What is shoulder pain?
Shoulder pain is a common condition that can affect people of all ages. It may result from injury, overuse, or age-related changes. The pain is often felt on the outside of the upper arm and may spread down the arm. It usually does not involve numbness or tingling, which may suggest a neck-related issue instead.
Common causes
- Rotator cuff problems (e.g. tendinopathy, injury)
- Frozen shoulder (adhesive capsulitis)
- Shoulder impingement (Bursitis)
- Osteoarthritis
- Referred pain from the neck
- Injury or trauma (e.g. falls, lifting injuries)
Symptoms
- Pain when lifting the arm or reaching overhead
- Stiffness or reduced range of motion
- Weakness in the shoulder or arm
- Pain at night or when lying on the affected side
Diagnosis
Shoulder pain is usually diagnosed through:
- Your medical history: including when the pain started, what makes it better or worse, and any recent injuries or repetitive activities.
- Physical examination: your GP or physiotherapist may assess your range of motion, strength, and areas of tenderness.
- Imaging is rarely needed initially, but may be used if:
- Symptoms persist beyond 6 to 12 weeks
- There is suspicion of a serious injury (e.g. fracture or full tendon tear)
- You are not responding to treatment
Common imaging tests include:
- X-rays: to check for arthritis or bone problems
- Ultrasound: to assess soft tissues like tendons
- MRI: is rarely required in a community setting, though if we refer you to the hospital, the surgical team may request an MRI – sometimes with a contrast (dye) to assess certain structures in more detail.
Self-care and management
1. Pain relief
- Use paracetamol or ibuprofen as needed
- Use heat packs for longer-term stiffness or muscle tension
2. Keep Moving
- Avoid complete rest—gentle movement helps prevent stiffness
- Modify activities rather than avoiding them completely
- Use your arm close to your body and avoid lifting at arm’s length
3. Exercises
Gentle exercises can help restore movement and reduce pain. Try to keep your Neck, Shoulder and Elbow moving to avoid the shoulder stiffening up.
When to seek medical advice
- Pain persists beyond 6 weeks. Consider seeing your GP or self-refer to your local MSK service.
- You experience severe pain or loss of movement. Consider seeing your GP, or attending the Emergency Department (A&E) if this was after an injury.
- You cannot use your arm at all. Consider attending the Emergency Department (A&E), especially if this was after an injury.
Outlook
- Most shoulder problems improve with time, exercise, and self-care
- MSK Rehabilitation may be recommended for persistent symptoms
- Surgery is rarely needed