Your shoulder is one of the most complex and mobile joints in your body. It allows you to scratch your head, play fetch with your dog, reach for kitchen gadgets stowed away on high shelves, and do countless other everyday activities. This mobility is a good thing, though it does mean you can experience some shoulder pain or injury from time to time. As frustrating as shoulder pain can be, you can always take steps to prevent and manage it.  

Here, learn more about what causes shoulder pain and how to treat it — especially with exercises from our Hinge Health physical therapists.

What Is Shoulder Pain? 

To learn more about what’s causing pain in your shoulder, it’s helpful to have a basic understanding of shoulder anatomy. The shoulder is made of up three bones: 

• The humerus (upper arm) 

• The scapula (shoulder blade) 

• The clavicle (collarbone) 

These bones create two different joints that allow you to move your shoulder:  

• The glenohumeral joint is a ball-and-socket joint where the head of the humerus fits into the socket of the scapula. 

• The acromioclavicular joint is where the scapula meets the clavicle.

A group of muscles and tendons known as the rotator cuff covers the top of the humerus and attaches it to the scapula. This tissue allows you to move your arm and provides your shoulder’s range of motion. 

A fall, accident, blow to the shoulder, repetitive motions, or conditions like arthritis can affect the structures in and around your shoulder and contribute to pain. Pain may occur only when you move your shoulder or all of the time. It can be acute (lasting less than 12 weeks) or chronic (lasting longer than 12 weeks). 

Shoulder Pain Symptoms

Signs of a shoulder problem may include: 

• Pain in your upper arm or the front or back of your shoulder

• Shoulder and upper arm weakness 

• Pain with shoulder or arm movement 

• A “catching” sensation in your shoulder 

• Pins-and-needles sensations

Shoulder Pain: A Hinge Health Perspective 

There are a lot of different causes of shoulder pain, which we’ll discuss below. No matter the primary cause of your shoulder pain, know this: There are always steps you can take to get back to doing what you love. Whether you’ve been diagnosed with arthritis or shoulder instability —or have no diagnosis at all — you’re not stuck with your pain. You can always take action to improve your situation — and that often starts with moving more. As our Hinge Health care team says, movement is medicine.

Causes of Shoulder Pain 

Many people wonder: “Why does my shoulder hurt if I haven’t had an injury recently?” Causes of shoulder pain can be grouped into two main categories: soft tissue issues and bone-related issues. 

Soft Tissue Issues 

Soft tissue refers to muscles, tendons, ligaments, nerves, and other structures that surround bones and joints. Common problems with soft tissues of the shoulder include: 

Bursitis. Bursae are small, fluid-filled sacs located near joints. They act like cushions by reducing friction between muscles and bones when you move. If a bursa in your shoulder becomes inflamed, it can cause shoulder pain, particularly with movement. 

Tendinitis. Tendons are strong, cord-like structures that attach muscles to bone. Tendon inflammation — often from an injury or repetitive motions that your body isn’t prepared for — can cause pain and discomfort. 

Rotator cuff tear. Tears that affect the muscles and tendons that attach your shoulder blade to your upper arm can cause weakness, pain with lifting, and crackling sounds with shoulder movement. They can result from natural age-related changes to the structures of your shoulder. They can also be the result of a sudden injury (e.g., falling on an outstretched arm) or repetitive overhead motions (e.g., painting, carpentry, tennis). 

It’s important to note that repetitive motions are not inherently bad. Your body is incredibly strong and resilient. But if repetitive movements contribute to shoulder pain for you, it may be an indication that your shoulder needs strengthening and stretching exercises to help it better handle those movements. 

Pinched nerve. Sometimes, a pinched nerve in the neck can cause symptoms that travel to your shoulder and even into your arm. It's often a sharp or burning pain that gets worse when you move your neck back and forth or side to side. 

Impingement syndrome. Shoulder impingement occurs when a bone puts pressure on the soft tissues of the shoulder during movement and causes swelling and pain. 

Frozen shoulder (also known as adhesive capsulitis). An inability to move your shoulder for a long time, such as after a fracture or surgery, can cause the tissues around your shoulder to thicken (develop adhesions). This makes arm and shoulder movement difficult and painful. 

Shoulder separation. Ligaments connect bones to one another. A fall or hard blow to the shoulder may stretch or tear the ligaments that hold the acromioclavicular joint together, causing shoulder separation.  

Bone-Related Issues  

Your bones are inherently strong, but many factors can affect the bones that make up your shoulder joint and contribute to shoulder pain, including:

Shoulder instability. If the humeral head (upper arm bone) is forced out of the cup-shaped socket of the shoulder blade, it results in a dislocation. This can cause numbness, muscle spasms, weakness, or tingling in the neck, shoulder, or arm. If dislocations happen repeatedly, it can cause ongoing pain and instability when you raise your arm.  

Fractures. Broken bones that cause shoulder pain typically involve the humerus, scapula, or clavicle. They can cause intense pain, swelling, and bruising. Fractures are often the result of a hard fall or injury from impact (e.g., contact sports or motor vehicle accidents).

Arthritis. There are more than 100 types of arthritis, though two most often impact the shoulder. Rheumatoid arthritis (RA) is an autoimmune condition that causes the immune system to attack its own joint lining (synovium). Osteoarthritis (OA) results in changes to the shock-absorbing articular cartilage at the ends of bones. While arthritis doesn’t always cause symptoms, RA and OA can contribute to joint pain and stiffness. Shoulder OA is more common among people who have had shoulder injuries such as fractures and dislocations (post-traumatic shoulder arthritis).

Bone spurs: Also known as osteophytes, bone spurs may form as part of the arthritis process. Bone spurs can also irritate tissues like the rotator cuff, causing pain and inflammation. 

Other common causes of shoulder pain include muscle tension, often from hunching your shoulders or staying in the same position for a long time and referred pain, or pain that stems from an issue in another part of your body. Neck issues in particular can cause pain in your shoulder blades or upper arms along with tingling sensations that extend down your arms or hands. 

When to See a Doctor 

Most shoulder problems last only a short time and can be managed at home. “While shoulder pain can definitely be uncomfortable and even scary, almost all types of shoulder pain can initially be managed with non-invasive treatments,” says Jonathan Lee, MD, orthopedic surgeon and senior expert physician at Hinge Health. “Treatments like injections and surgery are typically reserved for people who have persistent symptoms after first trying non-invasive choices, such as exercise therapy.”

In some cases, shoulder pain can indicate a serious problem. Sudden pain in your left shoulder may be a sign of a heart attack, especially if it occurs with shortness of breath, dizziness, sweating, or pain in your chest, neck, jaw, or arm. Seek immediate medical attention if you have these signs or any of the following:

• Shoulder pain with a fever, swelling, or redness

• Inability to move or use your shoulder

• A visible deformity near your shoulder

• Pain that persists for several weeks 

• Shoulder pain with arm weakness or numbness  

Prevention Tips

If you’re prone to shoulder pain, there are many things you can do to manage and prevent it, including: 

• Watch your body mechanics. There’s no such thing as perfect posture, but there are a few techniques that help many people avoid shoulder pain from sitting: 

  • Sit up straight and avoid leaning forward. 

  • Relax your shoulders and rest your arms at your sides, especially if you’re prone to neck pain, too. 

  • Support your low back with a pillow or lumbar support to reduce upper back and shoulder pain.  

• Tweak your sleeping position. You don’t have to give up your preferred sleep position, but a few adjustments may help reduce pain overnight. 

  • On your back: Avoid resting your arms above your head. Rather, rest your painful arm on top of a blanket or small pillow at your side. This reduces strain and keeps your shoulder in line with the rest of your body. 

  • On your side: Sleep on your non-painful side and rest your top arm on a pillow in front of you. “The top of your arm bone should be right next to your side, lying on your ribs,” says Heather Broach, PT DPT, a physical therapist at Hinge Health. 

  • On your stomach: Turn your head toward the painful side of your body to reduce shoulder pain. 

• Remember: Your next position is your best position. In other words, change positions. Often. It’s important to move your shoulder joints through a wide range of motion. This stabilizes and strengthens the muscles in and around your shoulders, which helps prevent pain and stiffness. 

• Warm up before exercise. Stretch your body and ease into activity, especially if you’re sore or stiff. For example, start a run by walking or jogging. Take a few practice swings before golf. Or hit balls gently before playing tennis. This slowly elevates your heart rate and body temperature, and activates the lubricating fluid in your joints. 

• Build in strength training. Strengthening your shoulder muscles helps support and stabilize the joint, which helps prevent injuries. 

• Do exercise therapy. Targeted movements, exercises, and stretches increase the strength and flexibility of the structures in and around your shoulders. (More information on this below).

Treatment for Shoulder Pain

The best course of treatment depends a lot on the nature and cause of your pain. The following tips from our Hinge Health physical therapists and medical doctors can provide relief for most cases of mild to moderate shoulder pain.

• Over-the-counter (OTC) medication. Pain relievers, such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol), can be helpful for shoulder pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Ice and heat. Put ice or heat on your shoulder for 15-20 minutes at a time up to four times per day. As a general rule, use ice for new injuries and to reduce swelling. Use heat to increase blood flow and reduce stiffness.

• Prop up with pillows. If sleeping increases your pain, lie on your non-painful side and place pillows:  

  • Under your neck 

  • Under your painful arm in front of your body (or to your side if you prefer to lie on your back) 

  • Behind your back to stop yourself from rolling onto your painful side  

• Make modifications. Gentle movement is very helpful for most types of shoulder pain, though you may benefit from temporarily modifying how you do some activities. Try to:   

  • Use short sweeping arm movements instead of movements that involve a lot of arm extension when doing household tasks like vacuuming and ironing. 

  • Avoid carrying heavy objects like grocery bags. Instead, divide the weight between several lighter bags or ask a loved one for help. 

  • Take breaks and give yourself plenty of time to do tasks that involve a lot of arm movement.  

• Be smart about smart devices. Limit the amount of time you spend looking down at smart devices if possible. Instead, use a stand to prop up your phone or tablet on a table. Keep your computer monitor directly in front of you. Use headphones when talking on the phone instead of cradling it between your ear and shoulder. 

• Steroid injections. If over-the-counter medication does not offer sufficient pain relief, your doctor may suggest cortisone steroid injections to help counter pain and inflammation. 

• Complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for shoulder pain relief, such as massage, acupuncture, or chiropractic care.

Above all, the most important treatment for shoulder pain is exercise. It’s important to keep active when you have shoulder pain, even if you’re not able to do as much as usual.

Movement helps reduce pain and prevent reinjury in the future. It also prevents your shoulder from getting stiff, improves mobility and range of motion, and strengthens weakened muscles.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Surgery for Shoulder Pain

In most cases, shoulder pain improves with time and conservative treatments like those listed above. Some conditions may benefit from surgery, though. Talk to your doctor about whether you’re a good candidate for surgery. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Andersen, C. H., Andersen, L. L., Zebis, M. K., & Sjøgaard, G. (2013). Effect of Scapular Function Training on Chronic Pain in the Neck/Shoulder Region: A Randomized Controlled Trial. Journal of Occupational Rehabilitation, 24(2), 316–324. https://doi.org/10.1007/s10926-013-9441-1

2. Creech, J. A., & Silver, S. (2022). Shoulder Impingement Syndrome. PubMed; StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/32119405/

3. Burbank, K. M., Stevenson, J. H., Czarnecki, G. R., & Dorfman, J. (2008). Chronic Shoulder Pain: Part I. Evaluation and Diagnosis. American Family Physician, 77(4), 453-460.