Shoulder pain can make simple tasks like lifting your arm, getting dressed, or reaching for something on a shelf feel difficult and frustrating. If you’re looking for clear answers and real ways to feel better, this guide is for you.
We’ll break down the common causes of shoulder pain, proven treatments that help relieve discomfort and restore movement, and steps you can take at home. You’ll also learn when it’s time to see a doctor for faster recovery.
Quick Overview: What Counts as “Shoulder Pain” and Why It Happens
Your shoulder joint is a ball-and-socket built for big motion. The ball of the upper arm sits in a shallow shoulder socket on your shoulder blade, and a group of muscles and tendons called the rotator cuff helps stabilize the shoulder while you move. Because this joint moves a lot, it also gets irritated a lot, especially with overhead work. That means pain can show up in the front, side, or top of the shoulder, and sometimes down the arm.
Most shoulder problems fall into four main categories:
- Tendon Problems – This includes tendinitis, bursitis, and rotator cuff tears.
- Instability – Such as a dislocated shoulder or repeated partial dislocations (subluxations).
- Arthritis or Wear-and-Tear – Conditions that cause cartilage to thin and joints to stiffen or ache.
- Fractures – Breaks in bones like the clavicle (collarbone) or humerus (upper arm bone).
Knowing which category your pain falls into can help you choose the right treatment; whether that’s physical therapy, injections, or surgery.
You’ll also hear specific terms that matter. Shoulder impingement happens when the tendons that surround the shoulder start rubbing under the bony roof known as the acromion. Bursitis means the small fluid-filled sacs called bursae get inflamed. Frozen shoulder traps you in pain and stiffness for months. All three limit mobility and change how the shoulder muscles fire. Good news, most cases respond to smart loading, targeted manual therapy, and progressive strength.
Is Your Pain Urgent? Red-Flag Checklist
You can handle many shoulder flares at home, but a few signs call for urgent care. If pain hits with chest pressure, shortness of breath, or heavy sweating, treat it like an emergency. If your shoulder looks deformed after a fall, if you cannot lift your arm away from your body, or if you have sudden swelling and intense pain, go to urgent care. Don’t try to “gut it out.”
If none of those apply, still book an appointment soon when you notice worsening stiffness, redness or warmth around the shoulder, or night pain that keeps you from sleeping. Early assessment shortens your timeline back to paddling, rolling, or serving.
Map of Shoulder Pain Causes
To make sense of where your pain is coming from, it helps to break it down into the main types of problems that affect the shoulder.
Tendon Causes
Tendon-related pain comes from issues like rotator cuff or biceps tendinitis, partial or full rotator cuff tears, bursitis, or shoulder impingement under the acromion. This pain is usually felt at the front or side of the shoulder and often gets worse when you reach or try to sleep on that side at night.
Instability Causes
Shoulder instability happens when one major dislocation or repeated smaller slips, called subluxations, stretch the soft tissues and leave the joint feeling loose. If you feel like the ball of your shoulder slides or shifts in the socket, it’s a sign to get it checked.
Arthritic Causes
Osteoarthritis or inflammatory arthritis can wear down the joint, causing grinding, stiffness, and steady pain during activity. Most cases are managed with conservative care at first, but severe cases may eventually need shoulder replacement.
Traumatic or Bony Causes
Falls, crashes, or heavy impacts can fracture the clavicle, humerus, or shoulder blade. These injuries require imaging and orthopedic care right away, and rehab should only begin after the bone is stable.
Less Common Causes
Shoulder pain can also come from less common issues like tumors, infections, or pain referred from the neck or nerves. These should be considered when symptoms don’t fit the usual patterns.
What Your Shoulder Pain Is Trying to Tell You
The precise location and quality of shoulder pain often provide reliable clues about the underlying problem. Let’s explore what your discomfort might be telling you.
Pain Location & Sensation
- Aching in the front or side of your shoulder when you reach: This often points to irritation in the rotator cuff or bursa.
- Pain that wakes you up at night, especially when you roll onto that shoulder: Could signal rotator cuff damage or a more serious tear.
- Clicking, popping, or grinding sounds: Usually a sign of joint wear and tear or arthritis.
- Pain and stiffness when reaching behind your back (like fastening a bra or grabbing a wallet): May indicate a tight shoulder capsule or early frozen shoulder.
Pain with Movement
- Sharp pain when reaching overhead: Commonly caused by impingement—when the space under the acromion (shoulder bone) gets tight and squeezes the rotator cuff tendons.
- Feeling like your shoulder “slips,” feels loose, or might pop out: This suggests shoulder instability.
Track Your Symptoms
Write down:
- Which movements cause pain
- When the pain started
- What improves or worsens it
This simple log makes it easier for your doctor or therapist to diagnose the problem quickly and accurately.
How We Diagnose What’s Really Going On
To uncover the real source of your shoulder pain, we follow a step-by-step process that starts with your story and ends with a clear plan.
History and Movement Check
We start by asking how the pain began, what you do for work or sport, and how you sleep. Then we watch how your shoulder moves; how the shoulder blade, ribcage, and upper arm line up and glide when you reach. This gives useful information before any tests or scans.
Testing to Pinpoint the Problem
We use specific tests to tell if it’s a tendon issue, instability, or arthritis. That includes strength tests, impingement tests, and relocation tests. If imaging is needed, we explain why.
- X-ray shows bone position and joint space.
- Ultrasound checks tendons and soft tissue.
- MRI shows tendons, labrum, and scar tissue.
- We only order scans if they help change or guide treatment.
Next Steps
If we see red flags, we refer you to a specialist right away. If not, we start a treatment plan that fits your diagnosis and your daily life in Honolulu.
First-Aid Playbook You Can Start Today (If No Red Flags)
If your symptoms aren’t dangerous, these are the first steps to calm things down without losing motion or strength.
Change How You Move, Don’t Stop Moving
Avoid the motion that spikes pain, keep other motions going. Shorten overhead work, reduce paddling volume, and change grips in the gym. This protects the irritated tendon and bursa without letting the shoulder become stiff.
Reduce Inflammation
Ice the shoulder 15 minutes, 2–3 times a day for the first week if it’s puffy and hot. Use painkillers like ibuprofen or other nonsteroidal anti-inflammatory drugs only as directed and only if safe for you. If you need meds beyond over-the-counter, your doctor may prescribe options or consider a steroid injection later.
Keep the Joint Moving
Try gentle pendulums, table slides, and supported external-rotation isometrics. Stay in pain-free ranges. If pain increases during the set, stop and reset your position or dosage. These basics protect range of motion while the tissue calms down.
Evidence-Informed Physical Therapy Pathways at Dynamic Stretch Therapy
You want relief that lasts, not a quick patch. That’s why we use research-backed methods to fix the root cause of your shoulder pain. Here are the services we offer at Dynamic Stretch.
- Fascial Stretch Therapy (FST) – We use table-based assisted mobility to create space in the joint, improve capsule glide, and restore clean motion under the acromion. This helps calm shoulder impingement and improves the way the ball tracks in the socket during reach.
- Manual therapy and joint work – Specific mobilizations tune the joint and soft tissue, support scapular upward rotation, and help the rotator cuff fire without grinding. Less pinch under the subacromial roof means more motion with less pain.
- IASTM blading, taping, cupping, flossing, LifeStretch – Tools that modulate tone, improve tolerance at end range, and give you short-term relief so you can train again. We use them to support progressive strength.
- Progressive strength and motor control – We build from isometrics to eccentric load, then into overhead progressions. Expect manual therapy first, then graded loading for the muscles and tendons that surround the shoulder joint. Each phase matches your goals (paddling catch, tennis serve, or BJJ frames).
Condition-Specific Game Plans
Not all shoulder pain is treated the same, so here’s how care shifts depending on the exact condition.
Rotator Cuff or Biceps Tendinopathy, Subacromial Bursitis
Pain is usually at the front or side of the shoulder, worse with reaching or at night. We reduce movements that trigger it, use isometric exercises to calm pain, then slowly add strengthening with controlled eccentric motions. We also work on posture and ribcage movement to create more space under the acromion. If progress stops after proper rehab, your doctor may recommend a corticosteroid injection.
Impingement Syndromes
You feel a pinch when lifting your arm overhead. Treatment focuses on improving shoulder blade upward rotation, stretching the back of the shoulder (posterior cuff), and adjusting pressing angles during exercise. These steps open up the subacromial space and take pressure off the tendons.
Instability or Post-dislocation
Your shoulder feels loose or like it might pop out. We limit you to safe movement ranges, use closed-chain exercises for stability, and add small external disturbances (perturbations) to train reflex control. If dislocations keep happening, a surgeon may need to check the labrum and joint capsule. Surgery is often recommended for repeated dislocations.
Arthritis and Degenerative Pain
You may feel stiffness, clicking, and slow loss of motion. Treatment includes strengthening shoulder muscles, gentle mobility work, heat for stiffness, and pacing long activities like paddling. If pain and loss of motion continue despite therapy, your surgeon may discuss options like arthroscopy or shoulder replacement.
Acute fractures or high-energy trauma
Caused by falls, crashes, or heavy impact. These cases need imaging, protection, and a staged rehab plan once the bone heals. This is not something to stretch or push through.
At-Home Exercise Ladder (Pain-Guided)
Move only in pain-free or low-pain ranges. If a drill spikes sharp pain, stop and ask for help.
Level 1: Pendulums, table slides, supported external-rotation isometrics. Great for early stiffness without flaring the soft tissue.
Level 2: Wall angels, serratus punches, prone Y/T, banded ER/IR at the side. These build scapular control and cuff strength without grinding the acromion area.
Level 3: Kettlebell carries, landmine presses, and a gradual return overhead once you meet control standards. Sleep on your back if you can, place a pillow under the arm to reduce night pain and improve rest.
Why Dynamic Stretch Therapy
Andrew started in contact sports (Brazilian Jiu-Jitsu) and lived through the same shoulder problems you might have now. He became FST-certified in 2019, then added IASTM blading, kinesiology taping, muscle flossing, cupping, and LifeStretch in 2020.
You get a plan that blends hands-on work, smart loading, and sport-specific coaching built for Honolulu’s mix of ocean and gym life. First visit looks like this: a focused exam, assisted stretch session, targeted strength, and a clear at-home checklist that fits your week.
Summary
Most shoulder pain comes from four main causes: tendon irritation, instability, arthritis, or trauma. Start with simple changes; modify activity, use antiinflammatory care, and keep pain-free motion. Add targeted manual therapy and strength work to restore clean shoulder movement.
If you’re unsure what’s causing your pain, schedule a consultation with Dynamic Stretch Therapy in Honolulu. We’ll assess your shoulder and create a plan to help you move pain-free again.
Medical disclaimer: This article shares general health information and is not individual medical advice. If you notice red flags or your pain worsens, seek care promptly.
