Shoulder Osteoarthritis (Omarthrosis): Causes, Symptoms and Treatment

Reaching for a high shelf, putting on a jacket, washing your hair: movements that used to be second nature can suddenly become painful with shoulder osteoarthritis. Many people notice increasing stiffness at first, or protect the shoulder without realising it. Over time, though, even everyday movements become harder.

Shoulder osteoarthritis is one of the most common causes of chronic shoulder pain and mainly affects people over the age of 60. The good news: when it’s recognised early, symptoms can often be eased significantly and mobility preserved for many years. Modern conservative and joint-preserving therapies can help delay surgery for as long as possible, or avoid it altogether.

On this page, you’ll find out how shoulder osteoarthritis develops, which symptoms are typical, how it’s diagnosed and which treatment options are available today, from conservative measures through to surgical procedures.

What is shoulder osteoarthritis?

The shoulder joint is made up of the head of the humerus and the socket of the shoulder blade, known as the glenoid. Both joint surfaces are covered with a smooth layer of cartilage. This cartilage acts as a natural shock absorber: it spreads the load evenly and allows the joint surfaces to glide against each other almost without friction.

In shoulder osteoarthritis, this protective cartilage gradually wears away. As a result, the joint glides less smoothly and the underlying bone comes under greater strain. As the wear progresses, this leads to pain, reduced mobility and often inflammation in the joint.

Doctors generally distinguish between two forms of shoulder osteoarthritis:

Primary shoulder osteoarthritis develops without a clearly identifiable cause. Age, genetic predisposition and the joint's natural wear usually play a role.

Secondary shoulder osteoarthritis develops as a result of another condition or injury, for example after a fracture of the humeral head, a shoulder dislocation, damage to the rotator cuff or an inflammatory joint disease.

The shoulder is the most mobile joint in the human body. This enormous range of movement gives it a wide radius of action in everyday life and in sport. At the same time, it also makes the joint more prone to wear and injury than many other joints.

Shoulder osteoarthritis in brief:

Shoulder osteoarthritis, also known as omarthrosis, is the progressive wear of the joint cartilage in the shoulder. As a result, the humeral head and the glenoid no longer glide smoothly against each other. This leads to pain, reduced mobility and increasing stiffness in the shoulder. The earlier the condition is recognised, the more often its progression can be slowed.

Our treatment philosophy: joint preservation before joint replacement

At Proarthros, we follow a clear principle: the natural shoulder joint should be preserved for as long as possible.

That’s why we first explore all conservative and regenerative treatment options before discussing surgery. The aim is to relieve pain, improve mobility and slow the wear of the joint wherever possible.

We only recommend a shoulder replacement once conservative measures no longer provide sufficient relief and your symptoms are significantly and permanently affecting daily life. Together with you, and based on careful diagnostics, we decide which treatment makes medical sense for your individual situation.

Causes: how does shoulder osteoarthritis develop?

Not every case of shoulder osteoarthritis has the same cause. In some people, the condition develops slowly with age, while in others, it results from an injury or an existing shoulder condition.

Primary shoulder osteoarthritis

With primary shoulder osteoarthritis, no clear cause can be identified. The joint cartilage wears away slowly over many years.
This process is encouraged by factors including:

Secondary shoulder osteoarthritis

Secondary shoulder osteoarthritis has a specific underlying cause. It often develops as a result of an injury or another shoulder condition.
The most common triggers include:

fractures of the humeral head or other bone injuries
shoulder dislocations
damage to the rotator cuff
chronic overuse at work or in sport
inflammatory joint diseases such as rheumatism or arthritis
previous shoulder surgery

Depending on the cause, joint wear can progress at different speeds. This is why accurate diagnostics are essential for choosing the right treatment.

Symptoms: how to recognise shoulder osteoarthritis

Shoulder osteoarthritis usually develops gradually. At first, symptoms often occur only with certain movements or after heavier strain. As cartilage wear progresses, however, the pain can increase and eventually occur at rest or at night too.
Typical symptoms of shoulder osteoarthritis include:

pain when moving the arm above shoulder height
pain when putting on a jacket or washing your hair
discomfort when reaching for a high shelf
morning stiffness or start-up pain
reduced mobility in the shoulder
grinding or grating noises in the joint
pain that can radiate into the neck, upper arm or back
reduced strength in the affected arm

Many patients also report that they struggle to reach their seatbelt, can no longer fasten a bra, or increasingly avoid everyday overhead tasks. These changes often develop gradually and are initially mistaken for a normal sign of ageing.

The earlier shoulder osteoarthritis is recognised, the greater the chances of relieving symptoms and preserving the
joint’s function in the long term.

Diagnosis: how is shoulder osteoarthritis identified?

Not every painful shoulder is caused by osteoarthritis. Conditions affecting the tendons, muscles or bursae can cause similar symptoms. That’s why careful diagnostics are essential to identify the real cause of your pain.
We begin with a detailed conversation between doctor and patient. We talk about your symptoms, how they’ve developed, any previous injuries and existing conditions. We then examine your shoulder specifically for mobility, strength, stability and areas of pain.

Depending on the findings, we supplement the examination with modern imaging techniques:

X-ray

An X-ray shows changes in the joint space, bony growths (osteophytes) and the degree of joint wear, forming the basis of osteoarthritis diagnosis.

Ultrasound

Ultrasound allows tendons, bursae and the rotator cuff in particular to be assessed without radiation. This helps identify or rule out any accompanying conditions.

MRI (magnetic resonance imaging)

MRI provides detailed, radiation-free information about cartilage, tendons, muscles and other soft-tissue structures. It’s mainly used when additional damage is suspected.

CT (computed tomography)

A CT scan is usually only needed for specific questions or to plan a shoulder replacement.

Shoulder osteoarthritis or another condition?

Shoulder pain can have many possible causes. Besides shoulder osteoarthritis, conditions such as calcific tendinitis, a rotator cuff tear, shoulder impingement syndrome or bursitis can also be behind your symptoms.

Because these conditions can present in very similar ways, we always look at the shoulder as a functional whole. Only once the actual cause has been established can treatment be targeted and successful.

Your path to treatment at Proarthros in Berlin

Patients who come to us with shoulder problems mainly want to know one thing: where the pain is coming from, and which treatment will really help. That’s why every appointment at Proarthros follows a clearly structured process.

1. Detailed initial consultation
We start by talking about your symptoms, how they’ve developed, and any previous injuries or treatments.

2. Thorough examination
We then examine the mobility, stability and function of your shoulder and assess which structures could be causing your symptoms.

3. Modern diagnostics
Depending on the findings, we supplement the examination with ultrasound and, if needed, MRI or further imaging.

4. Individual treatment planning
Based on all the findings, we discuss the various treatment options with you and put together a treatment plan tailored to your personal situation.

“Our goal is for you to leave the appointment knowing exactly where your symptoms come from
and which next steps make sense.”

Treatment: what options are available?

Which treatment makes sense for shoulder osteoarthritis depends, among other things, on the extent of cartilage wear, your symptoms and your personal goals. While early stages can often be treated successfully with conservative measures, surgery may be necessary in some cases of advanced osteoarthritis.

At Proarthros, we generally take a joint-preserving approach. Our aim is to relieve pain, improve mobility and preserve your natural shoulder joint for as long as possible. We only recommend surgery once conservative and regenerative treatments no longer provide sufficient relief.

Conservative treatment

In many cases, shoulder osteoarthritis can be treated successfully without surgery for a long time. What matters is starting treatment early and tailoring it to your individual symptoms. The aims of conservative treatment are to:

Depending on the findings, various options may be suitable.

Anti-inflammatory painkillers such as ibuprofen or diclofenac can relieve pain and reduce acute inflammation. They are mainly suited to short-term treatment of more severe symptoms and should only be taken long-term after consulting a doctor.

For severe pain, injections directly into the shoulder joint can be helpful. Cortisone has an anti-inflammatory effect and can bring rapid relief, particularly during acute flare-ups. Hyaluronic acid is intended to improve the joint’s gliding ability and can temporarily ease symptoms in selected patients. However, the effect varies from person to person and is time-limited.

Physiotherapy is an important part of treatment. Targeted mobilisation and strengthening exercises can help stabilise the shoulder muscles, improve movement patterns and often reduce pain long-term. An individually tailored exercise programme helps many patients keep their shoulder mobile in the long run.

Heat treatment can loosen tense muscles and ease chronic symptoms. Cold, on the other hand, is mainly used for acute inflammation or flare-ups. Depending on the situation, electrotherapy can also be a useful addition.

In suitable patients, stem cell therapy can be a further joint-preserving treatment option. The aim of treatment is to relieve pain, preserve the function of the shoulder joint for as long as possible and delay the point at which joint replacement may become necessary. Whether stem cell therapy is an option depends, among other things, on the extent of the cartilage damage and other individual factors. Stem cell therapy doesn’t replace the well-established standard conservative treatments and isn’t suitable for every form of shoulder osteoarthritis. That’s why we carefully assess, as part of a thorough examination, which treatment makes sense in your personal situation. You can find more information on our page about

Surgical treatment

If conservative measures are no longer sufficient in the long term, and pain or reduced mobility is significantly affecting your daily life, surgery may become the right option. Which surgical method is suitable depends on the extent of the osteoarthritis and the condition of the surrounding tendons and muscles.

In selected cases of early shoulder osteoarthritis, arthroscopic treatment can be useful. This involves flushing out the joint and removing any tissue that is causing problems. The aim is to relieve symptoms and improve mobility, although long-term success depends largely on the individual case.

If joint wear is very advanced, an artificial shoulder joint may become necessary. When the rotator cuff is intact, an anatomical shoulder replacement is generally used, which recreates the joint’s natural structure. If the rotator cuff is no longer functioning, a reverse shoulder replacement is often used instead. Here, the positions of the joint head and socket are reversed, allowing other muscle groups to take over the shoulder’s movement. Modern shoulder replacements typically last around 10 to 15 years, although this can vary depending on strain and individual circumstances. After surgery, an individually tailored rehabilitation programme with physiotherapy follows. In the first few weeks, the shoulder is initially protected and then gradually reintroduced to normal loads.

Self-help: what can you do yourself?

Although shoulder osteoarthritis can’t be reversed, there’s a lot you can do yourself to relieve symptoms and preserve mobility for as long as possible. The key is to keep moving the shoulder regularly, without overloading it.

Exercises at home

Many people protect their shoulder out of fear of pain. In fact, prolonged protective posture often causes the muscles to weaken, which further limits mobility.
Regular, joint-friendly exercises, on the other hand, can help keep the shoulder mobile and reduce pain.
Suitable exercises include:

It’s important that all exercises are carried out in a controlled way and, as far as possible, without pain. If you experience stronger pain, stop the exercise and have a doctor check whether any adjustments are needed.

Daily life and sleep

Even small changes to your daily routine can take the strain off your shoulder.
It helps to:

carry heavy loads as close to your body as possible
avoid sudden, jerky movements
reduce prolonged overhead work
keep moving the shoulder regularly rather than keeping it still for long periods
set up your workspace ergonomically

For a restful night’s sleep, it’s best to sleep on your back or on your unaffected side if possible. A pillow under the affected arm can take further pressure off the shoulder joint.
Heat treatment often helps with muscular tension. During acute inflammation, however, many patients find cold more soothing.

Diet and shoulder osteoarthritis

A balanced diet can’t replace medical treatment, but it can support the body in positively influencing inflammatory processes.
Recommended foods include:

Highly processed foods, excessive sugar and alcohol, on the other hand, should be kept to a minimum.

Sport with shoulder osteoarthritis: what's possible?

Many patients wonder whether they can keep doing sport despite having shoulder osteoarthritis. The short answer is yes: exercise is actually one of the most important parts of treatment. Regular physical activity strengthens the muscles around the shoulder joint, improves mobility and can reduce pain in the long term. The key is not to overload the shoulder. Well-suited activities include:

Less suitable are sports involving frequent overhead movements or heavy strain on the shoulder, such as:

handball
basketball
squash
climbing
gymnastics
weight training with heavy loads
combat sports

Which activities make sense in your case depends, among other things, on the stage of your osteoarthritis and any previous treatment. We’re happy to advise you individually on this.

When should you see a doctor?

Shoulder pain doesn’t always go away on its own. If your symptoms persist over a longer period or get worse, the cause should be investigated early. Book an appointment if:

shoulder pain continues despite resting it
mobility is becoming increasingly limited
night pain is disturbing your sleep
you're losing strength in your arm
everyday movements are becoming increasingly difficult

The earlier shoulder osteoarthritis is diagnosed, the greater the chances of preserving the joint in the long term and avoiding surgery wherever possible.

Frequently asked questions about shoulder osteoarthritis

What can be done about shoulder osteoarthritis?

Depending on the stage, options include physiotherapy, medication, injections, targeted exercises and, for suitable patients, regenerative treatments such as stem cell therapy. Surgery is only considered once these measures no longer provide sufficient relief.

Is shoulder osteoarthritis curable?

No. Cartilage damage that has already occurred currently can’t be fully reversed. The aim of treatment is to relieve pain, preserve mobility for as long as possible and slow the progression of the osteoarthritis.

Can shoulder osteoarthritis be treated without surgery?

In many cases, yes. Especially in early and moderate stages, symptoms can often be treated conservatively for a long time. Which therapy makes sense depends on your individual findings.

Can stem cell therapy help with shoulder osteoarthritis?

In suitable patients, stem cell therapy can be a joint-preserving treatment option. Whether it’s suitable depends, among other things, on the extent of the cartilage damage and other individual factors, and is assessed as part of a thorough examination.

Where can the pain radiate to?

Pain can radiate from the shoulder joint into the upper arm, neck or upper back. Because of this, the actual cause of the symptoms isn’t always recognised straight away.

How should I sleep with shoulder osteoarthritis?

Sleeping on your back or on your unaffected side is often the most comfortable option. A pillow under the affected arm can help take the pressure off the shoulder joint.

What's the difference between calcific tendinitis and shoulder osteoarthritis?

With calcific tendinitis, calcium deposits in the tendons cause the symptoms. With shoulder osteoarthritis, on the other hand, it’s the joint cartilage that has worn away. Both conditions can cause similar symptoms but require different treatments.

Which movements should I avoid?

Above all, avoid sudden overhead movements, heavy lifting and sports that put heavy strain on the shoulder. Regular, controlled movement, on the other hand, is usually beneficial and helps preserve joint function.

Treat shoulder osteoarthritis early and preserve mobility

Shoulder osteoarthritis doesn’t automatically mean surgery is required. When the condition is recognised early, symptoms can often be significantly relieved with conservative, joint-preserving treatment methods.
At Proarthros, we take the time for careful diagnostics and develop an individual treatment plan together with you. Our aim is to reduce pain, preserve your mobility and keep your natural shoulder joint for as long as possible.
Book an appointment with us in Berlin now and have your shoulder symptoms examined by a specialist.