Shoulder Pain – Common Causes & Treatment

Physiotherapists diagnose causes of shoulder pain by using a detailed history and physical examination. The physical examination includes measuring the shoulder range of motion throughout a range of different movements which isolate sub-groups of the shoulder complex.



Common causes of shoulder pain include:


1. Tendonitis: This is an inflammation of the tendons, the tissues that connect muscle to bone. It can be caused by overuse or repetitive motions.

2. Bursitis: This is an inflammation of the fluid-filled sacs (bursae) that cushion the bones, muscles, and tendons around the joints. Bursitis often occurs with tendonitis.

3. Rotator cuff injury: This is a tear in one of the muscles or tendons surrounding the shoulder joint. It is a common cause of pain, especially among people who play sports or do manual labor.

4. Arthritis: This is a general term for conditions that cause inflammation in the joints. There are many different types of arthritis, but osteoarthritis and rheumatoid arthritis are the most common forms that affect the shoulder.

5. Frozen shoulder: This is a condition in which the shoulder joint becomes stiff and painful. External Rotation is usually the first range of movement lost and the last to come back during rehab caused by inflammation of the soft tissue around the shoulder capsule.

6. Cervical spine problems: These are problems in the cervical spine, the part of the spine that runs from the base of the skull to the middle of the back. They can cause pain, tingling, and numbness in the shoulder and arm.

7. Labral tear: This is a tear in the cartilage that surrounds the shoulder joint. It can cause pain, clicking, or popping in the shoulder.

8. Referred pain: This is pain that is felt in a different area from where it is caused. For example, pain in the shoulder can be referred from problems with the neck, such as a herniated disk.

9. Dislocated shoulder: This occurs when the upper arm bone pops out of the socket. It can be caused by a fall, a blow to the shoulder, or a sudden twisting motion.

10. Fractured shoulder: This is a break in one or more bones that make up the shoulder joint. It is a common injury in people who fall on their outstretched arm.

Each of these conditions requires a different treatment plan, so it is important to see a doctor or physiotherapist for a diagnosis. Ignoring the pain or trying to treat it yourself can often make the problem worse.

Medical professionals will monitor range of motion (ROM) & pain levels throughout recovery, adjusting the treatment plan based on progress of recovery.



The treatment for shoulder pain depends on the underlying cause. In many cases, simple home remedies can help to relieve the pain. These include:

1. Resting the shoulder: This is often the best way to allow the injury or condition to heal. Avoid activities that worsen the pain, such as lifting heavy objects or participating in contact sports.

2. Applying ice: This can help to reduce inflammation and pain. Apply ice for 15-20 minutes at a time, several times a day.

3. Taking over-the-counter medication: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help to reduce pain and inflammation.

4. Wearing a sling: This can help to support the arm and take pressure off of the shoulder.

5. Doing physical therapy exercises: These exercises can help to stretch and strengthen the muscles and tendons around the shoulder joint. Depending on key symptoms such as ROM and pain levels, suitable exercises will vary from mobility exercises, to strengthening, and stabilising.

6. Getting a massage: Massaging the affected area can help to reduce pain and muscle tension.

7. Applying heat: This can help to increase blood flow and reduce stiffness. Apply heat for 15-20 minutes at a time, several times a day.

8.Using electrical stimulation: This is a treatment that uses low-voltage electrical currents to reduce pain. It is often done in physical therapy sessions.


Severe Shoulder Pain

If these home remedies do not relieve the pain, or if the pain is severe, you may need to see a doctor for further treatment. Your doctor may recommend:

1. Prescription medication: If over-the-counter medication does not work, your doctor may prescribe a stronger pain reliever, such as a muscle relaxant or steroid.

2. Injections: Your doctor may inject a corticosteroid into the shoulder joint to reduce inflammation and pain.

3. Surgery: In some cases, surgery may be necessary to repair the damage. This is usually only done if other treatments have not been successful.



Take control of your shoulder care. Image shows iPhones with Reflex Health app screens to monitor shoulder health