Dear Dr. Roach: My husband, 79, has to get both of his shoulders replaced (a reverse total shoulder replacement) due to osteoarthritis. He had the first shoulder done two months ago. It is a very painful procedure and consists of a long and painful recovery. Physical therapy is helping.

Now I’m concerned with every painful twinge in my shoulders. What, if anything, can people do to keep their shoulders healthy and keep themselves from needing surgery? He put off seeing his doctor for more than a year, even as his pain worsened. — S.Q.

Answer: There are several different types of arthritis. Osteoarthritis is the most common; nearly everyone over 65 will eventually experience it. Rheumatoid arthritis is much less common but much more dangerous. Without treatment, the joints can become deformed and lose most or all of their function. To treat this, rheumatologists use disease-modifying antirheumatic drugs (DMARDs), like methotrexate or etanercept (Enbrel), to stop the progression of the disease.

Unfortunately, osteoarthritis doesn’t have any approved disease-modifying agents, but several are in development and have the potential to keep people from needing surgery. Right now, the only drugs we have for osteoarthritis are to help symptoms. Fortunately, we have the option of exercise, which helps improve symptoms and restore or preserve function. This can delay the need for surgery, in addition to helping with pain and movement.

You may have some arthritis in your shoulder as it is very common, and your doctor may recommend an X-ray given your mild symptoms. There are good exercise programs that are available by video, but a trainer or physical therapist can give you specific advice for your issues. I can reassure you that shoulder replacement surgery isn’t common for osteoarthritis in the shoulder.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.