GLP-1 Drugs Associated with Higher Rates of Frozen Shoulder and Rotator Cuff Tears | Research

The takeaway

GLP-1 receptor agonist use was associated with increased rates of adhesive capsulitis (up to 2.5× higher), rotator cuff tears, and glenohumeral osteoarthritis across all patient subgroups over 5 years.

2.5× frozen shoulder risk
Obese non-diabetic GLP-1 users had the highest increased risk of adhesive capsulitis (HR 2.465)

What the researchers found

GLP-1RA use was associated with significantly higher 5-year incidence of adhesive capsulitis (HR up to 2.465), rotator cuff tears, and glenohumeral OA across all subgroups, but lower shoulder fracture risk in obese T2DM patients (HR 0.903).

Why it matters

GLP-1 drugs are taken by millions and their effects on musculoskeletal health are poorly understood. These findings suggest potential adverse effects on shoulder soft tissues that clinicians and patients should be aware of.

How the study worked

Retrospective cohort study using TriNetX database (2017-2019) with 1:1 propensity score matching across three subgroups, evaluating 5-year shoulder outcomes and 2-year metabolic outcomes.

What this study cannot tell us

Retrospective observational design. Cannot prove GLP-1 drugs cause shoulder pathology. Patients seeking GLP-1 prescriptions may be more health-aware and thus more likely to report shoulder symptoms. Confounding by indication possible.

How to read the evidence

Large retrospective cohort study with propensity matching across multiple subgroups. Consistent findings but observational design limits causal conclusions.

When this study was published

Published in 2025, highlighting an underexplored adverse effect of GLP-1 drugs.

The bigger picture

This adds to a mixed picture of GLP-1 effects on musculoskeletal health—beneficial for some outcomes (fractures) but potentially harmful for others (soft tissue conditions). Understanding these trade-offs is important for the millions on long-term GLP-1 therapy.

Questions still open

What mechanism could explain GLP-1 drugs increasing adhesive capsulitis risk?
Does rapid weight loss itself contribute to shoulder soft tissue changes?
Should patients on long-term GLP-1 therapy receive shoulder health monitoring?

Common questions

Can GLP-1 drugs cause frozen shoulder?

This study found a strong association: GLP-1 users had up to 2.5 times the risk of developing adhesive capsulitis (frozen shoulder). However, the study cannot prove the drugs directly cause it—other factors may contribute.

Should I stop GLP-1 drugs if I have shoulder pain?

Don't stop medications without consulting your doctor. If you develop shoulder stiffness or pain while on a GLP-1 drug, mention it to your physician so they can evaluate whether the medication might be contributing.

Read the original research

How do GLP-1 receptor agonists influence the progression of shoulder pathology? A matched cohort analysis.

JSES reviews, reports, and techniques, 6(1), 100613

View on PubMed ↗Publisher’s paper ↗

Citation

Davis, William R; Bank, Nicholas C; Lauck, Bradley J; Creighton, Robert A; Mistovich, R Justin. (2026). How do GLP-1 receptor agonists influence the progression of shoulder pathology? A matched cohort analysis.. JSES reviews, reports, and techniques, 6(1), 100613. https://doi.org/10.1016/j.xrrt.2025.100613