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Musculoskeletal Symptom

Shoulder pain

Shoulder pain is extremely common, affecting up to 26% of adults at any one time, and is the third most common musculoskeletal complaint seen in primary care. The shoulder is one of the most mobile joints in the body, which makes it particularly vulnerable to injury and overuse. Most shoulder pain responds well to physiotherapy, manual therapy and graded exercise.

See therapies that may help

What is Shoulder pain?

The shoulder is a complex joint involving the glenohumeral joint (ball and socket), the acromioclavicular joint, the sternoclavicular joint, and the scapulothoracic articulation — all of which need to work in coordination. This complexity means many different structures can be involved in shoulder pain.

Common causes of shoulder pain include rotator cuff disorders (tendinopathy, tears or impingement — accounting for the majority of presentations), frozen shoulder (adhesive capsulitis), acromioclavicular joint problems, biceps tendinopathy, and referred pain from the neck or thoracic spine.

Shoulder pain from rotator cuff disorders and impingement is often described as pain on the outer aspect of the shoulder, worsening with overhead movements and lying on the affected side at night.

Signs and symptoms

Shoulder pain symptoms vary by cause, but common presentations include:

  • Pain on the outer aspect of the shoulder — often worse with overhead movements, reaching behind the back, or lying on the affected side
  • Reduced range of movement — difficulty raising the arm fully or reaching across the body
  • Pain and stiffness that is worse at night, disturbing sleep
  • Weakness — difficulty lifting objects or performing overhead tasks
  • In frozen shoulder: progressive loss of movement in all directions, often with a characteristic pattern of restriction

How therapy can help

Most shoulder conditions respond well to conservative management:

  • Physiotherapy — the foundation of shoulder pain management. Specific exercise programmes addressing rotator cuff strength, scapular control and shoulder mechanics have strong evidence across all common shoulder conditions
  • Osteopathy and sports therapy — manual therapy to address joint restrictions, soft tissue tension and movement patterns
  • Massage therapy — particularly for shoulder pain with a significant muscle tension component (common in desk workers and those carrying stress in their shoulders)
  • Acupuncture — evidence for short-term pain relief in rotator cuff disorders and frozen shoulder
  • Shockwave therapy — specifically effective for calcific tendinopathy (calcium deposits in the rotator cuff)

Seeking help

A physiotherapist or GP is the appropriate first contact for most shoulder pain. Specific investigations (ultrasound, MRI) may be needed to clarify the diagnosis for surgical planning or steroid injection decisions. If shoulder pain follows significant trauma, involves severe weakness, or is associated with deformity, urgent medical assessment is indicated.

Therapies that may help with Shoulder pain

Showing 28 therapies linked to Shoulder pain.

Therapy Evidence Notes
Massage Therapist
strong

Core use for shoulder pain.

Osteopath
strong

Core use for shoulder pain.

Physiotherapist
strong

Core use for shoulder pain.

Sports Therapist
strong

Core use for shoulder pain.

Acupuncturist
moderate

Strong use for shoulder pain.

Bowen Technique Practitioner
moderate

Bowen commonly used for shoulder pain.

Chiropractor
moderate

Commonly used for shoulder pain.

Fascial Stretch Therapist
moderate

Fascial stretch therapy for shoulder pain.

Myofascial Release Practitioner
strong

Core use for shoulder pain.

Scar Tissue Release Therapist
moderate

Scar tissue release for shoulder pain.

Alexander Technique Practitioner
moderate

Useful for shoulder pain with postural component.

Biofeedback Practitioner
moderate

Biofeedback for chronic shoulder pain.

Body Stress Release Practitioner
moderate

Used for shoulder pain.

Clinical Pilates Practitioner
moderate

Shoulder strengthening and stability for shoulder pain.

Cognitive Behavioural Therapist
moderate

CBT for chronic shoulder pain distress.

Craniosacral Therapist
moderate

Used for shoulder pain.

Emmet Technique Practitioner
moderate

Emmett technique for shoulder pain.

Hydrotherapist
moderate

Hydrotherapy for shoulder pain.

Hydroterm Masseuse
moderate

Hydrotherm massage for shoulder pain.

Indian Head Masseuse
moderate

Indian head massage for shoulder tension.

Mindfulness Practitioner
moderate

Mindfulness for chronic shoulder pain.

Pilates Practitioner
moderate

Pilates for shoulder stability.

Rolfing Practitioner
moderate

Rolfing for shoulder pain.

Shiatsu Practitioner
moderate

Used for shoulder pain.

Structural Integration Practitioner
moderate

Used for shoulder pain.

Thai Masseuse
moderate

Thai massage for shoulder pain.

Yoga Therapist
moderate

Yoga for shoulder pain and mobility.

Zero Balancing Practitioner
limited

Zero balancing for shoulder pain.

Frequently asked questions

What is a frozen shoulder and how long does it last?

Frozen shoulder (adhesive capsulitis) involves progressive tightening of the joint capsule, causing pain and significant loss of movement in all directions. It typically progresses through three phases: freezing (painful, increasing restriction), frozen (less painful but restricted), and thawing (gradual improvement). The natural history is resolution within 1–3 years, though physiotherapy and steroid injections can significantly speed this.

Is rotator cuff injury serious?

This depends on the extent of the injury. Partial-thickness tears and tendinopathy typically respond well to physiotherapy. Full-thickness tears may require surgical assessment, particularly in younger, active people or those with significant weakness. A physiotherapist or orthopaedic surgeon can assess the appropriate management for your specific injury.

Why is my shoulder pain worse at night?

Night pain is very common in rotator cuff disorders and frozen shoulder. Lying on the affected shoulder compresses irritated tissues. Even lying on the unaffected side places the shoulder in a position that can tension the rotator cuff. A physiotherapist can advise on sleeping positions and pillows to reduce night pain.

Can shoulder pain be caused by referred pain from the neck?

Yes — the neck (cervical spine) and upper thoracic spine can refer pain into the shoulder and upper arm. If shoulder exercises do not improve the pain, or if neck stiffness and arm symptoms are also present, cervicogenic referral should be considered. A physiotherapist will assess both the neck and shoulder as part of a comprehensive evaluation.

When does shoulder pain require surgery?

Surgery is considered for full-thickness rotator cuff tears in appropriate candidates, persistent impingement that has not responded to physiotherapy and injection, acromioclavicular joint problems, and shoulder instability. Most shoulder pain does not require surgery and responds well to conservative management.