Shoulder pain

What you should know

It's quite common to develop new aches or pains from time to time, especially in the muscles, joints, or soft tissues of the body. These structures are part of what we call the musculoskeletal (MSK) system, and in most cases, discomfort in these areas settles down on its own with simple self-care.

Why do these pains happen?

Anyone can develop musculoskeletal pain - it can affect people of all ages, fitness levels, and lifestyles. As we age, natural changes occur in our tendons, joints, and soft tissues. These changes can increase our susceptibility to aches and pains.

Musculoskeletal pain often occurs without a clear injury. If you haven't had a fall or trauma, and you're otherwise feeling well, it's likely due to a minor strain or overuse.

Common triggers

Think about your recent activity:

• Have you taken on a new hobby or DIY task?
• Been gardening, walking, or on your feet more than usual?
• Lifted or moved something awkwardly?
• Have you been more sedentary than normal?

Even small changes in your routine can increase the physical load on your body. This can cause tissues to become irritated or inflamed-a common and normal response that's usually short-lived.

What you can do

Most of the time, symptoms settle with time, gentle movement, and some adjustments to your activity levels. Try to:

• Keep gently active - complete rest can make things worse
• Modify activities that aggravate symptoms - don't push through sharp or worsening pain
• Try simple, gentle exercises to support recovery
• Pace yourself and gradually build back up to your normal routine.

Some discomfort with movement or exercise is normal and usually not a cause for concern-as long as it isn't getting progressively worse and is steadily improving.

Recovery can take a few weeks, and it's not unusual for it to take up to six weeks for symptoms to fully resolve.

Simple exercises

We've included the link below to some gentle, joint-specific exercises that may help support your recovery. These can be useful for improving mobility, reducing stiffness, and supporting healing and strength rebuilding.

New shoulder pain exercises

When to seek further advice

In most cases, self-management is appropriate. However, it's best to get in touch with a healthcare professional if any of these apply:

• Your pain started after a significant fall or injury
• You have severe night pain that doesn't ease with position changes or simple pain relief
• You have neurological symptoms like numbness, tingling, or muscle weakness
• You're feeling generally unwell alongside your pain - for example, if you have a fever, unexplained fatigue, or weight loss
• Your symptoms are not improving after a few weeks of self-care.

For office use only: Version 1 PFD_TS106  Publication date: August 2025

What is it?

This is a condition where the shoulder becomes very stiff, which may come on for no reason or after an injury or surgery. It is more common in women around the ages of 45-60 years old and people with diabetes. The initial phase can be very painful and with time the shoulder becomes progressively stiffer, which is known as the freezing phase. After several months the pain should subside, but the shoulder remains stiff, which is known as the frozen phase.  Eventually the stiffness will subside, and you will be able to regain movement, which is known as the thawing stage. This whole process can take up to 2 years to recover but often this timeframe is much shorter. However, sometimes full movement may not be fully regained.

Management

The initial treatment is getting your pain under control with painkillers and anti-inflammatories. Once pain is under control you may have physiotherapy or carry out exercises at home. It is important to try and maintain as much movement as possible within your pain limits. Some people may require a corticosteroid injection to help with pain. For most people this is all that is needed to manage frozen shoulder, however for some people they may require an onward referral to orthopaedics to improve their pain and stiffness.

Exercises for Frozen Shoulder

Visit the BESS - British Elbow & Shoulder Society website 

For office use only: Version 1 PFD_TS090(2)  Publication date: April 2025

What is it?

OA occurs when there is a loss of cartilage that covers the joint surface and is common as we get older. This can cause the shoulder joint to become stiff and painful. There are two joints around the shoulder that can develop OA, the ball and socket joint (glenohumeral) and the joint at the end of the collar bone (acromioclavicular). The first symptom is usually pain, and the shoulder may feel stiff and weak. Some people will also experience grinding or catching in the shoulder and occasionally some people may hear crunching.

Management

There is no cure for OA, however the pain may fluctuate. The main forms of treatment include pain relief, physiotherapy and exercises and lifestyle changes to avoid irritating your shoulder. Maintaining range of movement and strength in your shoulder is very important, some people may be referred to physiotherapy but there are exercises that can be carried out at home. If initial pain relief and exercise does not improve symptoms, some people may have a corticosteroid injection to improve pain: the benefit of this is variable with some people only getting a few days relief and others a few months. Some people with OA in their ball and socket joint whose pain does not improve may be referred on to an orthopaedic surgeon to consider a joint replacement.

Exercises for OA

Visit the BESS -British Elbow & Shoulder Society website 

For office use only: Version 1 PFD_TS090(2)  Publication date: April 2025

 

What is it?

Shoulder pain can be caused by a variety of conditions. The most common type is rotator cuff tendinopathy (also known as subacromial shoulder pain).

Rotator cuff pain is a term used when describing pain that is related to the muscles of your shoulder called your rotator cuff. These muscles control your shoulder during movements of lifting the arm away from body, such as reaching upwards or when placing the hand behind your back.

Symptoms may consist of pain spreading down the arm and up towards the neck and shoulder blade and may have come on gradually or suddenly, often if the shoulder has been overused in any way beyond its normal use e.g. repeatedly lifting boxes whilst moving house.

Management:

This is a very common condition, and research has shown that with the right type of exercise-based rehabilitation and a greater understanding of how to manage this problem, people can successfully return to normal daily function. It may take a minimum of 6-12 weeks before you start to see improvements in your symptoms; however, it can take up to 6 months to see a bigger change.

Exercises:

Visit the BESS -British Elbow & Shoulder Society website

Rotator Cuff Class Class

You may be referred to the Rotator Cuff Class Class. 

Click here to access the Rotator Cuff Class Class participant booklet. 

For office use only: Version 1 PFD_TS090(3)  Publication date: April 2025

What is it?

The following information is for people who have been diagnosed with shoulder instability. Shoulder instability can result in the shoulder coming in and out of the joint (dislocation) which can result in pain, weakness, reduced function, and the person may feel apprehensive about moving the arm in certain ways.

The shoulder joint is made up of 3 bones that move together as one: the scapula (the socket - part of the shoulder blade), the head of the humerus (the ball section), and the clavicle (the collar bone).

The socket is very shallow, this is important to allow for a large amount of movement at the shoulder. This means the soft tissue structures of the shoulder (ligaments, tendons, labrum and capsule) are key to keeping the ball in the centre of the socket when the shoulder is moving.

Shoulder instability can occur when the ball is not suitably controlled within the socket. There are 3 types of shoulder instability:

• Traumatic - an injury causing dislocation (ball moving fully out of the socket), or subluxation (ball moving partially out of the socket)
• Atraumatic - without an injury, in people who have naturally more laxity (flexibility) in their surrounding tissues
• Muscle Patterning - a rare cause of shoulder instability due to muscle imbalances where the muscles are not coordinating well enough.

Management

If the shoulder is dislocated (comes out of joint), the patient will need to go to hospital to have it relocated (put back in). If the shoulder subluxes, it may feel like the shoulder partly came out of joint but quickly moved back into joint.

Recovery timescales will depend on the cause of the problem and how many times the problem has recurred. You should start to see subtle improvements in your symptoms after 6 weeks from starting shoulder rehabilitation, but it can take up to 6 months to notice more significant changes. If you do not notice any improvement by 6-12 weeks, or your symptoms deteriorate, please contact your health care provider.

When to speak to a health professional

If this is a first-time dislocation, you will need to attend A&E to have the arm assessed and relocated. Do not try to pop the arm back in yourself as it could damage the tissues, nerves and blood vessels around the shoulder.

In non-traumatic cases, physiotherapy is the most effective way to improve shoulder pain, movement and function. You can self-refer to physiotherapy here.

For office use only: Version 1 PFD_TS090(3)  Publication date: April 2025