Active Health Hub

Shoulder Pain: Causes, Conditions & Exercises

AI-generated illustration for health and exercise content

Everything you need to understand, treat and overcome shoulder pain — from common causes and conditions to exercises that actually help.

Conditions
Exercises
When To Seek Help

Introduction

If you’re struggling with shoulder pain you know how it can make everyday activities surprisingly difficult — from putting on a coat to sleeping comfortably or getting back to the gym.

In clinic, shoulder pain is one of the most common physical complaints that I treat, affecting people of all activity levels. I see patients of all ages — from the 19-year-old struggling to lift weights, to the 75-year-old struggling to pour the kettle.

Our shoulders are the most mobile joints in the body. That’s amazing when it’s working well — but if things go wrong, that mobility turns into instability.

The good news is that most shoulder problems can be managed successfully with the right combination of movement, rehabilitation and gradually increasing strength.

What This Page Will Help You Understand

  • Why shoulder pain is so common
  • The most common causes of shoulder problems
  • Common Shoulder Injuries
  • Can Your Neck Cause Shoulder Pain?
  • How shoulder problems are best treated
  • The best long-term solutions

Affiliate Disclosure: Some links on this page are affiliate links. If you purchase a product through one of these links, I may earn a small commission at no extra cost to you. I only recommend products I have personally used or would confidently recommend to patients in clinic. This does not influence my clinical advice.

Why Is Shoulder Pain So Common?

The shoulder is a complex area involving several joints, muscles, tendons and other structures that work together to allow movement.

Shoulder pain can develop suddenly following an injury, or gradually as the demands placed on the shoulder increase.

Here are some of the most common factors I see daily:

  • Repetitive overhead or lifting activities
  • A sudden increase in training or activity
  • Previous shoulder injuries
  • Reduced strength or upper-back strength
  • Wear and tear to tendon
  • Spending long periods in the same position

One thing I’ve noticed over time is that shoulder pain doesn’t always mean that something is seriously damaged. Also, symptoms can come from a number of different structures, and different shoulder problems can produce very similar symptoms.

Common Shoulder Injuries

Identifying the exact cause of a shoulder problem isn’t always straight forward as there can be multiple structures involved.

Here are some of the most common causes I see in clinic.

Rotator Cuff Injuries

The rotator cuff is a group of four muscles and tendons that help control and stabilise the shoulder.

Common symptoms include:

  • Pain when lifting the arm
  • Pain reaching overhead
  • Pain when lifting or rotating the arm
  • Discomfort when lying on the affected side
  • Weakness with certain movements

Read my guide to Rotator Cuff Problems.

Rotator cuff anatomy showing tendons and shoulder muscles

Shoulder Impingement

Shoulder impingement is a type of shoulder condition that leads to “pinching” of the tendons at the front of the shoulder.

Out of all types of shoulder problems I see, I would say that this is the most common. The most common symptoms are:

  • Pain when raising the arm sideways
  • Pain when internally rotating the arm when it is raised (think pouring a kettle or doing up a bra).

Read my guide to Shoulder Impingement.

Frozen Shoulder

Frozen shoulder causes significant pain and stiffness, with movement becoming progressively restricted.

People often struggle with everyday activities such as reaching overhead, and getting dressed.

Recovery can take time, but appropriate management can help maintain movement and function.

Read my guide to Frozen Shoulder.

AC Joint Sprain

The acromioclavicular (AC) joint is located at the top of the shoulder. I personally suffered a classic AC joint sprain a few years back after falling awkwardly during a football match. I’ve noticed in clinic that these injuries often occur due to repetitive strain and poor shoulder function.

Postural and Muscular Issues

The way you sit, work and move throughout the day can have a big influence on how your shoulder feels. Poor posture, prolonged desk work and muscular imbalances can place extra stress on the shoulder and upper back, contributing to stiffness, discomfort and reduced movement.

Man with shoulder pain at a computer desk

Desk and screen work is one of the most common drivers of shoulder pain I see in clinic. Rounded shoulders and a forward head position place continuous strain on the rotator cuff and upper back muscles.

If you spend a lot of time at a desk, improving your workstation may help reduce unnecessary strain.

See my guides to choosing an Ergonomic Chair and Standing Desk for practical advice on creating a more shoulder-friendly set-up

Can Your Neck Cause Shoulder Pain?

Not all pain felt around the shoulder actually comes from the shoulder. The nerves and joints of the neck can sometimes refer pain into the shoulder, shoulder blade or arm.

One of the biggest mistakes I see when assessing shoulder problems is focusing solely on the painful shoulder and overlooking the neck. The two areas are closely connected, and in some cases the neck can be contributing significantly to what feels like a shoulder problem.

This is particularly important if your shoulder pain is accompanied by:

If your symptoms don’t seem to fit a typical shoulder problem, the neck should also be considered as part of the assessment.

As a chiropractor, this is something I routinely assess when someone presents with shoulder pain. Sometimes the shoulder itself is the main problem; in other cases, the neck is contributing to the symptoms and needs to be addressed as part of the rehabilitation.

If your pain is felt in the shoulder, arm and shoulder blade, you should read the Pinched Nerve in the Neck guide

How Are Shoulder Problems Best Treated?

Stage 1 – Painful and irritable:

When the shoulder is very painful, my first advice to patients is always to reduce activities that aggravate it while maintaining gentle movement where tolerated. I call it “passive rest”. Appropriate pain relieving strategies may be required at this stage.

Stage 2 – Restore Movement

When symptoms become more managable, I shift the focus towards restoring comfortable shoulder movement. Gentle mobility exercises can help gradually increase the range that your shoulder can tolerate.

Stage 3 – Rebuild Strength:

Once movement is improving, I start to add in strength exercises to restore stability and control. These are normally the safest ones to test the water with:

Stage 4 – Return to Function

The final stage is about making your shoulder strong enough for the activities you actually want to return to. For one of my most recent patients, it was dancing. These were the two exercises that I progressed her to at this stage:

Note: Each stage can take several months. Stay consistent — the vast majority of shoulder cases improve with conservative, non-invasive approaches.

Painful Shoulder When Lying Down?

Night time pain can be particularly frustrating because it can interfere with sleep.

I experienced this myself after suffering a shoulder injury playing football. It gradually improved but I just could not shake the discomfort at night when lying on my side. Eventually I tried a firmer supportive pillow, and after about a month I woke up for the first time lying on that side without pain.

If this sounds familiar, an ergonomic pillow is worth trying as part of your recovery. One of the pillows I continue to recommend to my patients is The Groove Pillow due to the fantastic feedback that I get.

Find out more about The Groove Pillow.

Man sleeping on Groove Pillow showing spinal alignment

Common Shoulder Conditions

For more information on the most common shoulder conditions, click on the guides below

Shoulder Exercises

Exercise is an important part of rehabiliation for many shoulder problems.

The best exercise depends on the cause of your pain and how irritable your shoulder currently is.

Some exercise may be appropriate early in recovery, while others are better suited to strengthening and return-to-function stages.

Each exercise guide below includes instructions, advice on technique and a video demonstration.

Shoulder pain does not have to be permanent. With the right information and consistent action, most of my patients can gradually restore their function, reduce pain, and prevent future issues.

The Next Step

Shoulder pain can have many different causes, and the most appropriate treatment depends on what’s driving symptoms.

If you already know what’s causing your pain, read the relevant condition guide. Once you’ve identified the likely problem, the next step is to restore movement, rebuild strength and gradually return to the activities you enjoy. Good luck!

Related Guides

When to Seek Help

⚠ Seek urgent help if you experience:

  • Sudden severe pain after trauma with inability to move the arm
  • Significant swelling, bruising or visible deformity
  • Pins and needles or progressive weakness down the arm