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 helpThe 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.
Shoulder pain symptoms vary by cause, but common presentations include:
Most shoulder conditions respond well to conservative management:
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.
Showing 12 therapies linked to Shoulder pain.
| Therapy | Evidence | Notes |
|---|---|---|
| Massage Therapist |
strong
|
Massage can ease tight shoulder and upper-back muscles, easing tension that often accompanies and aggravates shoulder pain. |
| Myofascial Release Practitioner |
strong
|
Myofascial release targets tightness around the shoulder and shoulder blade to free restricted movement and ease pain. |
| Osteopath |
strong
|
Osteopaths assess shoulder, neck and posture together, using hands-on techniques to improve movement and reduce pain. |
| Physiotherapist |
strong
|
Physiotherapy is a mainstay for shoulder pain, using tailored exercises to restore strength, range of movement and stability. |
| Sports Therapist |
strong
|
Sports therapists treat overuse and rotator-cuff strains with targeted rehab to rebuild shoulder strength and function. |
| Acupuncturist |
moderate
|
Acupuncture may help relieve persistent shoulder pain and is sometimes used alongside exercise to support recovery. |
| Alexander Technique Practitioner |
moderate
|
The Alexander Technique retrains posture and how you carry the shoulders, which may reduce strain that contributes to pain. |
| Biofeedback Practitioner |
moderate
|
Biofeedback can help you recognise and release habitual shoulder muscle tension that may be maintaining your pain. |
| Body Stress Release Practitioner |
moderate
|
Body Stress Release is a gentle complementary approach; evidence for shoulder pain is limited and it is not a substitute for proper care. |
| Chiropractor |
moderate
|
Chiropractors assess the shoulder, neck and upper spine, using adjustments and soft-tissue work to improve movement. |
| Fascial Stretch Therapist |
moderate
|
Fascial stretch therapy gently mobilises the shoulder joint and surrounding tissue to improve flexibility and ease stiffness. |
| Scar Tissue Release Therapist |
moderate
|
After shoulder injury or surgery, scar tissue release aims to soften adhesions that can limit movement and cause discomfort. |
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.
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.
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.
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.
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.