Shoulder pain that shows up when you lift your arm is one of the most common reasons people visit a physio or chiropractor. It might be a sharp catch reaching for a high shelf, an ache putting on a jacket, or pain that wakes you at night.
The shoulder is a remarkably mobile joint, and that mobility comes at a cost. It relies on a group of small muscles and tendons, plus good movement of the shoulder blade and upper back, to stay stable as you move. When one part of that system is irritated or not pulling its weight, lifting the arm is often where you feel it first.
What is actually going on in the shoulder when I lift my arm?
As you raise your arm, the ball of the upper arm bone needs to stay centred in a fairly shallow socket. Your rotator cuff, a group of four muscles around the shoulder, does much of this work, while the shoulder blade rotates and tilts to make room.
If the rotator cuff tendons are overloaded, or the shoulder blade and upper back are stiff, the space and control around the joint can change. Tissues that are already sensitive can then become painful in a particular part of the movement, often between shoulder height and overhead.
What are the common causes?
There are several conditions that can cause pain when lifting the arm. Some of the more common include:
Rotator cuff related shoulder pain: irritation or tendinopathy of the rotator cuff tendons, often after a change in activity such as more gym work, painting, swimming or overhead tasks.
Subacromial bursitis: inflammation of the fluid filled sac that sits above the rotator cuff, which often travels with tendon irritation.
Rotator cuff tears: partial or full tears, which may follow a fall or heavy lift, or develop gradually with age. Weakness lifting the arm is a common sign.
Frozen shoulder (adhesive capsulitis): progressive pain and stiffness, where the arm becomes hard to move in every direction, not just up.
Referred pain from the neck: irritated joints or nerves in the neck can send pain into the shoulder and arm, sometimes with pins and needles.
Acromioclavicular (AC) joint pain: pain at the tip of the shoulder, often felt when reaching across the body or overhead.
You can read more about these on our rotator cuff and shoulder injuries and frozen shoulder pages.
Is there a "painful arc", and what does it mean?
Many people notice pain in a band of movement, roughly between 60 and 120 degrees as the arm comes out to the side, that eases once the arm is higher or lower. This is often called a painful arc. It is commonly associated with rotator cuff or bursa irritation, but it is not a diagnosis on its own.
A practitioner will usually look at the whole picture: which movements hurt, how strong the shoulder is, how the shoulder blade moves, whether the neck is involved, and how the pain behaves through the day. That assessment guides what is most likely to help.
What can I do at home in the meantime?
For a mild, recent flare up without any red flags, a few sensible steps may help settle things:
Modify, rather than stop, activity. Keep the arm moving in comfortable ranges and reduce the movements that clearly aggravate it, such as repeated overhead lifting.
Avoid complete rest in a sling unless advised, as the shoulder can stiffen quickly.
Try gentle movement such as pendulum swings or sliding your hand up a wall within comfort.
Heat or ice may ease discomfort for some people. Use whichever feels better.
When sleeping, a pillow under the sore arm or hugging a pillow can take pressure off the shoulder.
If the pain is not clearly settling within a week or two, or keeps returning, it is worth having it assessed rather than pushing through.
When should I see a GP or seek urgent care?
Most shoulder pain is musculoskeletal, but some symptoms need prompt medical attention. See your GP or call 000 if you have:
Left shoulder, arm or jaw pain with chest pain, shortness of breath, sweating or nausea, as this can be a sign of a heart problem.
A fall or injury followed by an obvious deformity, severe pain or inability to lift the arm at all, which may indicate a dislocation, fracture or significant tear.
A hot, red, swollen shoulder, especially with fever or feeling unwell.
Unexplained weight loss, a history of cancer, or constant pain that does not change with movement or position.
Spreading numbness, weakness in the hand or arm, or pain that is getting rapidly worse.
How can physio, chiro or osteo help with shoulder pain?
Research suggests that for many types of shoulder pain, a progressive, well dosed exercise program is one of the most useful parts of care. A practitioner can help you find the right starting point, so the shoulder is loaded enough to adapt without being flared up.
Depending on your assessment and preferences, care may also include hands on treatment for the shoulder, neck and upper back, soft tissue work, dry needling, advice on sleep and work positions, and a plan for returning to sport or the gym. If imaging or a medical review seems appropriate, your practitioner can discuss a referral with you.
Our physiotherapists, chiropractors and osteopaths all see shoulder pain, and can work alongside our remedial massage therapists.
Frequently asked questions
Do I need a scan before seeing someone about my shoulder?
Not usually. Many shoulder problems can be assessed clinically, and scans often show changes, such as tendon wear, that are common in people without pain. Your practitioner or GP can advise if an ultrasound, X-ray or MRI would change how your shoulder is managed.
Should I stop going to the gym?
Often you do not need to stop completely. Many people can keep training with some changes, such as reducing load, adjusting grip or range, or swapping overhead pressing for other exercises for a while. A practitioner can help you work out what is reasonable for your shoulder.
How long does shoulder pain take to settle?
It varies a lot. A mild tendon flare up may settle over a few weeks, while rotator cuff tendinopathy or frozen shoulder can take months. Your practitioner can give you a realistic idea based on your assessment and how you respond in the first few sessions.
Getting help on the Gold Coast
If lifting your arm has become a daily frustration, The Good Joint in Mermaid Beach has physiotherapists, chiropractors and osteopaths under one roof who can assess your shoulder and talk through your options. No referral is needed for most appointments. Learn more about our shoulder pain care or book online.
Related reading: Frozen shoulder: what are the stages and how long does it last? and Should I use heat or ice on an injury?
