Shoulder Pain: Causes, Symptoms and Treatment

Shoulder pain can make simple activities such as reaching overhead, getting dressed, lifting groceries, exercising or sleeping uncomfortable. Because the shoulder depends on several joints, muscles, tendons and other tissues working together, pain can develop for many different reasons.

Common causes include rotator cuff problems, shoulder impingement, bursitis, tendon injuries, frozen shoulder, arthritis, instability and trauma. Shoulder symptoms can sometimes also originate from the neck rather than the shoulder itself.

Elite Sports Medicine evaluates the shoulder, surrounding joints, strength, mobility and activities that reproduce your symptoms before recommending treatment. When conservative care is appropriate, chiropractic care may be combined with manual therapy, exercise and rehabilitation to reduce pain and restore comfortable movement.

What Causes Shoulder Pain?

Shoulder pain can arise from the shoulder joint itself or from the muscles, tendons, ligaments and bursae surrounding it. Pain can also sometimes be referred from the neck or other areas. Mayo Clinic lists causes ranging from bursitis and frozen shoulder to rotator cuff injuries, impingement, arthritis and cervical radiculopathy.

Common musculoskeletal causes include:

• Shoulder impingement or rotator cuff related shoulder pain
• Rotator cuff tendinopathy or tears
• Shoulder bursitis
• Frozen shoulder
• Tendonitis
• Arthritis
• Shoulder instability
• Dislocation or separation
• Labral injuries
• Muscle strains
• Repetitive overhead activity
• Falls, sports injuries or other trauma

The pattern of pain, how it began and which movements aggravate it can help narrow down the likely cause.

Where Is Shoulder Pain Usually Felt?

The location of pain can sometimes provide useful clues.

Pain may be felt:

• On the front of the shoulder
• Along the outside of the shoulder or upper arm
• Deep inside the joint
• Around the shoulder blade
• At the top of the shoulder
• During overhead reaching
• When reaching behind the back
• While lying on the affected side

Location alone cannot reliably diagnose the problem, which is why examination is important when pain persists.

Why Does My Shoulder Hurt When I Raise My Arm?

Pain during overhead movement is common in several shoulder conditions.

One possibility is shoulder impingement, which is often associated with rotator cuff related shoulder pain. People may experience discomfort as the arm moves overhead, during lifting or while performing repetitive reaching activities.

Bursitis, rotator cuff tendinopathy and other shoulder conditions can produce similar symptoms, so pain with arm elevation does not automatically mean one particular diagnosis.

What Is Shoulder Impingement?

Shoulder impingement is a commonly used term for pain involving the rotator cuff tendons and nearby structures during shoulder movement.

Patients often notice pain when reaching overhead, lifting the arm away from the body or sleeping on the affected shoulder.

Because this is one of the more common specific causes of shoulder pain, Elite Sports Medicine has a dedicated page explaining shoulder impingement symptoms and treatment.

Can Bursitis Cause Shoulder Pain?

Yes.

Bursae are small fluid-filled structures that help reduce friction between tissues. When a shoulder bursa becomes irritated, it can contribute to pain, stiffness and tenderness, particularly during movement. Mayo Clinic notes that repeated overhead motions can contribute to bursitis.

Shoulder bursitis can overlap with rotator cuff related symptoms, so patients with persistent pain may need an evaluation to determine which structures appear to be involved.

Elite Sports Medicine also provides more detailed information about bursitis and conservative treatment.

What Is Frozen Shoulder?

Frozen shoulder, also called adhesive capsulitis, causes both pain and progressive stiffness.

A key difference is that frozen shoulder typically limits both active movement, when the patient moves the arm, and passive movement, when someone else attempts to move it. Mayo Clinic describes the condition as involving thickening and tightening of the connective tissue surrounding the shoulder joint.

Symptoms often develop gradually and can last for an extended period, making frozen shoulder different from many shorter-term shoulder strains.

Can Rotator Cuff Problems Cause Shoulder Pain?

Yes.

The rotator cuff consists of muscles and tendons that help stabilize the shoulder and move the arm.

Rotator cuff problems can cause:

• A dull ache in the shoulder
• Pain when reaching or lifting
• Difficulty reaching behind the back
• Night pain
• Weakness
• Reduced function

Mayo Clinic notes that rotator cuff problems can develop gradually from repetitive activity and age-related tendon changes or occur suddenly after an injury.

Sudden weakness following trauma deserves prompt medical evaluation because it can indicate a more significant tendon injury.

Can Tendonitis Cause Shoulder Pain?

Yes.

Shoulder tendons can become painful when their workload exceeds what they can tolerate, particularly with repetitive lifting, overhead work or sports.

Rotator cuff tendinopathy is one of the most common examples. Patients with broader tendon-related symptoms can also review Elite Sports Medicine’s information about tendonitis treatment.

Treatment typically focuses on reducing aggravating load temporarily while progressively restoring strength and function rather than simply trying to eliminate every painful movement indefinitely.

Can Neck Problems Cause Shoulder Pain?

Yes.

Pain felt around the shoulder does not always originate within the shoulder.

A cervical nerve problem can sometimes produce pain extending from the neck into the shoulder or arm. Numbness, tingling, weakness or pain that changes substantially with neck movement may suggest that the cervical spine should be evaluated as well.

Patients whose symptoms seem to involve both areas may also find Elite’s neck pain treatment information useful.

This is one reason shoulder pain should not automatically be treated as a local shoulder problem without examining the broader clinical picture.

Can Poor Posture Cause Shoulder Pain?

Posture can influence comfort for some people, particularly during prolonged computer work or repetitive activity, but it should not be presented as the universal cause of shoulder pain.

People with rounded shoulders or forward head posture may have no pain, while someone with visually good posture may still develop a shoulder problem.

When prolonged sitting, workstation habits or movement patterns appear relevant, posture correction and movement training may be incorporated into a broader treatment plan.

The goal is not to force the body into one rigid “perfect posture,” but to improve movement options, strength and tolerance.

Can a Chiropractor Help With Shoulder Pain?

Chiropractic care may be appropriate for many musculoskeletal causes of shoulder pain, depending on the diagnosis and examination findings.

An evaluation may include:

• Shoulder range of motion
• Rotator cuff strength
• Joint mobility
• Shoulder blade movement
• Neck screening when appropriate
• Neurological testing when symptoms suggest nerve involvement
• Previous injuries
• Work and exercise demands
• Movements that increase or reduce pain

Treatment should be based on those findings rather than assuming every painful shoulder is caused by a joint being “out of alignment.”

How Does Elite Sports Medicine Treat Shoulder Pain?

Treatment depends on what appears to be causing the pain and what the patient needs to return to doing comfortably.

Care may include:

Therapeutic exercise: Strengthening can improve the capacity of the rotator cuff, shoulder blade muscles and surrounding tissues.

Joint mobilization or manipulation: Manual treatment may be used when relevant mobility restrictions or associated musculoskeletal symptoms are identified.

Soft tissue treatment: Techniques may be used for surrounding muscles and soft tissues when appropriate.

Mobility exercises: Treatment may address limited shoulder, upper-back or other relevant movement.

Activity modification: Particularly painful movements may temporarily be reduced or changed while the shoulder recovers.

Progressive rehabilitation: Exercise can gradually prepare the shoulder for work, lifting, exercise, sports or overhead activity.

These approaches can be incorporated with other chiropractic treatments available at Elite Sports Medicine.

Why Is Exercise Important for Shoulder Pain?

Exercise can be an important part of treatment because the shoulder needs sufficient strength and capacity for everyday movement.

Depending on the diagnosis, rehabilitation may include rotator cuff strengthening, shoulder blade exercises, mobility work and progressively returning to reaching or lifting.

Mayo Clinic notes that physical therapy exercises can improve flexibility and strength around the shoulder and may be sufficient for many people with rotator cuff problems.

Patients who need a more extensive rehabilitation program can also receive physical therapy through Elite Sports Medicine.

Why Does My Shoulder Hurt at Night?

Several shoulder conditions can become more noticeable at night.

Rotator cuff problems can produce night pain, and frozen shoulder symptoms may also interfere with sleep.

Sleeping directly on the painful shoulder can increase discomfort for some people.

Persistent night pain should be evaluated rather than automatically attributed to sleep position, particularly when it occurs together with weakness, significant loss of motion or worsening symptoms.

Should I Use Ice or Heat for Shoulder Pain?

Both may help with symptoms depending on the situation and individual preference.

Ice is commonly used after an acute injury or when the shoulder feels particularly irritated after activity. Heat may feel more comfortable when stiffness or muscle tension is prominent.

Neither addresses every possible cause of shoulder pain, so persistent symptoms should not be managed indefinitely with ice or heat alone.

Do I Need an MRI for Shoulder Pain?

Not always.

Many shoulder problems can initially be evaluated through history and physical examination.

Imaging may become useful when there has been significant trauma, substantial weakness, persistent symptoms, concern for a major rotator cuff tear or another structural problem, or when the result is likely to influence treatment decisions.

The fact that an MRI shows tendon or joint changes also does not automatically prove that those findings are responsible for every symptom.

Can Shoulder Pain Be Treated Without Surgery?

Many shoulder conditions are initially treated conservatively.

Treatment may include activity modification, exercise, rehabilitation and appropriate manual therapy.

However, surgery can be appropriate for certain injuries, including some significant traumatic rotator cuff tears, instability problems or other structural conditions.

If symptoms warrant further medical evaluation, Elite Sports Medicine’s multidisciplinary model includes orthopedic care as part of the treatment pathway.

When Should Shoulder Pain Be Evaluated?

Persistent or worsening shoulder pain deserves evaluation, especially when it limits work, exercise, sleep or normal movement.

More urgent medical attention is appropriate when shoulder pain follows significant trauma or is accompanied by:

• Visible deformity
• Sudden inability to use the arm
• Severe swelling
• Significant weakness after an injury
• Redness, warmth or fever
• Progressive numbness or weakness
• Chest tightness, shortness of breath or sweating

Mayo Clinic notes that shoulder pain occurring with breathing difficulty, chest tightness or sweating can be associated with a heart attack and requires emergency care.

Why Choose Elite Sports Medicine for Shoulder Pain Treatment?

Shoulder pain can arise from several different structures and sometimes from outside the shoulder altogether.

Elite Sports Medicine evaluates the shoulder, rotator cuff, shoulder blade, neck when appropriate, strength, mobility and the activities that reproduce your symptoms before developing a treatment plan.

Because Elite is a multidisciplinary practice, treatment can incorporate chiropractic care, physical therapy and rehabilitation, with access to pain management or orthopedic evaluation when additional care is appropriate.

Elite Sports Medicine provides shoulder pain treatment in Woodland Hills, Los Angeles (LAX), Montebello, West LA, Orange, and South Central LA.

Schedule a Shoulder Pain Evaluation

If shoulder pain is affecting work, sleep, exercise or everyday activities, identifying what is contributing to the problem can help determine the right treatment plan.

Request an appointment with Elite Sports Medicine in Woodland Hills, Los Angeles (LAX), Montebello, West LA, Orange, and South Central LA.