Shoulder pain: causes, frozen shoulder and what helps

In short

• The common causes are rotator cuff or tendon problems, impingement and frozen shoulder.
• Pain that gets worse with use points toward tendonitis, bursitis or impingement, while long-lasting pain with stiffness points toward frozen shoulder or arthritis.
• Stay active and move the shoulder gently instead of stopping use altogether.
• Recovery usually begins to ease within about 2 weeks, but full recovery can take 6 months or longer.
• Shoulder pain with chest pain, shortness of breath or sweating needs 911.

Common causes and how they differ

1. Rotator cuff problemsPain when lifting or lowering the arm, weakness when lifting or rotating it, and sometimes pain at night, especially lying on the affected side. Tears can be sudden after a fall, or wear-related and slow with age. People over 40 and overhead workers are at higher risk.
2. Tendonitis, bursitis or impingementPain that worsens with use of the arm.
3. Frozen shoulderPain and stiffness that last. The key sign is that both passive motion, when someone else moves your arm, and active motion, when you move it yourself, are limited.
4. ArthritisLong-lasting pain and stiffness, either osteoarthritis or rheumatoid arthritis.
5. Sudden severe pain with trouble moving the armA dislocated shoulder, a broken bone or a torn tendon. This needs prompt care.

Pain on top of the shoulder can come from the acromioclavicular joint, and tingling, numbness, weakness or a clicking or locking feeling can point to shoulder instability.

Frozen shoulder: what to expect

Frozen shoulder most often affects people between 40 and 60 and affects women more often than men. Diabetes is strongly linked to it, and thyroid conditions and long periods of immobilization after surgery or injury are also associated with it.

• Freezing stage: pain gradually increases and the shoulder loses motion. This lasts about 6 weeks to 9 months.
• Frozen stage: pain may ease but stiffness persists and daily tasks can be very hard. This lasts about 4 to 6 months.
• Thawing stage: motion slowly returns. Full or near-full recovery of strength and motion can take about 6 months to 2 years.

Frozen shoulder often improves without surgery, but full recovery may take up to 3 years. First-line treatment includes managing related conditions such as blood sugar, pain relievers, steroid injections and physical therapy focused on stretching and restoring motion.

The first weeks at home

1. Keep moving gentlyStay active and move the shoulder gently rather than stopping its use altogether. Long periods of keeping it still can themselves bring on stiffness.
2. Ease off what hurtsAvoid activities that make the pain worse, and do not attempt strenuous or heavy-equipment exercises on your own.
3. Use pain relief carefullyOver-the-counter pain relievers can help you keep moving. Follow the label and ask a pharmacist if you take other medicines.
4. Use heat or coldA heat or cold pack for up to 20 minutes at a time can ease discomfort.
5. Fix your postureSit with a cushion behind your lower back and rest your arm on a cushion. Avoid slouching.

Exercise and physical therapy

A physical therapist can assess your range of motion and strength and build a program, and this is the main treatment for most causes. For frozen shoulder, physical therapy usually lasts at least 6 weeks and includes stretching, strengthening and posture advice. NHS advice for shoulder pain also suggests doing shoulder exercises for 6 to 8 weeks to help prevent it coming back.

The general order is range of motion first, then strength. Little and often tends to work better than one long session. Ask for a program matched to your diagnosis rather than copying one from the internet.

Everyday habits

• Avoid long stretches of repetitive overhead work and take breaks.
• Keep frequently used items within easy reach rather than on high shelves.
• Avoid carrying heavy loads on the painful side.
• Adjust your desk so you are not reaching forward and up.
• If sleep is the problem, try a cushion that supports the sore arm.

Do you need an X-ray or MRI?

A provider diagnoses shoulder problems from your history, a physical exam and sometimes imaging. X-rays show bone and help rule out arthritis, but they do not show soft tissue and are usually normal in rotator cuff pain. MRI or ultrasound shows the location and size of a tear.

Many degenerative rotator cuff tears are relatively painless, and some never cause pain, so a finding on a scan does not always explain your symptoms. Nonsurgical treatment helps about 80 to 85 percent of people with rotator cuff tears, and surgery is considered when pain persists despite it, or for a recent acute injury or significant weakness.

Red flags

Red flags: call 911 now if shoulder pain comes with chest pressure or discomfort, shortness of breath, sweating, nausea, dizziness, or pain spreading to the arm, back, neck, jaw or upper stomach, which can be a heart attack. Do not drive yourself.

Get urgent care for sudden or very severe pain, an arm you cannot move, a visibly changed shape or significant swelling, persistent pins and needles or loss of feeling, a shoulder that feels hot or cold, pain after an injury or fall, severe pain in both shoulders, or fever and feeling generally unwell.

When to see a provider and what to ask

See a provider if the pain is getting worse or has not improved after 2 weeks, or if it is very difficult to move your arm or shoulder. People with diabetes or thyroid disease should not wait, given the higher risk of frozen shoulder.

• Which structure in my shoulder is likely involved?
• Do I need an X-ray, ultrasound or MRI, and how would it change treatment?
• Which exercises should I do, and how often?
• How long will recovery take in my case?
• Would an injection help, and what are the risks?

Questions and answers

Sources

1. NHS — Shoulder pain
2. NHS — Frozen shoulder
3. MedlinePlus — Shoulder injuries and disorders
4. AAOS OrthoInfo — Frozen shoulder (adhesive capsulitis)
5. AAOS OrthoInfo — Rotator cuff tears
6. MedlinePlus — Heart attack

Sources checked on 29 October 2026.