Shoulder Pain Treatment: Causes, Symptoms & Care

What Are the Most Common Causes of Shoulder Pain?

The shoulder is one of the most mobile joints in the body. This mobility allows us to reach, lift, throw and perform complex movements, but it also means that several different structures must work together effectively.

Shoulder pain can develop gradually or follow an injury. Identifying the likely cause is important because different shoulder conditions may require different approaches to treatment and rehabilitation.

Common causes of shoulder pain include:

• Rotator cuff-related shoulder pain
• Rotator cuff tears
• Frozen shoulder
• Calcific tendinopathy
• Acromioclavicular joint injuries
• Shoulder instability or dislocation
• Labral injuries
• Shoulder arthritis
• Biceps tendon problems
• Pain referred from the neck

The diagnosis matters because treatment that is appropriate for one shoulder condition may not be appropriate for another.

Looking for local help with shoulder pain? Find out more about shoulder pain treatment in Milton Keynes, shoulder pain treatment in Northampton or shoulder pain treatment in Aylesbury.

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What Are the Symptoms of Shoulder Problems?

Shoulder conditions can produce different patterns of pain, stiffness and weakness. Understanding these patterns helps us identify which structures may be involved.

Common symptoms include:

• Pain when lifting the arm or reaching overhead
• Difficulty reaching behind the back
• Pain when lying on the affected shoulder
• Shoulder stiffness or restricted movement
• Weakness when lifting or carrying objects
• Pain extending into the upper arm
• Clicking, catching or a feeling of instability
• Tingling or numbness when the neck or nerves may be involved

Symptoms often overlap between different conditions. Their pattern, together with the examination findings, helps guide diagnosis and treatment.

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What Is Rotator Cuff-Related Shoulder Pain?

Rotator cuff-related shoulder pain is one of the most common presentations involving the shoulder.

The rotator cuff is a group of muscles and tendons that helps control and stabilise the shoulder during movement.

Symptoms often include pain when lifting the arm, reaching overhead or behind the back, lying on the affected shoulder or performing repeated lifting activities.

Terms such as rotator cuff tendinopathy, subacromial pain and shoulder impingement have historically been used to describe overlapping presentations.

Read more about rotator cuff-related shoulder pain →

Can a Rotator Cuff Tear Cause Shoulder Pain?

Yes. Rotator cuff tears range from relatively small partial tears to larger full-thickness tears.

Some tears cause pain and weakness, while others may be present on imaging without producing significant symptoms.

Assessment therefore considers both the clinical findings and, where appropriate, imaging rather than assuming that a tear seen on a scan is necessarily the sole cause of pain.

An acute injury followed by marked weakness or an inability to lift the arm may require prompt medical or specialist assessment.

Read more about rotator cuff tears →

What Is Frozen Shoulder?

Frozen shoulder, or adhesive capsulitis, causes progressive pain and marked restriction of shoulder movement.

Both active and passive movement usually become restricted, often making everyday tasks such as dressing, reaching behind the back or sleeping on the affected side difficult.

Frozen shoulder can improve with time, but recovery may be slow. Treatment should be matched to the stage and severity of the condition.

Read more about frozen shoulder →

What Is Calcific Tendinopathy?

Calcific tendinopathy occurs when calcium deposits develop within one of the rotator cuff tendons.

Some people have calcium deposits without symptoms, while others develop significant shoulder pain and restricted movement.

The appropriate treatment depends on the symptoms, examination findings and characteristics of the deposit.

Read more about calcific tendinopathy →

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Can Neck Problems and Posture Affect the Shoulder?

Yes. The neck, upper back, shoulder blade and shoulder work together during many everyday movements.

Problems in the cervical spine can sometimes refer pain into the shoulder, while irritation of a cervical nerve can produce shoulder or arm pain together with tingling, numbness or weakness.

Even where the primary problem is within the shoulder itself, movement of the neck, upper back and shoulder blade may be relevant to how the shoulder functions.

Posture is sometimes blamed for shoulder pain, but the relationship is more complicated than simply having good or bad posture.

Prolonged positions, changes in workload, physical conditioning and repetitive activities may influence symptoms. However, there is no single ideal posture that prevents shoulder problems.

At Isis Chiropractic Centres, assessment therefore considers the shoulder, cervical spine, upper back and shoulder-blade movement where relevant.

Read more about neck pain →

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How Is Shoulder Pain Assessed?

Assessment begins with understanding your symptoms, including when the problem started, whether there was an injury, which activities aggravate the pain and whether you have weakness, stiffness or difficulty sleeping.

We also ask how the problem affects your work, exercise, sport and everyday activities.

Depending on your symptoms, the examination may include:

• Active and passive shoulder movement
• Muscle strength testing
• Rotator cuff examination
• Assessment of the acromioclavicular joint
• Shoulder stability testing
• Neck and upper-back examination
• Neurological testing where appropriate
• Assessment of movement and rehabilitation needs

Our aim is to identify the most likely source of your symptoms, assess whether conservative treatment is appropriate and determine whether further investigation or referral is needed.

We will explain what we find and discuss suitable treatment and rehabilitation options with you.

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Do I Need an X-Ray or MRI for Shoulder Pain?

Imaging is not necessary for every shoulder problem.

For many patients, the history and physical examination provide sufficient information to begin appropriate conservative management.

An X-ray may be useful where arthritis, fracture, significant trauma or calcification is suspected.

Ultrasound or MRI may sometimes be appropriate where a significant tendon tear, labral injury or another soft-tissue problem is suspected and the result is likely to influence management.

All three Isis Chiropractic Centres have on-site X-ray facilities. Where clinically indicated, we can also advise on referral for ultrasound, MRI or specialist assessment.

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What Is the Best Treatment for Shoulder Pain?

The most appropriate treatment depends on the diagnosis, the tissues involved, the duration of the problem and what you need your shoulder to be able to do.

At Isis Chiropractic Centres, we take an individual approach rather than treating every painful shoulder in the same way.

Depending on the condition, treatment may include:

• Advice and appropriate modification of aggravating activities
• Progressive shoulder strengthening and rehabilitation
• Manual therapy or mobilisation where appropriate
• Soft-tissue treatment for associated muscle pain
• Assessment and treatment of relevant neck or upper-back problems
• Exercises for shoulder-blade movement and control
• Low Level Laser Therapy or TECAR therapy as supportive treatments in selected cases
• Shockwave therapy for selected tendon conditions, particularly some cases of calcific tendinopathy
• A gradual return to work, exercise and sport

For many common shoulder conditions, progressive exercise and rehabilitation form a central part of management.

Manual therapy and other treatments may be used alongside rehabilitation where appropriate, but they do not replace the need to restore strength, movement and tolerance to activity.

Where assessment suggests that medication, injection treatment, further imaging or specialist surgical opinion would be more appropriate, we will explain the available options and recommend an appropriate referral.

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Do Anti-Inflammatory Drugs Affect Tendon Healing?

Anti-inflammatory medicines, including non-steroidal anti-inflammatory drugs (NSAIDs), can help relieve pain in some musculoskeletal conditions.

Inflammation also plays a role in normal tissue healing, and laboratory and animal studies have suggested that suppressing certain inflammatory pathways may influence tendon repair and tissue remodelling.

However, human research is less conclusive. Short-term NSAID use has not consistently been shown to impair tendon healing, and it would be inappropriate to suggest that everyone with shoulder pain should avoid anti-inflammatory medication.

Medication may provide useful symptom relief, but it does not replace appropriate assessment, exercise or rehabilitation when these are indicated.

If you require medication, particularly for regular or prolonged use, discuss the benefits and risks with your GP, pharmacist or prescribing clinician.

Can Chiropractic Treatment Help Shoulder Pain?

Chiropractic care may be appropriate for some musculoskeletal causes of shoulder pain.

Our chiropractors assess the shoulder, neck and surrounding structures before recommending treatment. We consider how the symptoms affect your movement, function and everyday activities.

Where appropriate, management may include manual therapy, mobilisation and soft-tissue techniques alongside exercise, rehabilitation and self-management advice.

Manual therapy should not replace progressive strengthening where rehabilitation is required. Some shoulder conditions are more appropriately managed through physiotherapy, medical treatment or specialist assessment.

Our aim is to recommend the approach most appropriate for the individual rather than assume that every shoulder problem requires chiropractic manipulation.

Read more about chiropractic treatment →

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What Does the Research Say About Shoulder Rehabilitation?

Exercise and progressive rehabilitation are important components of conservative treatment for many common shoulder problems, particularly rotator cuff-related shoulder pain.

Research suggests that appropriately prescribed exercise can improve pain and function. The most suitable programme depends on the individual’s symptoms, physical capacity and functional goals.

Evidence for adding manual therapy to exercise is mixed. Some studies have suggested additional benefit, while others have found little difference compared with exercise alone.

This is why we regard manual treatment as one possible component of care rather than the whole treatment programme.

Further research:

• Manual therapy and exercise for rotator cuff-related shoulder pain
• Exercise therapy for rotator cuff-related shoulder pain: systematic review and meta-analysis

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Can Shockwave Therapy Help Shoulder Tendon Problems?

Extracorporeal shockwave therapy is one of the treatment options available at Isis Chiropractic Centres for selected musculoskeletal conditions.

Shockwave therapy delivers mechanical energy into tissues. Its clinical effects may involve changes in pain signalling and biological processes associated with tissue repair and remodelling.

However, its effectiveness varies between conditions, and it should not be considered a routine treatment for every type of shoulder pain.

It is also more accurate to describe shockwave as a treatment that may influence tissue responses rather than claim that it simply breaks up scar tissue.

Shockwave Therapy for Calcific Tendinopathy

One of the better-studied applications in the shoulder is calcific rotator cuff tendinopathy, where calcium deposits develop within a rotator cuff tendon.

Some clinical studies have reported reductions in pain, improvements in function and reductions in calcium deposits following extracorporeal shockwave therapy.

Results vary, and the evidence is influenced by the type of shockwave treatment used, the characteristics of the calcium deposit and the patient’s individual circumstances.

Focused and higher-energy shockwave treatments have been particularly studied for calcific tendinopathy. The evidence for one type of treatment should not automatically be applied to every shockwave device.

Treatment recommendations should therefore be based on the clinical assessment, available evidence and the specific treatment being offered.

Read more about calcific tendinopathy →

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Can Laser and TECAR Therapy Support Soft-Tissue Recovery?

At Isis Chiropractic Centres, Low Level Laser Therapy, also called photobiomodulation, and TECAR therapy may be considered as supportive treatments for selected shoulder conditions.

Photobiomodulation uses specific wavelengths of light to influence biological processes within tissues. Some clinical studies suggest that it may help reduce pain and improve function in certain musculoskeletal conditions, although results vary according to the condition and treatment parameters.

TECAR therapy uses radiofrequency energy to produce physiological effects within tissues. Some studies report improvements in pain and function, but the available clinical evidence remains limited for several shoulder conditions.

These treatments are considered adjuncts to appropriate rehabilitation. They do not replace progressive loading, strengthening or other management where indicated.

We discuss the potential benefits, limitations and suitability of these treatments with patients before recommending them.

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When Should Shoulder Pain Be Assessed Urgently?

Most shoulder pain is related to musculoskeletal problems and does not require emergency treatment. However, some symptoms may indicate a serious injury or medical condition.

Call 999 if shoulder pain occurs with:

• Chest pain or pressure, particularly with breathlessness, sweating, nausea or feeling faint
• Sudden weakness, facial drooping, speech difficulties or other symptoms suggesting a stroke

Seek urgent medical assessment for:

• A significant injury with obvious deformity or suspected dislocation
• Inability to move or lift the arm following an injury
• Severe swelling or rapidly increasing bruising after trauma
• A hot, red or markedly swollen joint, especially with fever or feeling unwell
• New or rapidly worsening weakness, numbness or loss of sensation
• Severe unexplained pain or other symptoms suggesting a serious underlying condition

Not all pain felt around the shoulder originates from the shoulder itself. Unusual or unexplained symptoms should be assessed appropriately.

Do not wait for a routine chiropractic appointment if you develop emergency warning signs.

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Shoulder Pain Treatment Near You

Isis Chiropractic Centres provides assessment, treatment and rehabilitation for shoulder problems at our clinics in Milton Keynes, Northampton and Aylesbury.

Our approach combines clinical assessment, appropriate hands-on treatment, exercise and rehabilitation, with additional investigations or referral where indicated.

Shoulder Pain Treatment in Milton Keynes

Our Milton Keynes clinic provides assessment, treatment and rehabilitation for shoulder pain, with on-site X-ray facilities where clinically indicated and rehabilitation facilities to support recovery.

Treatment may include appropriate manual therapy, exercise and progressive rehabilitation. Additional therapies may be considered for selected shoulder conditions.

Shoulder pain treatment in Milton Keynes →

Shoulder Pain Treatment in Northampton

Our Northampton clinic provides assessment, treatment and rehabilitation for shoulder pain, with on-site X-ray facilities where clinically indicated.

Management may include manual therapy, exercise, rehabilitation and other appropriate treatment options, depending on the clinical findings.

Shoulder pain treatment in Northampton →

Shoulder Pain Treatment in Aylesbury

Our Aylesbury clinic provides assessment and treatment for shoulder pain, with on-site X-ray facilities where clinically indicated.

Depending on the condition, management may include manual therapy, exercise, rehabilitation and appropriate supportive treatments.

Shoulder pain treatment in Aylesbury →

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Frequently Asked Questions About Shoulder Pain

Why does my shoulder hurt when I lift my arm?

Pain when lifting the arm can occur with several conditions, including rotator cuff-related shoulder pain, tendon problems, frozen shoulder and joint disorders. The pattern of movement and examination findings help distinguish between them.

Why does my shoulder hurt at night?

Night pain is common with several shoulder conditions, including rotator cuff-related pain and frozen shoulder. Persistent night pain should be considered alongside your other symptoms and examination findings rather than used alone to make a diagnosis.

Should I rest a painful shoulder?

Some temporary modification of painful activities may help, but prolonged complete rest is rarely the goal for uncomplicated musculoskeletal shoulder pain. Gradual movement and progressive exercise are often important parts of recovery.

Can shoulder pain be caused by a trapped nerve?

Yes. Irritation or compression of a cervical nerve can sometimes produce pain around the shoulder and arm, particularly when accompanied by tingling, numbness or weakness.

Other neurological and musculoskeletal conditions can cause similar symptoms, so appropriate assessment is important.

Do all rotator cuff tears need surgery?

No. Management depends on the type of tear, severity of weakness, how the injury occurred, activity requirements and response to conservative treatment.

Some tears can be managed without surgery, while others, particularly certain acute traumatic tears, benefit from prompt specialist assessment.

Do I need an X-ray or MRI for shoulder pain?

Not necessarily. Many shoulder conditions can be assessed clinically without immediate imaging. X-rays, ultrasound or MRI may be considered when the findings are likely to influence diagnosis or treatment.

Can exercise help with shoulder pain?

Exercise and progressive rehabilitation are important for many shoulder conditions. The most suitable programme depends on the diagnosis, symptoms, stage of recovery and individual goals.

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Start by Finding the Cause of Your Shoulder Pain

There are many reasons why a shoulder can become painful, and symptoms alone do not always reveal which structure is responsible.

Our first step is to assess the shoulder properly, explain what we find and recommend the most appropriate treatment, rehabilitation or referral pathway.