Shoulder pain can show up in surprisingly ordinary situations. Reaching into a cupboard, carrying groceries, sleeping on one side, lifting at work or getting back into the gym after a break can all suddenly make your shoulder feel sore, weak or difficult to move.
Sometimes the cause is obvious. Other times, shoulder pain builds slowly without one clear injury.
The shoulder is designed to move through a large range, which makes it useful but also means several muscles, tendons and joints need to work together. Pain can come from the rotator cuff, the joint itself, surrounding muscles, the neck, or simply from asking the shoulder to handle more than it is currently prepared for.
Here are some of the most common causes of shoulder pain in everyday life, what the symptoms may feel like and when it is worth getting assessed.
Why Does My Shoulder Hurt?
There is no single cause of shoulder pain.
Your shoulder includes the upper arm bone, shoulder blade, collarbone, rotator cuff muscles, tendons, ligaments and several joints that work together whenever you reach, lift, push, pull or carry.
Common shoulder pain causes can include:
- Rotator cuff-related shoulder pain
- Tendon overload or irritation
- Bursitis
- Frozen shoulder
- Shoulder arthritis
- Joint irritation
- Muscle strain
- Shoulder instability
- Referred pain from the neck
- Sudden injury or trauma
The way the pain started, where you feel it, which movements aggravate it and whether there is weakness or stiffness can all help narrow down what may be contributing.
Rotator Cuff-Related Shoulder Pain
Rotator cuff-related shoulder pain is one of the most common causes of shoulder symptoms.
The rotator cuff is a group of muscles and tendons that help control and stabilise the shoulder. Symptoms can develop gradually after repetitive use, heavier lifting, a change in training or simply an increase in how much you are using the arm.
You may notice:
- Pain when lifting your arm
- Pain reaching overhead
- Pain reaching behind your back
- Discomfort lying on the affected shoulder
- Pain with lifting or carrying
- Weakness or reduced confidence using the arm
- A dull ache around the outside or front of the shoulder
Terms such as tendinopathy, bursitis and impingement are often used around this type of shoulder pain, although symptoms can involve a combination of tissues rather than one single structure.
Shoulder Pain From Repetitive Work or Everyday Activities
Your shoulder does not have to suffer one major injury to become painful.
Repeatedly reaching overhead, carrying children, lifting boxes, using tools, stocking shelves, gardening or spending hours doing repetitive work can gradually increase shoulder load.
Pain may develop when the amount of work being asked of the shoulder increases faster than its current capacity.
Common examples include:
- Starting a new manual job
- Doing more overhead work than usual
- Moving house
- Increasing gym training
- Carrying heavy bags regularly
- Painting or renovating
- Repetitive pushing or pulling
- Returning to work after time off
The problem is not necessarily that these movements are “bad”. Often, the shoulder simply needs time and strength to adapt to the workload.
Shoulder Pain After Gym or Exercise
Shoulder pain after exercise can happen when training volume, weight or intensity increases too quickly.
Exercises such as bench press, overhead press, push-ups, dips and lateral raises can place significant demand on the shoulder, particularly if you have recently increased your training.
You may also notice problems after returning to exercise following a long break.
Some post-exercise muscle soreness can be normal. However, pain deserves more attention if it:
- Feels sharp rather than like general muscle soreness
- Gets worse each training session
- Causes weakness
- Limits normal shoulder movement
- Wakes you at night repeatedly
- Changes the way you lift
- Does not settle after reducing the aggravating load
Exercise itself is not necessarily the problem. The amount, progression and current capacity of the shoulder often matter more.
Frozen Shoulder
Frozen shoulder is different from ordinary shoulder tightness.
It typically involves significant pain and progressively reduced movement. People may notice that reaching overhead, putting on a shirt, fastening a bra, reaching into a back pocket or sleeping comfortably becomes increasingly difficult.
The two main features are pain and stiffness, and the condition can persist for months or longer.
Frozen shoulder can sometimes develop without an obvious reason. It can also occur after injury or surgery that has limited shoulder movement and is more common in people with diabetes.
If your shoulder is becoming progressively stiffer rather than simply painful, it is worth getting assessed.
Shoulder Arthritis
Arthritis can also cause shoulder pain, particularly as people get older.
Osteoarthritis involves changes within the joint that can lead to pain and stiffness.
Symptoms may include:
- A deep ache inside the shoulder
- Stiffness
- Reduced movement
- Pain during everyday activities
- Grinding or clicking sensations
- Difficulty reaching overhead or behind the body
However, imaging changes do not always explain how much pain someone feels. Treatment generally needs to consider the person’s symptoms, strength, movement and daily demands rather than an X-ray alone.
Shoulder Pain From Sleeping Position
Shoulder pain at night is common, particularly with rotator cuff-related shoulder pain and frozen shoulder.
Sleeping directly on a sensitive shoulder can compress already irritated tissues and make symptoms more noticeable.
You may find it more comfortable to:
- Sleep on the opposite side
- Support the painful arm with a pillow
- Avoid leaving the arm overhead for long periods
- Experiment with positions that reduce pressure on the shoulder
Changing your sleeping position may help symptoms, but recurring night pain can still be worth assessing, especially if it is accompanied by weakness or progressive stiffness.
Shoulder Pain From the Neck
Not all pain felt around the shoulder actually starts in the shoulder.
Problems involving the neck can sometimes cause referred pain into the shoulder blade, upper arm or surrounding area.
Clues that the neck may be contributing include:
- Neck pain or stiffness
- Pain travelling below the shoulder
- Pins and needles
- Numbness
- Arm weakness
- Symptoms that change when you move your neck
Shoulder and neck problems can also occur together, which is why a proper assessment often looks at both areas rather than focusing only on where the pain is felt.
Shoulder Pain After a Fall or Sudden Injury
Sudden shoulder pain after falling, landing awkwardly, lifting something heavy or being involved in an accident needs a slightly different approach.
Possible injuries can include:
- Muscle or tendon strain
- Rotator cuff tear
- Shoulder dislocation
- AC joint injury
- Fracture
- Ligament injury
Sudden severe pain, difficulty moving the arm, deformity or major weakness may indicate a more significant injury.
If you cannot comfortably use the arm after a significant injury, it is better to get assessed rather than trying to push through it.
Can Posture Cause Shoulder Pain?
Posture is often blamed for shoulder pain, but the relationship is more complicated than simply having “bad posture”.
Sitting with rounded shoulders for a short period does not automatically damage your shoulder.
However, staying in the same position for hours, working at an awkward setup or repeatedly using the arm from one position may contribute to discomfort, particularly if the shoulder and upper back are already sensitive.
Instead of trying to hold one perfect posture all day, it is often more useful to:
- Change position regularly
- Move your shoulders and upper back
- Take short movement breaks
- Build shoulder and upper back strength
- Adjust your workstation where needed
The body generally benefits from movement variety rather than one supposedly perfect position.
What Can Help Everyday Shoulder Pain?
The right approach depends on what is causing the pain, but many non-traumatic shoulder problems respond to sensible activity modification and progressive exercise.
For mild symptoms, useful starting points may include:
- Temporarily reducing movements that repeatedly aggravate the shoulder
- Keeping the shoulder gently moving rather than completely resting it
- Avoiding sudden increases in lifting or training
- Gradually rebuilding shoulder strength
- Working on upper back and shoulder blade control
- Reviewing work, gym or activity demands
- Changing sleeping positions if the shoulder is sensitive at night
Exercise is commonly used for rotator cuff-related shoulder pain, although there is no single exercise program that is clearly best for every person. Tailoring and progression matter.
When Should Shoulder Pain Be Assessed?
It is worth booking an assessment if:
- Shoulder pain has lasted more than a couple of weeks
- Pain keeps returning
- You are losing shoulder movement
- You feel noticeably weaker
- You cannot comfortably lift or reach
- Pain repeatedly wakes you at night
- Symptoms are affecting work, gym or daily activities
- You have numbness or tingling into the arm
- The shoulder feels unstable or repeatedly gives way
Seek prompt medical care if there is:
- Severe pain after a fall or accident
- Obvious deformity
- Inability to move the arm after an injury
- Sudden major weakness
- Significant swelling
- Persistent numbness or neurological symptoms
- Chest pain, shortness of breath or other symptoms suggesting the pain may not be coming from the shoulder itself
Sudden severe pain with an inability to move the arm can be associated with injuries such as dislocation, fracture or significant tendon injury and warrants timely assessment.
How Physiotherapy Can Help With Shoulder Pain
Physiotherapy for shoulder pain usually starts by working out what movements are difficult and what demands the shoulder needs to return to.
At Next Phase Injury Therapy in Yagoona, shoulder pain treatment may include:
- Assessment of shoulder movement and strength
- Rotator cuff and shoulder blade strength testing
- Neck assessment where relevant
- Advice on modifying work, gym or daily activities
- Progressive shoulder strengthening
- Mobility exercises where appropriate
- Manual therapy to help support movement and comfort
- Gradual return to lifting, training, work or sport
Exercise-based rehabilitation is widely used for rotator cuff-related shoulder pain and can improve pain and function for many people, although the exact program should be matched to the person.
Shoulder Pain Treatment at Next Phase Injury Therapy
At Next Phase Injury Therapy in Yagoona, our team supports people with shoulder pain, rotator cuff problems, work injuries, gym-related pain and sports injuries.
We work with you to:
- Understand what may be contributing to your shoulder pain
- Identify aggravating movements and loads
- Improve shoulder strength and mobility
- Build confidence with lifting and reaching
- Progress you back towards work, gym, sport or everyday activities
If you are looking for shoulder pain treatment in Yagoona, physiotherapy for shoulder pain, rotator cuff rehabilitation or injury rehabilitation, our team can help assess where you are now and what the next step should look like.
Explore our physiotherapy, chiropractic and remedial massage services, or book an appointment with Next Phase Injury Therapy. We are located at 444 Hume Highway, Yagoona NSW 2199, and open 8am to 8pm, seven days a week.
Frequently Asked Questions About Shoulder Pain
What are the most common causes of shoulder pain?
Common causes include rotator cuff-related shoulder pain, tendon overload, bursitis, frozen shoulder, arthritis, muscle strain, instability, sudden injury and pain referred from the neck.
Why does my shoulder hurt when I lift my arm?
Pain when lifting the arm is commonly associated with rotator cuff-related shoulder pain, but several structures can cause similar symptoms. The cause is easier to understand by assessing your movement, strength and how the pain started.
Why does my shoulder hurt at night?
Night pain can occur with several shoulder problems, including rotator cuff-related pain and frozen shoulder. Sleeping directly on the painful side may also aggravate symptoms.
Can shoulder pain come from the neck?
Yes. Neck-related pain can sometimes be felt around the shoulder or travel into the arm. Pins and needles, numbness, weakness or symptoms that change with neck movement can suggest the neck may be contributing.
Should I rest my shoulder if it hurts?
Short-term activity modification may help, but completely avoiding shoulder movement for long periods is not usually the goal for most non-serious shoulder problems. Gentle movement and gradual strengthening are often useful once appropriate for the condition.
Can physiotherapy help shoulder pain?
Physiotherapy may help by identifying contributing factors, improving shoulder movement and strength, managing activity load and guiding a gradual return to work, exercise or sport.
This article provides general information only and is not a substitute for individual clinical assessment or medical advice. Shoulder pain can have many different causes, and treatment should be tailored to your symptoms, injury history and goals. Seek medical attention for severe pain following trauma, major weakness, deformity or other concerning symptoms.
References
- NHS. “Shoulder Pain.” National Health Service. https://www.nhs.uk/symptoms/shoulder-pain/
- NHS. “Frozen Shoulder.” National Health Service. https://www.nhs.uk/conditions/frozen-shoulder/
- University Hospitals of Derby and Burton NHS Foundation Trust. “Rotator Cuff Related Shoulder Pain.”
- Medeiros de-Queiroz, Jeffeson Hildo, et al. “Exercise for Rotator Cuff Tendinopathy.” Revista Brasileira de Medicina do Trabalho, 2023. https://pubmed.ncbi.nlm.nih.gov/36793454/
- Pavlova, Anastasia Vladimirovna, et al. “Effect of Resistance Exercise Dose Components for Tendinopathy Management: A Systematic Review with Meta-Analysis.” British Journal of Sports Medicine, 2023. https://pubmed.ncbi.nlm.nih.gov/37169370/
Information on this page is general in nature and is not a substitute for individualised advice from a registered health practitioner. Our practitioners are registered with AHPRA.
