Shoulder pain in older adults

Overview

Shoulder pain in older adults is discomfort or stiffness in the shoulder joint or the muscles and tendons around it. It can make everyday activities like dressing, reaching, or lifting difficult.

Yes, shoulder pain is very common in older adults. Nearly one in three people over 65 experience it at some point.

It mainly affects people over 60, but can also occur in younger adults. It is more common in those with a history of heavy lifting, repetitive arm movements, or conditions like diabetes or heart disease.

Symptoms

Common symptoms

• Aching or sharp pain in the shoulder, especially when moving the arm
• Stiffness or reduced range of motion
• Pain that wakes you up at night or when lying on the affected side
• Weakness in the arm or difficulty lifting objects

Symptoms in older adults

• Gradual onset of pain with no clear injury
• Pain that radiates down the arm or to the neck
• Clicking, grinding, or popping sensations with movement
• Difficulty reaching overhead, behind the back, or across the body

Causes

Main causes

• Osteoarthritis – wear and tear of the cartilage in the shoulder joint
• Rotator cuff problems – tears or tendinopathy (inflammation or damage to the tendons that move the shoulder)
• Frozen shoulder (adhesive capsulitis) – thickening and tightening of the shoulder joint capsule
• Bursitis – inflammation of the fluid-filled sacs that cushion the joint
• Referred pain – shoulder pain that comes from another area, like the neck or heart

Risk factors

• Age over 60
• Previous shoulder injury or surgery
• Repetitive overhead activities (e.g., painting, gardening)
• Diabetes, thyroid disorders, or heart disease
• Osteoporosis or other bone diseases

When to see a doctor

See a doctor urgently if:

• You have sudden severe shoulder pain after a fall or injury
• You cannot move your arm or hand at all
• Your shoulder looks out of place (deformed) after an injury
• You have chest pain, shortness of breath, or dizziness along with shoulder pain

Book a routine appointment if:

• Pain lasts more than a few days and does not improve with rest and simple pain relief
• Stiffness is making it hard to do everyday tasks
• You notice weakness or numbness in your arm or hand
• The pain wakes you up at night

Diagnosis

A doctor will ask about your symptoms, medical history, and any injury. They will examine your shoulder, checking for tenderness, range of motion, and strength.

Tests that may be done

• An X-ray to check for arthritis, fractures, or bone spurs
• An ultrasound or MRI to look at soft tissues like tendons and muscles
• Blood tests if infection or inflammatory conditions (like rheumatoid arthritis) are suspected

What to expect at your appointment

The doctor may move your arm in different positions to see which movements hurt or feel stiff. They might also press on areas around the shoulder. Tests are usually painless and help find the cause.

Treatment

Treatment depends on the cause but usually starts with simple steps like rest, ice, and gentle exercises. Many people improve without needing surgery.

Self-care at home

• Rest the shoulder for a day or two, then begin gentle movement to avoid stiffness
• Apply an ice pack wrapped in a cloth for 15–20 minutes several times a day to reduce pain and swelling
• Use over-the-counter pain relief such as paracetamol or ibuprofen (check with your doctor or pharmacist first)
• Do gentle stretching exercises as recommended by a physiotherapist

Medical treatments

Your doctor may recommend physiotherapy to strengthen and stretch the shoulder. They might suggest a corticosteroid injection to reduce inflammation, or prescribe stronger pain relief. Treatment is always tailored to your specific condition and health.

When is surgery considered?

Surgery is usually only considered if pain and stiffness do not improve after several months of non-surgical treatment, or if there is a large rotator cuff tear or fracture that needs repair.

Living with this condition

Living with shoulder pain can be frustrating, but small changes can help. Use assistive tools like a reaching aid or long-handled scrubber. Avoid carrying heavy bags on the affected side. Take breaks during repetitive tasks.

Lifestyle tips

• Keep moving gently – complete rest can make stiffness worse
• Avoid heavy lifting or sudden overhead movements until the pain eases
• Use good posture – keep your shoulders back and down when sitting or standing
• Sleep with a pillow under your arm or between your legs if lying on your side

Diet and exercise

A healthy diet rich in fruits, vegetables, and omega-3 fatty acids (like from fish) may help reduce inflammation. Low-impact exercise like walking, swimming, or gentle yoga can keep the shoulder moving without strain. Always check with a physiotherapist before starting new exercises.

Mental health and emotional wellbeing

Chronic shoulder pain can cause frustration, sleep problems, and low mood. It is important to talk to your doctor if you feel sad or worried. If you are in crisis, contact a mental health helpline or your local emergency number for support.

Prevention

Not all shoulder pain can be prevented, but you can reduce your risk by staying active, avoiding repetitive heavy lifting, and maintaining a healthy weight. Strengthening the muscles around the shoulder may help protect the joint.

Complications

If left untreated

• Long-term stiffness (frozen shoulder) that is hard to reverse
• Permanent loss of movement or strength in the arm
• Chronic pain that affects sleep and daily activities

Long-term outlook

Most older adults with shoulder pain improve with simple treatments like physiotherapy and home care. Even if recovery takes time, staying active and seeking help early gives the best chance of returning to normal activities. Many people manage their shoulder pain well and continue to enjoy life.

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