In short
Most shoulder pain comes from the rotator cuff, the group of tendons around the joint, and improves with exercise-based physiotherapy. Frozen shoulder, arthritis and pain from the neck are other common causes. Left shoulder or arm pain with chest pain, breathlessness or sweating needs 000.
On this page
Why does my shoulder hurt?
The shoulder is the most mobile joint in the body, which makes it prone to pain. In UK general practice, about 2 in every 100 adults see a GP about a shoulder problem each year. The most common causes are below.
Rotator cuff related shoulder pain
The rotator cuff is a group of four muscles and tendons that hold the ball of the shoulder in its socket. Problems here are the most common cause of shoulder pain. Pain is usually felt on the outside of the upper arm, and is worse when lifting the arm out to the side or overhead, reaching behind your back, or lying on that side.
It can follow a change in activity or overuse, or develop gradually with age. Tears in the rotator cuff are common on scans in people over 50, including in people without pain.
Exercise-based physiotherapy is the main treatment and helps most people, though it can take several months. Some people are offered an injection or surgery when exercise hasn’t helped.
Pain that isn’t settling?
Talk it through with an Australian doctor online. No referral needed.
Frozen shoulder
Frozen shoulder (adhesive capsulitis) causes pain followed by marked stiffness, so that the arm can’t be moved fully even with help. It’s most common between the ages of 40 and 60, and in people with diabetes. It usually improves over one to three years. Treatment focuses on pain relief and keeping movement.
Other causes
- Osteoarthritis of the shoulder joint, causing aching and stiffness, usually in older people.
- Instability or dislocation, often in younger people after an injury.
- Pain from the neck, felt over the shoulder and down the arm. See neck pain.
- Problems in the chest or abdomen, such as the heart, lungs, gallbladder or diaphragm, can refer pain to the shoulder.
Left shoulder pain
Most left shoulder pain is muscular or comes from the joint. But pain in the left shoulder, arm or jaw can be a sign of a heart attack. Call 000 if it comes with chest pain or pressure, breathlessness, sweating, nausea or dizziness.
What helps
- Keep the shoulder moving within comfort. Long periods of rest can lead to stiffness.
- Avoid the movements that cause sharp pain for a while, then build back gradually.
- Heat or ice, whichever eases it best.
- A physiotherapist can guide strengthening and range-of-movement exercises.
When to see a doctor
See a GP if shoulder pain lasts more than a couple of weeks, you can’t lift your arm, it follows a fall, or it’s affecting your sleep. Get urgent care for a deformed shoulder after an injury, a hot, red, swollen joint with fever, or shoulder pain with chest symptoms.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Lewis J. Rotator cuff related shoulder pain: Assessment, management and uncertainties. Man Ther. 2016;23:57-68.
- Linsell L, Dawson J, Zondervan K, et al. Prevalence and incidence of adults consulting for shoulder conditions in UK primary care; patterns of diagnosis and referral. Rheumatology (Oxford). 2006;45(2):215-21.
- Cohen SP, Hooten WM. Advances in the diagnosis and management of neck pain. BMJ. 2017;358:j3221.
- healthdirect. Shoulder pain.
- Better Health Channel (Victorian Government). Shoulder pain.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.