PATIENT EDUCATION
Shoulder Symptoms
Select the symptom that most closely describes what you are experiencing. The information below describes common causes and general guidance.
Select a symptom below to view more information.
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Pain With Overhead Activity
What you'll notice or feel
- You may feel pain when reaching up to a shelf, combing your hair, or reaching behind your back.
- You might notice a painful "arc" — pain in the middle of lifting your arm that eases again near the top.
- The discomfort may ease when you lower your arm.
- You may feel the pain more on the outer upper arm than the shoulder itself.
Common causes
- Irritation or minor injury to the muscles and tendons holding the shoulder in place (rotator cuff).
- The tendons getting pinched under the bony arch of the shoulder during overhead movement (impingement).
- General shoulder overuse from repetitive lifting or throwing.
- Age-related wear of the shoulder tendons.
What it could be
- Irritation of the muscles and tendons stabilising the shoulder (rotator cuff tendinopathy).
- Pinching of these tendons under the bony arch of the shoulder during movement (subacromial impingement).
- A partial or full tear of one of these tendons.
- Inflammation of the fluid-filled cushion under the shoulder bone (subacromial bursitis).
- Referred pain from the neck, which can sometimes feel like shoulder pain.
Initial self-care
- Avoid repeated overhead activity for a short period.
- Gentle range-of-motion exercises within a comfortable range.
- Ice application after activity if there's associated swelling or acute pain.
- Over-the-counter pain relief if needed, as per the label.
When to see a doctor urgently
- You suddenly lose the ability to lift your arm following an injury.
- You have significant swelling, deformity, or bruising after a fall or injury.
- You have severe pain following a sudden, forceful movement.
When to see a doctor
- Your pain lasts more than 2 weeks despite rest and simple care.
- The pain is limiting your work or daily activities.
- It keeps recurring with the same activities.
Night Pain
What you'll notice or feel
- Pain may wake you up, especially when lying on the affected side.
- You may find it hard to get comfortable at night.
- The pain may feel worse at night than during the day.
- You may have stiffness on waking that eases somewhat through the day.
Common causes
- Increased pressure on an already irritated shoulder tendon when lying on that side.
- Reduced movement overnight allowing inflammation and stiffness to build up.
- Progression of a tendon problem that started as daytime activity-related pain.
- Early features of a stiffening shoulder (frozen shoulder).
What it could be
- Ongoing irritation of the shoulder tendons (rotator cuff tendinopathy), now advanced enough to disturb sleep.
- A tear in one of the shoulder tendons.
- A stiffening and thickening of the shoulder capsule (frozen shoulder / adhesive capsulitis).
- Inflammation of the fluid-filled cushion under the shoulder bone (bursitis).
- Wear of the shoulder joint surface itself (osteoarthritis), less common at younger ages.
Initial self-care
- Try sleeping on the opposite side, or on your back with a pillow supporting the affected arm.
- Avoid sleeping with the arm overhead.
- Gentle stretching before bed within a comfortable range.
- Simple pain relief before bedtime if needed, as per the label.
When to see a doctor urgently
- You have night pain with fever or feel generally unwell.
- You have severe, unrelenting pain not eased by any position or simple pain relief.
- Your night pain follows a significant shoulder injury.
When to see a doctor
- Your night pain persists beyond 2–3 weeks.
- It's accompanied by increasing daytime stiffness.
- Your sleep is regularly and significantly disrupted.
Stiffness / Loss of Range of Motion
What you'll notice or feel
- You may find it hard to reach behind your back (fastening a bra, tucking in a shirt).
- You may struggle to reach overhead or out to the side.
- Your shoulder may feel "stuck," especially first thing in the morning.
- Others, such as a physiotherapist or family member, may notice your reduced movement before you do.
Common causes
- A stiffening and thickening of the shoulder capsule, often for no obvious reason (frozen shoulder).
- Prolonged disuse after an injury, surgery, or a period of pain.
- Wear of the shoulder joint surface (osteoarthritis).
- Certain underlying conditions, including thyroid problems and diabetes, which are linked to a higher chance of frozen shoulder.
What it could be
- A stiffening and thickening of the shoulder capsule (frozen shoulder / adhesive capsulitis) — very common, particularly in midlife.
- Wear of the joint surface itself (shoulder osteoarthritis).
- Stiffness following a tendon tear that has not been moved properly.
- Stiffness secondary to a previous fracture or surgery in the area.
Initial self-care
- Keep the shoulder gently moving within a comfortable range — avoid complete rest.
- Simple pendulum-type swinging exercises.
- Heat before stretching, to ease muscle tightness.
- Pace activity — some stiffness in the early stages is expected to improve slowly.
When to see a doctor urgently
- Your stiffness follows a fall or injury, especially with severe pain.
- You suddenly can't move your shoulder at all.
- Your stiffness comes with fever or feeling unwell.
When to see a doctor
- Your stiffness lasts more than a few weeks and is clearly limiting daily tasks.
- It's progressively worsening rather than improving.
- You have a known diagnosis of diabetes or thyroid disease with new shoulder stiffness.
Weakness, Especially With Lifting or Reaching
What you'll notice or feel
- You may find it hard to lift objects that previously felt easy.
- Your arm may feel like it "gives way" during lifting or reaching.
- You may notice weakness specifically with overhead reaching, rather than at rest.
- You may find it hard to hold your arm out to the side against resistance.
Common causes
- A tear in one of the muscles or tendons holding the shoulder in place (rotator cuff).
- Pain-related weakness, where the shoulder is not truly weak but hurts too much to usefully.
- Nerve-related weakness, occasionally from the neck or a nerve around the shoulder blade.
- General muscle deconditioning after a period of reduced use.
What it could be
- A partial or full tear of the muscles and tendons stabilising the shoulder (rotator cuff tear).
- Weakness from pain avoidance rather than true structural damage.
- A nerve problem affecting the muscles around the shoulder blade.
- A pinched nerve in the neck contributing to shoulder-area weakness.
Initial self-care
- Avoid heavy lifting until the cause is clearer.
- Note whether the weakness is constant or only present with certain movements.
- Gentle, pain-free strengthening only, avoiding forcing through resistance.
When to see a doctor urgently
- You have sudden weakness following a fall, lifting injury, or shoulder dislocation.
- You're completely unable to lift your arm away from your body.
- Your weakness comes with numbness or significant pain.
When to see a doctor
- Your weakness lasts more than 2 weeks.
- It isn't improving with rest.
Clicking, Catching or Instability
What you'll notice or feel
- You may hear or feel a click, clunk, or grinding sensation with certain movements.
- You may feel like your shoulder might "pop out" or is loose.
- You may have episodes where the shoulder briefly feels like it slips out of place.
- You may notice catching or hesitation during specific arm movements.
Common causes
- Irregularities in the smooth cartilage lining of the joint or its cushioning ring (labrum).
- General joint looseness, sometimes present from a young age.
- A previous shoulder dislocation making the joint more prone to further episodes.
- Wear-related changes in the joint surface producing clicking without instability.
What it could be
- A tear or irregularity in the cartilage ring that deepens the shoulder socket (labral tear).
- Generalised joint looseness (shoulder hypermobility or instability).
- Repeated partial or full dislocation of the shoulder.
- Age-related joint surface wear causing painless or painful clicking without true instability.
Initial self-care
- Avoid positions that reproduce the feeling of the shoulder slipping.
- Avoid heavy overhead or behind-the-back activity until assessed if instability is suspected.
- Gentle strengthening of the muscles around the shoulder blade, once pain allows.
When to see a doctor urgently
- You have any episode where your shoulder visibly or felt like it came out of place.
- You suddenly can't move your arm after a clicking or catching episode.
- Your clicking or instability follows a significant injury, with severe pain or deformity.
When to see a doctor
- Your clicking is painless and not associated with any instability — this can often simply be monitored.
- Recurrent catching or clicking is starting to limit your activity.
YOUR CONSULTATION
What to Expect at Your Visit
- The doctor will ask when your symptoms started, how they've progressed, and what specifically limits you
- You'll be examined for shoulder movement — both what you can do actively and what the doctor moves for you — along with strength testing and tests aimed at your particular symptom
- Your neck is often checked too, since neck problems can sometimes mimic shoulder symptoms
- Imaging depends on what's suspected: an X-ray for the joint and bone, an ultrasound or MRI for the tendons and soft tissues, or occasionally an MRI with contrast dye if a cartilage-related problem is suspected
- If stiffness is significant, underlying conditions like thyroid problems or blood sugar may be checked
- Management ranges from physiotherapy and activity modification to injections, with surgical opinion reserved for significant tears, instability, or cases not responding to conservative treatment
* IMPORTANT - A Note Before You Go
This page covers some of the more common reasons for shoulder symptoms. It is not a complete list of everything that can affect the shoulder and is not a substitute for a proper medical assessment.
Please do not use this information to diagnose yourself or decide your own treatment. If anything here concerns you, the appropriate next step is to have it assessed by a healthcare professional.