What Is Shoulder Arthritis?
Shoulder arthritis is the deterioration of the smooth articular cartilage that lines the glenohumeral joint — the ball-and-socket joint formed by the head of the humerus and the glenoid of the scapula. Healthy cartilage allows the joint surfaces to glide effortlessly; when it wears away, the exposed bone ends rub against each other, producing pain, inflammation, stiffness, and progressive joint damage.
The most common form is osteoarthritis, a degenerative process driven by aging and mechanical wear. Shoulder arthritis can also occur as a consequence of a prior injury (post-traumatic arthritis), inflammatory disease such as rheumatoid arthritis, or advanced rotator cuff disease — a condition called cuff tear arthropathy. Dr. Jay Levin at Duke Health in Durham, NC, is experienced in diagnosing and treating all forms of shoulder arthritis, serving patients throughout North Carolina including Cary, Chapel Hill, and Raleigh.
Causes
Shoulder arthritis develops when the protective cartilage within the glenohumeral joint is progressively lost. Contributing factors include:
- Age and wear — Cartilage naturally thins over time, and repetitive loading accelerates this process.
- Prior shoulder injury — Fractures, dislocations, or significant ligament injuries can alter joint mechanics and lead to post-traumatic arthritis years later.
- Rotator cuff disease — A massive rotator cuff tear allows the humeral head to migrate upward and abrade the overlying acromion and glenoid, causing cuff tear arthropathy.
- Inflammatory arthritis — Rheumatoid arthritis and other autoimmune conditions cause synovial inflammation that erodes cartilage from the inside out.
- Avascular necrosis — Loss of blood supply to the humeral head leads to bone collapse and secondary arthritis.
- Genetic predisposition — A family history of arthritis increases individual risk.
When to See a Specialist
Consider scheduling an evaluation if you notice:
- Shoulder pain that interferes with daily activities such as reaching overhead, dressing, or sleeping
- Progressive stiffness that does not improve with stretching or home exercises
- A grinding or grating sensation (crepitus) during shoulder movement
- Swelling or warmth around the shoulder joint
- Pain that has not responded to rest, physical therapy, or over-the-counter anti-inflammatories
Early evaluation allows Dr. Levin to confirm the diagnosis with X-rays and, when needed, MRI, and to initiate the most appropriate treatment before the joint deteriorates further.
Treatment Options at Duke Health
Dr. Jay Levin provides individualized shoulder arthritis care at Duke Health in Durham, NC, with a strong preference for nonsurgical management when appropriate.
Nonsurgical treatment includes:
- Physical therapy focused on range-of-motion and periscapular strengthening
- NSAIDs and topical anti-inflammatory agents
- Corticosteroid injections to reduce inflammation and pain
- Hyaluronic acid (viscosupplementation) injections in selected cases
- Activity modification and ergonomic guidance
Surgical treatment is recommended when conservative measures no longer control symptoms or when imaging shows severe joint destruction. Dr. Levin performs:
- Anatomic total shoulder replacement (TSA) — Replaces the arthritic ball and socket with an implant that recreates normal shoulder anatomy. Ideal for patients with intact rotator cuff tendons and good bone stock.
- Reverse total shoulder replacement (rTSA) — Reverses the joint geometry, enabling the deltoid muscle to power elevation when the rotator cuff is deficient or irreparable. Also used as a primary option in elderly patients with complex fractures or massive cuff tears.
- Shoulder hemiarthroplasty — Replaces only the humeral head; considered in specific cases such as avascular necrosis with preserved glenoid cartilage.
- Arthroscopic débridement — A minimally invasive option for early-stage arthritis in younger patients who are not yet candidates for replacement, providing temporary symptom relief.
Shoulder replacement is one of the most reliably successful operations in orthopaedic surgery, with high rates of pain relief and patient satisfaction. Dr. Levin will guide you through the decision-making process and help you understand what to expect at every stage of recovery.