Orthopaedic Health Guide

Shoulder pain: causes, symptoms & treatment options

Shoulder pain can make everyday activities such as getting dressed, lifting objects, driving, or sleeping uncomfortable. Whether your discomfort developed after an injury or appeared without an obvious cause, identifying the underlying problem is essential for effective treatment.

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Medically reviewed by Dr. Hasan Syed, MDBoard-certified orthopedic surgeon
Woman holding her painful shoulder
Dr. Hasan Syed, MD

Individualized evaluation and treatment for shoulder conditions, sports injuries and joint problems in Chino and Loma Linda, California.

Board-certified orthopedic surgeon Associate Professor Shoulders & Sports
Call 911

Shoulder discomfort with chest pressure, shortness of breath, sweating or other possible heart attack symptoms.

Seek urgent care

Severe pain after trauma, visible deformity, sudden inability to move the arm, or a hot, swollen joint with fever.

Book an evaluation

Pain lasting beyond two weeks, interrupting sleep, or limiting work, exercise and daily life.

In short

Common causes of shoulder pain include rotator cuff injuries, tendonitis, bursitis, frozen shoulder, arthritis, and shoulder instability. Treatment depends on the diagnosis and may involve activity modification, physical therapy, medication, injections, or surgery. See all orthopedic services.

Causes

What causes shoulder pain?

The shoulder consists of bones, muscles, tendons, ligaments, and cartilage that work together to provide movement and stability. Because the shoulder moves in several directions, its surrounding tissues are vulnerable to injury, inflammation, and degeneration.

1 2 3 4 5
Simplified front view of the right shoulder
  1. 1
    Clavicle (collarbone)Connects the arm to the body
  2. 2
  3. 3
  4. 4
    Humerus & biceps tendonBiceps tendinitis · Avascular necrosis
  5. 5
    Scapula (shoulder blade)Shoulder instability
Tear Rotator cuff
Cause 1

Rotator cuff injuries

The rotator cuff consists of four muscles and their tendons that stabilize the shoulder. Repetitive overhead activities, aging, or sudden trauma can cause tendon irritation or tears.

Common symptoms include:

  • Pain when lifting or rotating the arm
  • Weakness during overhead movements
  • Difficulty reaching behind the back
  • Shoulder pain at night, especially when lying on the affected side
Learn about rotator cuff tears →
Bursa Tendon
Cause 2

Shoulder tendonitis & bursitis

Tendonitis is irritation or inflammation of a tendon; bursitis affects the fluid-filled sacs that cushion surrounding tissues. Both often follow repetitive movements, heavy lifting, or sports, and pain typically increases when raising the arm.

Biceps tendinitis →
Limited motion
Cause 3

Frozen shoulder

Frozen shoulder, medically called adhesive capsulitis, develops when the joint capsule becomes inflamed and stiff. Patients typically experience progressive pain and restricted movement. Diabetes and prolonged immobilization are recognized risk factors.

Learn about frozen shoulder →
Worn cartilage Bone spurs
Cause 4

Shoulder arthritis

Osteoarthritis occurs when protective joint cartilage gradually deteriorates, potentially causing stiffness, discomfort, and reduced mobility. Patients may notice grinding, difficulty reaching overhead, or persistent aching during daily activities.

AC joint osteoarthritis →
Socket Out of place
Cause 5

Shoulder dislocation & instability

A dislocation occurs when the upper arm bone moves out of its socket. Previous dislocations, trauma, and damaged stabilizing tissues can lead to recurring instability — sudden pain, visible deformity, weakness, or a feeling the shoulder is slipping.

Learn about shoulder instability →
AC joint injury Shoulder avascular necrosis Biceps tendinitis

Symptoms

Shoulder pain symptoms: what does your pain indicate?

The location and behavior of shoulder pain can provide useful diagnostic clues, although symptoms alone cannot confirm a condition.

123
  1. 1
    Top of the shoulderOften the AC joint
  2. 2
    Front or side, worse lifting the armOften the rotator cuff or a tendon
  3. 3
    Down the arm, with numbnessPossible nerve irritation in the neck
SymptomsPossible causes
Pain when lifting your armRotator cuff injury or tendonitis
Shoulder pain at nightRotator cuff disease, bursitis, or frozen shoulder
Progressive stiffnessFrozen shoulder or arthritis
Pain on top of the shoulderAcromioclavicular (AC) joint problems
Pain following a fallFracture, dislocation, or tendon injury
Pain with arm numbnessPossible cervical nerve irritation

A medical examination helps distinguish between these conditions and determine whether additional testing is necessary.

No clear injury

Why does my shoulder hurt without an injury?

Answer

Shoulder pain without injury may result from repetitive strain, tendon degeneration, arthritis, frozen shoulder, or pain referred from the neck.

Many shoulder conditions develop gradually rather than following a specific accident. Repeated overhead movements, prolonged computer work, and changes in tendon health can contribute to discomfort.

If pain persists, worsens, or interferes with sleep, an orthopedic evaluation can help identify the cause.

Woman with both hands on her neck and upper shoulders, feeling tension
Everyday tension in the neck and upper back can build into shoulder pain without a single injury.

Diagnosis

How is shoulder pain diagnosed?

Accurate diagnosis begins with a medical history and physical examination. An orthopedic specialist evaluates tenderness, strength, joint stability, and range of motion — and may also assess the neck when nerve-related symptoms are present. Depending on the findings, tests may include:

X-ray images displayed on a light board
X-rays show fractures, arthritis and bone changes.
MRI scan images reviewed on a tablet screen
MRI shows tendons, ligaments and cartilage.
X-raysIdentify fractures, arthritis, and certain bone abnormalities.
MRIEvaluates tendons, ligaments, cartilage, and other soft tissues.
UltrasoundHelps assess rotator cuff tendons and selected abnormalities during movement.
CT scansDetailed bone images for complex injuries or surgical planning.

Not every patient requires advanced imaging. Testing is selected according to symptoms, examination findings, and suspected conditions.

Treatment

Shoulder pain treatment options

Shoulder pain treatment typically begins with nonsurgical care, although significant injuries may require earlier surgical assessment.

Therapist treating a patient's shoulder by hand
Hands-on therapy helps restore shoulder movement.
Therapist using an ultrasound device on a patient's arm
Therapy is tailored to the diagnosis and stage of recovery.

  1. Activity modification & rest

    Temporarily reducing painful movements can help irritated tissues recover. Complete immobilization should generally be avoided unless medically recommended, because prolonged inactivity may increase stiffness.

  2. Physical therapy

    Restores flexibility, strengthens shoulder-supporting muscles, and improves movement patterns. A personalized program may include gentle stretching, rotator cuff strengthening, and shoulder blade stabilization exercises.

  3. Medication & injections

    Pain relievers or NSAIDs may help selected patients, but NSAIDs aren't appropriate for everyone — particularly people with certain kidney, stomach, or cardiovascular conditions.

    Corticosteroid injections may provide temporary relief for specific inflammatory conditions; discuss their risks and benefits with your physician.

When is shoulder surgery necessary?

Surgery may be considered when structural damage, instability, or persistent functional limitations can't be adequately managed with conservative treatment. Depending on the diagnosis, options may include:

Dr. Hasan Syed offers surgical and nonsurgical shoulder care, including arthroscopic procedures and shoulder replacement. Recommendations depend on examination findings, imaging, patient health, and functional goals.

Self-care

How can you relieve shoulder pain at home?

For mild shoulder discomfort without warning signs, several measures may provide temporary relief:

  1. 1Apply a cold pack wrapped in a towel for 15–20 minutes after an acute strain.
  2. 2Avoid movements that repeatedly trigger sharp pain.
  3. 3Maintain comfortable, gentle shoulder movement when safe.
  4. 4Support the affected arm with a pillow during sleep.
  5. 5Resume strengthening activities gradually under professional guidance.
Man doing gentle neck and shoulder stretches on a yoga mat at home
Gentle, pain-free movement helps keep the shoulder from stiffening.

Avoid forcing painful stretches or attempting to reposition a suspected dislocation yourself.

Next step

When should you see a shoulder pain specialist?

Schedule an orthopedic evaluation if shoulder pain:

  • Continues beyond two weeks without improvement
  • Frequently interrupts sleep
  • Causes persistent weakness or restricted movement
  • Develops after a sports injury or fall
  • Interferes with work, exercise, or everyday activities
Urgent warning signs

Seek urgent medical attention for severe pain after trauma, visible deformity, sudden inability to move the arm, or a hot, swollen joint accompanied by fever.

Call 911 for shoulder discomfort accompanied by chest pressure, shortness of breath, sweating, or other possible heart attack symptoms.

FAQs

Frequently asked questions about shoulder pain

What is the most common cause of shoulder pain?

Rotator cuff disorders, including tendonitis and tendon tears, are common causes. Arthritis, bursitis, and frozen shoulder can produce similar symptoms.

Can shoulder pain go away without surgery?

Yes. Many shoulder conditions improve with activity modification, physical therapy, and appropriate medication. Surgery is considered according to the underlying diagnosis.

Why is shoulder pain worse at night?

Nighttime shoulder pain can occur with rotator cuff disorders, bursitis, and frozen shoulder. Sleeping positions may also increase pressure on sensitive tissues.

How long does shoulder pain take to heal?

Recovery varies considerably. Minor strains may improve within weeks, while frozen shoulder or rehabilitation after major tendon repair can require months.

Should I see an orthopedic specialist for shoulder pain?

Consider specialist evaluation when symptoms persist, movement becomes limited, weakness develops, or pain substantially affects daily life.

Chino & Loma Linda, CA

Expert shoulder pain treatment in Chino and Loma Linda

Shoulder pain should not prevent you from enjoying everyday activities. Understanding the diagnosis is the first step toward restoring movement and function.

Dr. Hasan Syed, MD, is a board-certified orthopedic surgeon and Associate Professor of Orthopedic Surgery who provides patient-centered care for shoulder injuries, joint conditions, and sports-related problems.

  • Board-certified orthopedic surgeon
  • Associate Professor of Orthopedic Surgery
  • Arthroscopy & shoulder replacement
  • Offices in Chino & Loma Linda
Call 909-315-6515 Text to request an appointment

Request an appointment

909-315-6515

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Chino5365 Walnut Avenue, Suite M
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5365 Walnut Avenue, Suite MChino, CA 91710Get directions →

Loma Linda office

25915 Barton Road, Suite 203Loma Linda, CA 92354Get directions →

Contact

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