Modification:
Small adjustments can prevent flare-ups:
Limiting repetitive overhead work
Avoiding heavy lifting
Modifying gym routines
Using proper ergonomics at work
4. Heat Therapy & Home Exercises:
Applying warm compresses before exercise helps relax the joint, making stretching easier.
5. Supportive Aids:
Occasional use of supportive braces or kinesiology taping can relieve stress during activities.
When is Surgery Needed for Shoulder Arthritis?
Surgery is recommended only after non-surgical measures have been tried consistently. Indicators include:
1. Persistent pain that limits daily life: When pain remains constant and affects routine tasks such as dressing, cooking, lifting, or sleeping.
2. Severe stiffness and restricted motion: If physiotherapy does not improve mobility, and shoulder function continues to decline.
3. X-rays showing advanced arthritis: Significant joint space loss, deformity, or bone-on-bone contact indicates that conservative treatment is unlikely to restore function.
4. Post-traumatic structural damage: In cases where previous injuries have altered joint alignment or created mechanical symptoms like catching or grinding.
5. Failed response to injections and medication: When multiple rounds of conservative care no longer offer meaningful relief.
Surgical Treatment Options for Shoulder Arthritis
1. Arthroscopic Debridement:
A minimally invasive option that removes loose cartilage, bone spurs, or inflamed tissue. Helps improve the smoothness of movement in early arthritis.
2. Total Shoulder Replacement:
Ideal for advanced osteoarthritis with an intact rotator cuff. Artificial components replace the damaged joint surfaces, restoring comfort and function.
3. Reverse Shoulder Replacement:
Recommended when arthritis is accompanied by a deficient or torn rotator cuff. The reversed design allows the deltoid muscle to compensate for rotator cuff weakness.
Recovery Expectations After Surgery
Recovery depends on the type of surgery, but generally follows a structured timeline:
1. Week 0-2:
Arm supported in a sling
Gentle wrist, elbow, and early shoulder movements
Pain reduces gradually
2. Week 3-6:
Guided physiotherapy begins
Focus on restoring the passive range of motion
Gradual reduction of sling use
3. Week 6-12:
Active strengthening exercises start
Improved overhead movement
Increased daily activity tolerance
4. Month 3-6:
Significant improvement in strength and flexibility
Return to most routine activities
Minimal pain with movement
5. Month 6 Onwards:
Continued strengthening
Full functional recovery for everyday activities
Long-term comfort and improved quality of life
When to See a Shoulder Specialist in Bangalore for Shoulder Arthritis
You should consult a specialist if you experience:
Pain lasting longer than 3 to 4 weeks
Difficulty lifting or rotating the arm
Night pain affecting sleep
Stiffness that limits daily activities
Previous injury with ongoing discomfort
Early specialist evaluation ensures the right diagnosis and treatment plan.
Why Patients Choose Dr. Kushalappa Subbiah for Shoulder Arthritis Treatment
Dr. Kushalappa Subbiah is a fellowship-trained shoulder and elbow specialist in Bangalore, with advanced expertise in treating all forms of shoulder arthritis. His approach includes:
Accurate diagnosis tailored to each patient
Comprehensive non-surgical management
Expertise in arthroscopic and joint replacement techniques
Personalised rehabilitation plans for long-term improvement
His goal is to restore pain-free mobility and improve quality of life through evidence-based care.
Final Thoughts: Managing Shoulder Arthritis With the Right Care
Shoulder arthritis can significantly affect daily function, but early recognition and structured treatment can slow progression and maintain mobility. With a combination of physiotherapy, lifestyle adjustments, and targeted interventions, many patients experience meaningful relief without surgery. For those with advanced arthritis, modern surgical options offer excellent long-term outcomes.
If shoulder pain or stiffness is affecting your quality of life, consulting a shoulder specialist in Bangalore ensures a personalised treatment plan that supports safe and effective recovery at every stage.
Frequently Asked Questions (FAQs)
1. What are the early signs of shoulder arthritis?
Early signs include deep shoulder pain, stiffness, difficulty lifting the arm, grinding or clicking sounds, and night pain when lying on the affected side. As the condition progresses, movement becomes more restricted and daily activities feel increasingly uncomfortable.
2. Can shoulder arthritis be treated without surgery?
Yes. Most patients improve with non-surgical treatments such as physiotherapy, anti-inflammatory medications, heat therapy, activity modification, and corticosteroid injections. These options help reduce pain, improve mobility, and delay the progression of arthritis.
3. When should someone consider surgery for shoulder arthritis?
Surgery is considered when pain persists despite months of physiotherapy, medications, and injections, or when X-rays show advanced cartilage loss. Severe stiffness, difficulty performing daily activities, or post-traumatic changes are also strong indicators for surgical treatment, including shoulder replacement.
Comments