What it is
Glenohumeral osteoarthritis is characterised by cartilage loss and joint changes in the ball-and-socket joint. Pain, stiffness, and grinding limit reach and load. It follows age-related change, prior injury, or heavy cumulative use.
Goals are to reduce pain, maintain range of motion, and build strength for reliable daily function. Joint replacement is considered when a person's function has stalled and a considerable impact on activities of daily living and personal care is experienced.
What happens when it occurs
Cartilage thins and bone adapts. The capsule tightens, and the muscles around the joint weaken. With planned loading and strength work, pain usually settles and confidence returns.
Common causes and risk factors
- Ageing and family history
- Post-traumatic change after fractures or instability
- High physical workload over the years
- Higher body weight and metabolic health factors
Who is most affected
Older adults. Individuals with a history of shoulder injury tend to present earlier.
Typical symptoms
- Deep shoulder ache with reach and lifting
- Start-up stiffness that eases with movement
- Catching or grinding sensations
When to seek care
If pain limits dressing, grooming, or sleep, or if overhead work becomes unreliable.
How we diagnose
History and examination of range, strength, and function. X-rays show joint space changes and osteophytes. MRI is reserved for use in complex cases or for surgical planning.
Management
- Education on pacing and task changes
- Strength for rotator cuff, deltoid, and scapular muscles
- Range work for the capsule and thoracic mobility
- Analgesics and image-guided injections for flares
- Anatomic total shoulder replacement for persistent limitation; reverse replacement when the cuff is deficient
Rehabilitation milestones
Phase 1 weeks 0 to 4: pain control, gentle range, deltoid and cuff activation.
Phase 2 weeks 4 to 12: progressive strength, functional reach and carry.
Phase 3 months 3 to 6: overhead tolerance, work and sport tasks.
Post-arthroplasty: Hospital and clinic protocols guide staged loading.
Readiness to progress
- Pain is stable across a week
- Elevation and hand behind the back, improving
- Strength and endurance targets met
Long-term care
- Maintain strength and a healthy weight
- Plan workloads during busy weeks
- Keep simple mobility habits for capsule health
Australia snapshot
- Less common than hip and knee arthritis, but a regular reason for referral
- Post-traumatic patterns feature after contact sports and falls
- Shoulder arthroplasty services are available in metropolitan centres
Latest insights
Strength around a stiff joint changes pain and function more than any single modality.
Surgery is for functions that stall despite a well-run program.
