Shoulders are vulnerable to injury. Whenever possible, physical therapies are the main line of treatment. Massage and chiropractic treatments that guide healing may be supplemented with pain medications. If these health strategies prove inefficient, or if the shoulder injury is severe enough, surgery may be required to correct the problem.

Shoulder arthroscopy is primarily an exploratory and diagnostic, minimally-invasive surgery. A handheld instrument called an arthroscope, with a tiny camera at one end, is inserted into a small incision. Using the inserted camera, the surgeon can view the interior structure of the shoulder. Minute tools within the arthroscope also allow surgeons to make repairs to or extract damaged tissues. Arthroscopic shoulder surgery is common; 1.4 million patients receive this treatment each year.

Rotator cuff repair is also very common. In fact, a torn rotator cuff is the most common injury in the shoulder area. The rotator cuff is composed of muscle tissues that encircle the main shoulder joint. This large joint isn't quite a ball-and-socket, but it has a similarly wide range of rotating motion. It's this rotator, so to speak, with its range of motion that often leads to damage in the sleeve-like structure or "cuff" of muscle tissues that surrounds it.

Total shoulder replacement or total shoulder arthroplasty (not to be confused with arthroscopy) involves the removal of parts of the shoulder joint and their replacement with metal and plastic hardware. Reverse total shoulder replacement is a similar concept using a different technique; one of the differences between the two surgeries is the placement and orientation of the hardware replacements.

Arthritis symptoms often affect the shoulder and shoulder joint. Osteoarthritis degenerates the cartilage that protects the bones of the joint, preventing them from colliding with each other. Conditions caused by inflammatory or rheumatoid arthritis can cause pain and a loss of function in the shoulder. Shoulder replacement surgery is often used to relieve arthritic pain and restore the shoulder's mobility.

Bone fractures in the shoulder are likely to require some amount of surgery due to the complexity of the shoulder's mechanics. To aid healing, surgically implanted hardware such as pins and plates can help keep the bones from shifting as they heal. Broken bones may also require replacement through arthroplasty. Fractures are a common symptom of osteoarthritis.

Shoulder instability or chronic dislocation is caused by injuries to or conditions that affect the labrum. The labrum is the cartilage that cushions, protects, and reinforces the shoulder joint. A damaged labrum can be treated with arthroscopic or open surgery, such as in total shoulder replacement.

Shoulder impingement is when muscles rub against the shoulder blade causing pain and inflammation. Impingement is common in people who engage in activities that require a great deal of overhead motion, but many conditions can cause it. Bony growths or bone spurs can start to irritate the adjacent tissues, leading to impingement. It can also be caused by torn or damaged cartilage, ligaments, and tendons; such cases can usually be treated using arthroscopic surgery.