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Shoulder pain

Shoulder Pain

Shoulder pain is very common and lots of us will experience shoulder pain in our life. Most people who get shoulder pain will greatly recover despite some recurrences. For a small group of people it may become persistent (lasting beyond 6-12 weeks) and can disrupt many aspects of a person’s life. Even if the pain is very bad, it is very rare for shoulder pain to be a sign of something serious.

rcrsp fact sheet

What are the symptoms?

Most people experience shoulder pain in one or both of their shoulders, but may also feel it around their neck, upper back and occasionally down the arm. Persistent shoulder pain is typically shoulder pain that has been going on for longer than 12 weeks.

Shoulder pain may limit your willingness or ability to do certain activities, movements, or tasks. For some people this may affect their work, sleep, and social activities as well. These limitations often lead to people experiencing low mood, anxiety, and depression.

What are the causes?

Shoulder pain can appear with no clear trigger, or some people can describe a movement that started the symptoms. This may be sports injury or a fall, but it can also be a simple movement we do a lot, usually with no issues, like reaching for something, or sometimes just waking up with it.

The shoulder has lots of muscles, tendons, ligaments, nerves, and bursae that might be involved in a pain episode. These structures can heal and repair if they have been injured or inflamed. It is not essential to identify the structures involved, as this will not usually change the advice you are given.

It can often be contributed by a combination of the factors below:

  • Being inactive
  • Doing too much
  • Doing activities that we are not fit or strong enough for
  • Being overweight or obese
  • Poor fitness levels
  • High stress levels
  • Low mood
  • Poor sleep
  • Smoking

The good news is that many of these things can be modified as part of an effective treatment plan.

For more information to help support your general health and well-being, please click here to access our "Healthy You" page. This includes information on exercise, mental health, smoking and weight management.

How long will it last?

In many cases, with some simple advice, keeping active, and some lifestyle modifications, you may see a good improvement within 2-12 weeks. For some – pain can persist much longer because people adapt and cope in different ways. It important to know that for some people, life-long self-management is needed.

What can I do to help myself?

shoulder advice

What else can I do?

Look to gradually increase what you can tolerate in terms of movement, activity, and exercises you can manage. Below you will find some resources/exercises to get you started with regards to your shoulder pain. Start with the easiest and gradually work through them over time.

Shoulder pain exercises - EASY

Shoulder pain exercises - MODERATE

Shoulder pain exercises - ADVANCED 

You may prefer to increase your activity levels in other ways, such as simply walking, swimming, or joining an exercise class like Pilates, Thai chi, aquafit, or yoga.

The important thing is you find something you enjoy doing that you can do regularly to stay active.

Do I need an x-ray or a scan?

In most cases, no. A good history and physical examination of your shoulder alone provides enough information to diagnose your problem. Scans and x-rays are not always useful for diagnosing shoulder pain. While a scan or x-ray may provide information it rarely alters the treatment plan. 

Imaging findings are very poorly linked with pain and often people with no pain have very similar findings on their scans/x-rays to those that do. X-rays and scans can help for a small number of people in certain situations and will be recommended by a healthcare professional if required.

What about a steroid injection?

A steroid injection may be considered to help control the pain in some circumstances. The risks and benefits would be discussed with your Physiotherapist or GP and is not always an appropriate option for all patients.

Symptoms to check

Click the plus sign to see a list of problems that could be a sign you may need to be checked urgently

Get advice from 111 now if:

  • the pain is sudden or very bad
  • you cannot move your arm
  • your arm or shoulder has changed shape or is badly swollen
  • you have pins and needles that do not go away
  • your arm or shoulder is hot or cold to touch
  • the pain is severe and started after an injury or accident, like a fall
  • hurts when you exercise but goes away when your rest
  • you are experiencing chest pain/tightness with your shoulder pain

111 will tell you what to do. They can tell you the right place to get help if you need to see someone.

Go to 111.nhs.uk or call 111.

Immediate medical advice is available by contacting NHS 111

Referral information

If you are struggling with managing your shoulder pain you can self-refer to a physiotherapist for further guidance. 

Refer