Shoulder Pain

Overview

Shoulder pain is discomfort in or around the shoulder joint. The shoulder is a ball-and-socket joint that allows a wide range of movement, but this also makes it prone to injury and wear. Common problems include inflammation of the tendons (tendonitis), tears in the muscles or tendons, arthritis, and stiffness (frozen shoulder). Most shoulder pain gets better with rest and simple treatments, but some causes need medical help.

Yes, shoulder pain is one of the most common orthopaedic complaints. It can affect people of all ages, though the causes differ between age groups.

Shoulder pain can affect anyone – from young athletes to older adults. It is especially common in people who do repetitive overhead activities (like painting or swimming), those who have had a shoulder injury, and older adults with age-related joint changes.

Symptoms

Common symptoms

• Pain in the shoulder area, especially when lifting your arm or reaching overhead
• Stiffness or difficulty moving the shoulder normally
• Aching that may spread down the arm or into the neck
• Weakness in the arm
• Clicking, popping, or grinding sensation when moving the shoulder

Symptoms in children

• Pain after a fall or sports injury
• Reluctance to use the arm or lift it
• Swelling or bruising around the shoulder

Symptoms in older adults

• Gradual onset of pain and stiffness, often worse at night
• Difficulty reaching behind the back (e.g., fastening a bra)
• Pain that limits daily activities like dressing or combing hair

Causes

Main causes

• Rotator cuff problems: The muscles and tendons that keep the shoulder stable can get inflamed (tendonitis) or tear.
• Frozen shoulder: The shoulder joint becomes stiff and painful, often for no clear reason.
• Arthritis: Osteoarthritis (wear and tear) or rheumatoid arthritis can affect the shoulder.
• Bursitis: Inflammation of the fluid-filled sacs (bursa) that cushion the joint.
• Shoulder instability: The ball of the joint slips partially or completely out of the socket (dislocation).
• Tendonitis: Inflammation of the biceps tendon in the front of the shoulder.
• Fracture: A break in the collarbone, upper arm bone, or shoulder blade usually from injury.

Risk factors

• Doing repetitive overhead activities (e.g., swimming, tennis, painting, construction work)
• Getting older – tissues wear out over time
• Previous shoulder injury or dislocation
• Poor posture, especially hunching forward while sitting
• Smoking – it can weaken tendons and slow healing
• Certain health conditions like diabetes, thyroid disease, or rheumatoid arthritis

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe shoulder pain after an injury and cannot move the arm normally.
• If the shoulder looks deformed or the pain is accompanied by chest pain or breathing difficulty.

Book a routine appointment if:

• If shoulder pain lasts more than a few days despite rest and simple pain relief.
• If pain wakes you up at night or interferes with daily activities.
• If you have a known shoulder problem that is getting worse.

Diagnosis

A doctor will ask about your symptoms, how the pain started, and your activities. They will also examine your shoulder – checking for tenderness, range of motion, and strength. This is often enough to make a diagnosis.

Tests that may be done

• X-rays: To look for arthritis, fractures, or bone spurs.
• Ultrasound: To check the rotator cuff tendons and bursa for inflammation or tears.
• MRI: Provides detailed images of soft tissues like tendons, ligaments, and muscles.
• Arthroscopy: A small camera placed into the shoulder joint to see inside – used if other tests are not clear.

What to expect at your appointment

The doctor may ask you to move your arm in certain ways to reproduce the pain. They might press on different spots to find where it hurts. Usually no special preparation is needed. If you need an MRI or arthroscopy, you will get instructions beforehand.

Treatment

Treatment depends on the cause but usually starts with rest, ice, and gentle exercises. Many shoulder problems get better without surgery. Your doctor may suggest physiotherapy or simple pain relievers. If the pain is severe or persists, other options like steroid injections or surgery may be considered.

Self-care at home

• Rest the shoulder for a day or two, but avoid complete immobilization – gentle movement helps.
• Apply an ice pack (wrapped in a cloth) for 15–20 minutes several times a day to reduce pain and swelling.
• After 48 hours, apply gentle heat (e.g., a warm towel) to relax tight muscles.
• Take over-the-counter pain relief like paracetamol or ibuprofen, following the package instructions.
• Do gentle range-of-motion exercises as advised by a physiotherapist to prevent stiffness.

Medical treatments

If self-care is not enough, a doctor may recommend physiotherapy to strengthen muscles and improve movement. For more significant pain, they may offer a steroid injection into the shoulder joint to reduce inflammation quickly. Other treatments include anti-inflammatory medications (taken by mouth) that you can get on prescription. Always follow your doctor's advice about which treatment is right for you.

When is surgery considered?

Surgery may be considered if the problem does not improve after several months of non-surgical treatment, or for certain injuries like a full-thickness rotator cuff tear, a dislocated shoulder that happens repeatedly, or a fracture that does not heal well. Common procedures include arthroscopy to repair a torn tendon or remove inflamed tissue, or shoulder replacement for severe arthritis.

Living with this condition

Most people can manage shoulder pain with simple lifestyle changes. Use good posture – keep your shoulders back and down. Avoid lifting heavy objects overhead. When sleeping, try to lie on your back or on the unaffected side with a pillow supporting your arm. Take breaks during repetitive tasks.

Lifestyle tips

• Improve your posture, especially when using computers or phones.
• Use ergonomic equipment at work (e.g., a chair with armrests, a keyboard at the right height).
• Avoid carrying heavy bags on the painful shoulder.
• Stay active, but avoid activities that aggravate the pain while it heals.

Diet and exercise

A healthy diet rich in calcium and vitamin D supports bone and tendon health. Include foods like dairy, leafy greens, and fortified cereals. Exercise is important – a physiotherapist can show you gentle strengthening and stretching exercises. Swimming and walking are often good low-impact options, but avoid strokes that hurt.

Mental health and emotional wellbeing

Chronic shoulder pain can be frustrating and affect your mood, sleep, and ability to do things you enjoy. It is normal to feel down sometimes. If you feel anxious or depressed, talk to your doctor. Remember that most shoulder pain improves, and you are not alone.

Prevention

You may not be able to prevent all shoulder problems, but you can lower your risk. Warm up before exercise, strengthen your shoulder and back muscles, and use correct technique in sports and work. Listen to your body – if an activity causes pain, stop or modify it.

Complications

If left untreated

• Chronic pain that lasts for months or years
• Loss of range of motion, leading to a stiff shoulder (frozen shoulder)
• Weakening of the shoulder muscles, making daily tasks harder
• Tears in the rotator cuff can get larger over time, making treatment more difficult

Long-term outlook

The outlook for shoulder pain is generally good. Most people recover fully within a few weeks to months with simple treatments. Even more serious problems like rotator cuff tears or frozen shoulder often improve with time and physiotherapy. Surgery, if needed, has high success rates. Staying active and following your treatment plan gives you the best chance of getting back to normal activities.

Find support

International organisations

• NHS (UK) - Shoulder Pain ↗

Local organisations

• Versus Arthritis (UK) ↗ · UK
• Cleveland Clinic (USA) - Shoulder Pain ↗ · USA
• Healthdirect Australia - Shoulder Pain ↗ · Australia

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.