Shoulder arthritis tends to announce itself quietly: a shoulder that aches after golf, trouble reaching the back seatbelt, sleep interrupted when you roll onto that side. By the time most patients see me, they''ve been adapting around it for years. The good news is that treatment isn''t a binary choice between suffering and surgery — it''s a spectrum, and we climb it one step at a time.
## Step one: the foundation
Care starts with the simplest, least invasive interventions that can help you achieve your goals. Physical therapy focused on the rotator cuff and scapular stabilizers often delivers surprising improvement — not because it reverses arthritis, but because a well-conditioned shoulder loads the damaged joint more efficiently. Activity modification, anti-inflammatory strategies, and a structured home program round out the base.
## Step two: injections and orthobiologics
Corticosteroid injections can calm an inflamed arthritic shoulder effectively, though relief is typically temporary. For early to moderate wear, orthobiologic treatments — PRP, microfat, and bone marrow concentrate — offer an option aimed at the joint environment itself, with the goal of longer-lasting improvement. Candidacy depends on severity, and this is where an honest assessment of your imaging matters.
## Step three: when replacement is the right answer
When arthritis is advanced and the simpler steps no longer hold — pain dominating sleep, function genuinely lost — shoulder replacement is one of the most successful operations in orthopedics. Modern anatomic and reverse replacements reliably relieve pain and restore function. Recovery typically involves about a month in a sling, with return to most activities by four to six months.
## How we choose
The right step depends on your X-rays, your exam, your goals, and honestly appraising what each option can deliver for your particular shoulder. Some patients never climb past step one. Others are best served by going straight to replacement rather than spending a year on treatments unlikely to work.
The point is that it''s a planned progression, tailored to you — not a leap. If shoulder arthritis is limiting your life, come in and let''s map your options.