660 patients (>35 yr old) with persistent shoulder pain and limitation, resulting from glenohumeral joint osteoarthritis, rotator cuff tear, and/or adhesive capsulitis, were randomized to receive either 5 weekly injections of sodium hyaluronate, 3 weekly injections of sodium hyaluronate followed by 2 weekly injections of saline, or to 5 weekly injections of saline. Although sodium hyaluronate failed to cause symptomatic improvement at 13 weeks,overall, it had a favorable safety profile and was effective and well tolerated, as a nonoperative treatment of osteoarthritis in persistent shoulder pain refractory.