Shoulder Pain: Common Causes and How Physiotherapy Can Help

Shoulder pain is one of the most frequent reasons people visit a physiotherapist. Whether it’s a dull ache when reaching overhead, sharp pain while lifting, or discomfort that keeps you awake at night, shoulder pain can make even simple daily tasks challenging.

The shoulder is a highly mobile but complex joint, and its strength lies in movement — but that mobility also makes it vulnerable to injury and strain. The good news is that most shoulder problems can be effectively managed with physiotherapy, without the need for surgery.

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Understanding the Shoulder Joint

The shoulder (glenohumeral joint) is a ball-and-socket joint formed between the upper arm bone (humerus) and the shoulder blade (scapula). It relies on a group of muscles and tendons known as the rotator cuff to stabilise and move the arm.

When these muscles, tendons, or surrounding structures become irritated or injured, pain and loss of motion often follow.

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Common Causes of Shoulder Pain

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1. Rotator Cuff Tendinopathy or Tear

• The rotator cuff helps lift and rotate your arm. Overuse, poor posture, or trauma can lead to inflammation or tears.

• Symptoms: Pain when lifting the arm, weakness, and difficulty sleeping on the affected side.

Physiotherapy Treatment:
Treatment focuses on pain reduction and progressive strengthening of the rotator cuff and shoulder blade (scapular) muscles. Manual therapy, taping, and specific exercises help restore function and prevent recurrence.

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2. Shoulder Impingement Syndrome

• Occurs when shoulder tendons become “pinched” during overhead movement, often due to poor posture or muscular imbalance.

• Symptoms: Sharp pain when reaching up or behind the back, and discomfort when lying on the shoulder.

Physiotherapy Treatment:
Physiotherapy helps by improving posture, mobility, and muscle balance. Exercises that strengthen the rotator cuff and stabilising muscles

relieve pressure and restore smooth movement.

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3. Frozen Shoulder (Adhesive Capsulitis)

• A condition where the shoulder capsule becomes thickened and tight, severely limiting movement.

• Symptoms: Gradual onset of stiffness and pain that can last for months.

Physiotherapy Treatment:
Treatment focuses on gentle stretching, joint mobilisation, and pain management. Early physiotherapy can help prevent stiffness from worsening, while guided exercises help restore range of motion over time.

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4. Shoulder Instability or Dislocation

• Can occur after trauma (e.g., falling on an outstretched arm) or repetitive strain in athletes.

• Symptoms: A feeling of the shoulder “slipping out,” weakness, or apprehension during certain movements.

Physiotherapy Treatment:
The goal is to strengthen stabilising muscles and retrain the shoulder’s control system to prevent future dislocations. Post-surgical rehab may also be required in severe cases.

5. Postural or Overuse-Related Pain

• Common in office workers, students, or people who spend long hours sitting or working at a computer.

• Symptoms: Dull ache across the upper shoulder or between the shoulder blades, often worse at the end of the day.

Physiotherapy Treatment:
Postural retraining, ergonomic advice, stretching, and strengthening exercises for the upper back and neck can make a big difference. Manual therapy may also help release tight muscles and improve mobility.

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How Physiotherapy Helps Shoulder Pain

Physiotherapy is one of the most effective and evidence-based treatments for shoulder pain. It aims to:

• Identify the underlying cause of pain

• Restore normal movement and strength

• Reduce inflammation and discomfort

• Prevent recurrence and long-term stiffness

 

Treatment Techniques May Include:

• Manual therapy – joint mobilisation, soft tissue release

• Targeted exercise programs – strengthening and stability training

• Posture and ergonomic advice

• Taping or bracing for support and pain relief

• Education on activity modification and gradual return to exercise

 

When to See a Physiotherapist

You should seek help if you experience:

• Shoulder pain lasting more than a few days

• Difficulty lifting or reaching overhead

• Pain at night or while sleeping on one side

• Weakness, clicking, or instability in the joint

Early physiotherapy assessment can speed up recovery and prevent secondary issues such as stiffness or chronic pain.

 

Final Thoughts

Shoulder pain can affect your work, sport, and sleep — but with the right physiotherapy approach, you can regain movement and confidence. Through a combination of hands-on treatment, exercise therapy, and education, physiotherapy not only relieves pain but also addresses the root cause for lasting results.

If shoulder pain is holding you back, book an appointment with your physiotherapist today. The sooner treatment begins, the quicker your shoulder can get back to full strength and function.