If you’re experiencing shoulder pain, stiffness, or weakness, it can impede your ability to perform daily activities like reaching for items on high shelves or even brushing your hair. Determining the root cause of your shoulder discomfort is crucial to finding a solution. Given the complexity of the shoulder joint, there are various potential causes of shoulder pain. Our health experts provide their opinions and recommendations to help you identify the possible causes of your shoulder pain.

How to tell if shoulder pain is serious

Regarding shoulder pain, your overworked joint is quick to let you know something’s wrong. But how can you tell if it’s a minor ache or a severe injury that requires medical attention?

Here are symptoms that often serve as warning signs of a shoulder injury:

• Sudden and sharp pain.
• Decreased range of motion.
• Pain along with swelling, pressure or bruising.
• Constant stabbing pain or discomfort that continues to worsen.
• Pain that prevents you from falling asleep or wakes you up.
• After several days of rest, icing and over-the-counter anti-inflammatory medications, no pain relief.

Conditions that cause shoulder pain

What is causing all this pain in your shoulder? Here are 11 possible reasons for your sudden discomfort.

Rotator cuff injuries

The rotator cuff, a group of small muscles and tendons surrounding the shoulder joint, plays a crucial role in arm movement. These muscles and tendons work together to keep the upper arm bone in place within the shoulder socket, but their continuous use can lead to wear and tear, resulting in rotator cuff tears. Rotator cuff tears may occur from a single event or repeated motions, such as frequently raising one’s arms overhead. Symptoms of a rotator cuff tear include shoulder pain at night, difficulty lifting the arm aloft, and weakness in the shoulder. Initial treatment may consist of rest, ice, over-the-counter anti-inflammatory medications, and physical therapy. According to expert physicians, night pain is a significant indicator of a rotator cuff tear.

Rotator cuff tendonitis

Shoulder pain due to rotator cuff tendonitis can be a real nuisance. This condition occurs when tendons in your joint become inflamed and irritated, causing pain on the front and side of your shoulder. Stiffness is also common. According to expert physicians, activities that involve using your arms overhead, like tennis, yoga, or painting a room, can cause this condition. The pain usually worsens at rest and improves with activity. Fortunately, most people recover from tendonitis within a few weeks with rest, ice application, and taking NSAIDs.

Rotator cuff bursitis

Bursitis can cause shoulder pain also, which can be pretty uncomfortable. Bursae, tiny fluid-filled sacs, help lubricate your shoulder joint and cushion it as you move your muscles, tendons, and bones. When these sacs become irritated due to overuse or improper joint positioning, it can lead to swelling and inflammation, known as bursitis. Often occurring in conjunction with tendonitis, the symptoms and treatment methods are similar. A physical therapist may recommend specific lifestyle tips, stretches, and exercises to lower your risk of developing bursitis.

Three tips to address shoulder bursitis

The first step to calming your bursitis? Stop aggravating it. “Try to avoid the things that cause you pain,” says Our physical therapy experts: That sounds easy enough. But it can require some fundamental changes to how you do things.”

Here are three common causes of shoulder bursitis in your daily life — and how you might be able to resolve them. 

Sleeping position

Does your arm hurt when you get up in the morning? If so, it may be because of your sleeping position. “If you’re laying on your side with your arm extended under your pillow, that’s not good,” says Kinsey.

Leaving your arm in that position pinches your bursae and rotator cuff for hours, putting unnecessary impingement and stress on your shoulder.

The solution: Try a new pillow. “Usually, if you want to put your arm under your pillow, it’s because the pillow is too thin or too soft,” notes Our physical therapy experts. “Getting a new, thicker pillow will help you not want to do that.”

Leaning

Leaning on your elbows for long periods compresses your shoulder, which is also a no-no for your shoulder health. (Examples include elbows on your desk at work or leaving your arm on your car’s centre console when driving.)

“When you do this, you’re basically squishing the water balloon that is your bursa and aggravating it,” says Our physical therapy experts.

The solution: Reposition yourself. Move around a bit, so you’re not leaning on your elbows for extended periods and overtaxing your shoulders. At work, maybe try a standing desk.

Posture

Sitting in a reclined position pulls your shoulder blades forward and can put the pinch on the bursae, creating the conditions for bursitis. (You may fall into this body alignment while tapping a computer keyboard or scrolling through your cell phone.)

Poor posture can also strain your neck and back, leading to a network of overworked muscles.

The solution:

1. Focus on sitting up straight.
2. Review your desk setup to minimize your time looking at a downward angle.
3. Get up and move around regularly to avoid getting stuck in one position.

Stretches to lower the risk of shoulder bursitis

Let’s start with this reality: You can’t exercise or stretch a bursa sac. (Remember, it’s a cushion.) What you can do, though, is work the muscle and tendons surrounding the bursae to give it the space it needs.

“We start with freedom and looseness in our shoulders,” says Kinsey. “But our normal, every day habits can tighten things up in a negative way. Stretching helps address that by loosening the shoulders and creating room for the bursae to operate efficiently.”

Here are three simple stretches to keep the joints in good working order.

Doorway stretch

The stretch targets your pectoral muscles and the front of your chest.

• Stand in an open doorway.
• Put your arms out and grab hold of each side of the doorway. Keep your hands at or below shoulder level.
• Lean forward and hold for 30 seconds. Repeat three times.

Shoulder blade squeeze

The stretch improves limb mobility and helps improve posture.

• Stand or sit with your arms at your side.
• Relax your shoulders so they’re in a normal resting position. (No shrugging!)
• Move your arms back, squeezing your shoulder blades together. Hold for a second and then return to your starting position. Do two sets of 10 squeezes.

Cross arm stretch

The stretch hits the back of your shoulders to improve flexibility.

• Bring your right arm across the front of your body at chest height.
• Bend your left arm at the elbow and press your left forearm against your right arm, pressing your right arm closer to your chest.
• Hold for 20 seconds, then switch arms and repeat. Do three sets.

Shoulder impingement syndrome

Shoulder impingement syndrome can occur when a rotator cuff injury causes swelling, resulting in rubbing or pinching of muscles and tendons as they pass through a narrow space. This can lead to significant discomfort. However, symptoms usually improve over several weeks or months with physical therapy, rest, ice, and NSAIDs. If you’re experiencing shoulder pain or discomfort, seeking medical attention and getting an accurate diagnosis is vital to ensure proper treatment.

Frozen shoulder

There’s a formal name — adhesive capsulitis — for the painful condition where your shoulder becomes stiff and can’t move. Most people know it by a more descriptive moniker: frozen shoulder.

If a frozen shoulder is left untreated, the problem can worsen and lead to complete immobility. Although it can follow an injury, many patients cannot recall any specific injury that caused it. Additionally, it’s more common in people with conditions like diabetes and Parkinson’s disease, although the reason for this is still unclear. It can take several months to resolve, even with treatment. Range of motion exercises and stretches can help prevent symptoms from worsening. However, post-injury stiffness, which occurs after immobilization, such as wearing a sling, is a different condition and typically responds quickly to physical therapy.

Calcific tendonitis

Another worry with your shoulder? Something called calcific tendonitis.

This condition — less common — develops when calcium deposits build up within tendons running through your shoulder. The bigger these deposits grow, the more irritation and pain they cause.

Calcific tendonitis can arise in the face of chronic tendonitis of the rotator cuff. The deposits can typically be seen on X-rays. Treatment usually centers on physical therapy, NSAIDs and steroid injections.

Shoulder osteoarthritis

Osteoarthritis may be the culprit if you experience a deep ache in the back of your shoulder. This type of shoulder pain is caused by the deterioration of cartilage, which serves as a cushion for your bones. As osteoarthritis progresses, your shoulder may become stiff, making it difficult to reach behind your back or perform everyday tasks. “Patients often report difficulty scratching their back or fastening a belt,” explains our expert physician.

Osteoarthritis develops slowly over time, and while a shoulder injury can accelerate the degenerative process, many people develop it through natural wear and tear. Treatment for shoulder osteoarthritis typically involves rest, ice, and over-the-counter anti-inflammatory medication. If the condition is severe, shoulder joint replacement surgery may be necessary, similar to joint replacement surgery for hips and knees.

Other forms of shoulder arthritis

While osteoarthritis may be the most common form of shoulder arthritis, a few more types can bring pain. The list includes:

• Rheumatoid arthritis. This chronic autoimmune disease targets joints in your body, including your shoulder.
• Post-traumatic arthritis. A shoulder injury may heal, but long-term damage can show itself later through post-traumatic arthritis.
• Rotator cuff tear arthropathy. Count this form of arthritis among the potential after-effects of a rotator cuff tear.
• Avascular necrosis. This painful condition happens when something blocks blood flow to your bone tissue. A fracture or disease typically causes it.

When to see your doctor about shoulder pain

Shoulder pain is not uncommon. Given that many injuries above are related to general wear and tear, it’s easy to see why. The joint takes a beating in daily life. That’s just a reality.

But when that pain begins to affect basic activities — such as reaching up to wash your hair — it’s time to get your shoulder checked. A combination of physical therapy, rest and other at-home remedies can often resolve the problem.

“Solutions are available,” says our experts. “It’s often just a matter of correctly identifying the problem.”