The short answer
Shoulder arthritis is the progressive loss of cartilage cushioning the shoulder joint, common after age fifty. As the bones move closer together it causes pain, morning stiffness that eases with activity, and night pain. Non-surgical care includes rotator cuff physical therapy, limited cortisone injections, PRP, and microfragmented fat; replacement is a last resort.
Medically reviewed by Marc Gruner, DO, MBA, RMSK
Sports medicine physician, Mayo Clinic fellowship. Last reviewed June 2026
Overview
Shoulder arthritis is an age-related degenerative condition in which the cartilage cushioning the joint deteriorates and the bones gradually move closer together, producing pain, stiffness, and reduced mobility. It is common in people over fifty and can be aggravated by weakness or overuse.
Early on, pain often fluctuates — worse with overuse and at night, better with gentle movement. Dr. Gruner focuses on rotator cuff strengthening, cortisone injections, and orthobiologics such as PRP or microfragmented fat before considering total or reverse shoulder replacement. Cortisone relief tends to be short term, and it should not be repeated more than three times in a year.
Common symptoms
- Shoulder pain, sometimes referred to the neck or elbow
- Morning stiffness that improves with activity
- Pain at night
- Pain that worsens with overuse
Videos from Dr. Gruner
Arthritis vs. Arthrosis — Inflammation vs. Wear and Tear
What to expect at your visit
- 1.
A focused conversation
Dr. Gruner reviews your history, prior imaging, and goals — what you want to get back to doing.
- 2.
Point-of-care ultrasound
When useful, a diagnostic musculoskeletal ultrasound evaluates the injury in real time, with no radiation.
- 3.
A clear, individualized plan
You leave understanding the diagnosis, the non-surgical options, and the expected timeline — in plain language.
Rehabilitation protocol
What to expect week by week after your procedure. Your plan is individualized; follow these alongside your physical therapist.
Shoulder — Ultrasound-Guided Lipogems / PRP Protocol
Week 1
Protect, reduce pain and swelling
- Sling for 7 days; begin weaning after day 3
- No lifting > 5 lbs; avoid overhead activity 2 weeks
- Don't sleep on the procedure side
- Begin gentle active ROM (pendulums) 4×/day
Week 2
Begin active range of motion
- No lifting > 10 lbs; avoid overhead activity
- Continue AROM and PROM
- Begin isometrics and thoracic mobility
- Stop any exercise if pain > 4/10
Weeks 3–6
Shoulder strengthening
- May lift 10–20 lbs; avoid eccentrics
- Continue active ROM
- Progressive strengthening
Weeks 6–12
Return to sport
- Activities as tolerated
- Begin eccentric training/loading
- Sport-specific exercises
Do not use NSAIDs (ibuprofen, Aleve, aspirin) for 4 weeks, and avoid ice for the first week — both blunt the healing response. Acetaminophen (Tylenol) is fine for discomfort. Care is tailored to you; use these guidelines with your physical therapist.
Frequently asked questions
- What non-surgical treatments help shoulder arthritis?
- Physical therapy focused on the rotator cuff, activity modification, a limited number of cortisone injections per year, and orthobiologics such as PRP or microfragmented fat can reduce pain and maintain function before surgery is considered.