Thinking about shoulder replacement? Here’s what you should know 

If you’re dealing with persistent shoulder pain that’s affecting your sleep and daily activities, you might be surprised to learn that shoulder replacement could be an option for you.

“I hear it all the time,” says Rufus Van Dyke IV, MD, an orthopedic surgeon with MultiCare Orthopedics & Sports Medicine. “People tell me, ‘I didn’t even know you could replace a shoulder.’”

Although not as well-known as hip or knee replacement — which most people are familiar with through friends or family members who have had one — shoulder replacement is equally transformative.

Why consider a shoulder replacement?

The shoulder is an incredibly complex joint that gives the arms immense range of motion and function. It allows you to reach, lift, throw, carry, comb your hair or grab something from a high shelf.

But when you’re experiencing pain in the shoulder joint from arthritis, a rotator cuff tear or a fracture, simple movements can become difficult or impossible.

“For many people, the tipping point is sleep,” Dr. Van Dyke says. “They come in to see me because they can’t sleep. They can’t find a comfortable position to sleep in, and it starts affecting every part of their life.”

Shoulder replacement can relieve that pain and restore lost motion — sometimes even when it’s been years since a person could lift their arm overhead.

When other options don’t help your shoulder pain

In many cases, physical therapy (PT) or other nonsurgical treatments come first.

“We talk through the anatomy of what’s happening in the shoulder, talk about their specific goals and go through their treatment options,” Dr. Van Dyke explains. “PT might be the best option for them and might get them to the result they’re looking for.”

But if nonsurgical methods haven’t helped, or if the tissue in the shoulder is too damaged or not suitable to be repaired, shoulder replacement surgery may be worth considering.

“It’s not just for people with completely nonfunctioning shoulders,” he adds. “Even patients with ongoing pain or limited strength may benefit.”

How shoulder replacement works

Shoulder replacement involves removing the damaged parts of the shoulder joint and replacing them with artificial components. Unlike hip and knee replacement, shoulder replacement often needs to account for soft tissue, especially the rotator cuff.

“In some cases, we can adjust the mechanics of the joint so you don’t need every muscle functioning the way it used to,” Dr. Van Dyke says. “That’s what’s so exciting — being able to restore motion and function even when the anatomy isn’t repairable.”

What shoulder surgery recovery looks like

Shoulder replacement surgery is typically followed by a few months of recovery and physical therapy.

In the first six weeks, expect to focus on gentle movement and protection of the joint. You’ll wear a sling and begin basic exercises to maintain mobility.

After six weeks, you’ll work on restoring range of motion and building strength. It can take a few more months for strength to be fully restored.

Compared to knee replacement, shoulder replacement surgery generally involves less post-operative pain and a slower, more gradual rehabilitation process.

“We give patients very specific instructions on exercises they need to do, but it’s typically not as aggressive or rehab-intensive as recovering from a knee replacement,” Dr. Van Dyke explains.

Life-changing results

While most shoulder replacements are done in midlife to retirement age, Dr. Van Dyke says he sees a wide age range.

“In younger patients, we often try repair-focused surgeries because the tissue is more responsive,” he says. “But as we age, that healing potential decreases, and that’s when replacement becomes a better option.”

Dr. Van Dyke recalls a patient who hadn’t been able to raise his arm above his head for some time.

“He was very distraught about it; he felt like he didn’t know what to do,” Dr. Van Dyke says. “We talked through his options, and he decided to move forward with replacement surgery.”

When Dr. Van Dyke saw him at a follow-up appointment a few months later, the man raised his arm effortlessly over his head and had tears in his eyes.

“He said to me, ‘I didn’t think I’d ever be able to do that again,’” Dr. Van Dyke recalls. “I love when I can see patients improve. It doesn’t get old.”

You don’t have to live with shoulder pain

If your shoulder pain is interfering with sleep, daily activities or the ability to care for yourself, don’t assume you have to live with it. Discuss your symptoms with your doctor or other health care provider.

“Unfortunately, some people accept they have a bum shoulder and they’ll never reach overhead again,” Dr. Van Dyke adds. “But with the right approach, we can get that motion and their quality of life back.”