Shoulder Pain: Causes from Rotator Cuff to Frozen Shoulder

At-a-Glance

• Shoulder pain affects up to 26% of adults, making it one of the most common joint complaints
• Most common causes include rotator cuff problems, frozen shoulder, arthritis, and tendinitis
• Pain location helps identify the underlying cause
• Most cases improve with rest, physical therapy, and targeted exercises
• Sudden severe pain after injury requires immediate evaluation

What It Feels Like

Shoulder pain ranges from a dull ache deep in the joint to sharp, stabbing pain with movement.

Common experiences:

• Deep, aching pain in shoulder joint
• Sharp pain with overhead reaching or lifting
• Stiffness and reduced range of motion
• Pain radiating down the arm
• Weakness when lifting or rotating arm
• Pain worsening at night, disrupting sleep
• Catching or popping sensations

Common Causes

Rotator Cuff Tendinitis and Tears

The rotator cuff is a group of four muscles and tendons stabilizing the shoulder. Inflammation or tears cause significant pain and weakness.

Signs:

• Pain on top and outer side of shoulder
• Pain worsens with overhead activities
• Weakness when lifting arm to side
• Pain at night, especially lying on affected shoulder
• Age over 40 (degenerative tears)

What helps: Rest, ice, NSAIDs, physical therapy, corticosteroid injections, surgery for complete tears

Frozen Shoulder (Adhesive Capsulitis)

Causes progressive stiffness and pain, severely limiting movement. Typically develops in three stages over 1-3 years.

Signs:

• Gradual onset of pain and stiffness
• Severely limited range of motion in all directions
• Pain worsens at night
• Difficulty with daily activities
• More common with diabetes, thyroid disorders
• Often affects ages 40-60

What helps: Physical therapy, NSAIDs, corticosteroid injections, patience (most cases eventually improve)

Shoulder Impingement Syndrome

Occurs when rotator cuff tendons get pinched between bones during arm movement.

Signs:

• Pain when raising arm overhead
• Painful arc (pain between 60-120 degrees)
• Weakness with overhead activities
• Night pain

What helps: Avoid overhead activities temporarily, ice, NSAIDs, physical therapy, corticosteroid injections

Shoulder Arthritis

Osteoarthritis or rheumatoid arthritis can affect the shoulder joint.

Signs:

• Deep, aching pain in joint
• Stiffness, especially in morning
• Grinding, clicking, or popping sensations
• Pain worsens with activity
• Reduced range of motion

What helps: NSAIDs, physical therapy, heat/ice, activity modification, injections, shoulder replacement in severe cases

Bursitis

Inflammation of fluid-filled sacs that cushion the shoulder.

Signs:

• Pain on outer side of shoulder
• Swelling and warmth
• Pain worsens with overhead movement
• Tenderness when pressing on shoulder

What helps: Rest, ice, NSAIDs, physical therapy, corticosteroid injections

When to See a Doctor

Schedule appointment if:

• Pain persists more than 2-3 weeks despite home treatment
• Pain interferes with sleep or daily activities
• Weakness or inability to perform normal activities
• Swelling or deformity

Treatment and Management

Conservative Treatment

Rest and Ice:

• Avoid overhead activities and heavy lifting
• Ice for acute pain (15-20 minutes, 3-4 times daily)
• Heat for chronic stiffness

Medications:

• NSAIDs (ibuprofen, naproxen)
• Acetaminophen for pain
• Topical pain creams

Physical Therapy:

• Stretching exercises to improve flexibility
• Strengthening exercises (rotator cuff, scapular stabilizers)
• Posture correction
• Manual therapy techniques

Injections:

• Corticosteroid injections for inflammation
• Hyaluronic acid for arthritis
• Platelet-rich plasma (PRP) for tendon healing

Self-Care and Prevention

Exercises:

• Pendulum exercise (gentle arm swings)
• Doorway stretch (chest and front of shoulder)
• Rotator cuff strengthening with resistance band
• Scapular strengthening (rows, squeezes)

Prevention:

• Warm up before sports or exercise
• Strengthen rotator cuff and scapular muscles
• Avoid repetitive overhead activities when possible
• Use proper lifting technique
• Maintain healthy weight

Frequently Asked Questions

The Bottom Line

Shoulder pain is extremely common and can significantly impact daily activities. Most shoulder pain results from rotator cuff problems, frozen shoulder, impingement, or arthritis.

The good news is that many cases respond well to conservative treatment: rest, physical therapy, targeted exercises, and anti-inflammatory medications. Physical therapy, particularly exercises to strengthen the rotator cuff and scapular stabilizers, is crucial for both treatment and prevention.

Early intervention prevents chronic problems. Certain warning signs—severe pain after injury, inability to move the shoulder, or shoulder pain with chest discomfort—require immediate medical attention.

Remember: This information is educational and doesn't replace professional medical advice. If you're experiencing persistent or severe shoulder pain, consult a healthcare provider for proper evaluation and treatment.