If your shoulder has been aching for a few weeks or you’ve woken up at 3am unable to find a comfortable position, you’re not alone. Shoulder pain is one of the most common things we see at Sundial Clinics and it can come from a surprising range of causes.
The good news is that, for the majority of people, it does improve with the right understanding and treatment. The first step is working out what’s actually going on.
This guide is written for anyone in Brighton, Hove, or the surrounding areas who’s been dealing with shoulder pain and wondering whether to get it checked, what might be causing it and what, if anything, you can do in the meantime.
Why Is Shoulder Pain So Common?
The shoulder is the most mobile joint in the body. That’s what lets you reach overhead, swim, carry a bag or swing a golf club. But that same freedom of movement comes at a cost: the shoulder relies on a complex arrangement of muscles, tendons and ligaments working together, and when any part of that system is under strain, pain can follow.
Shoulder problems become noticeably more common from the mid-40s onwards. They affect active adults, people who spend long hours at a desk, those doing physical work and keen gardeners and golfers alike.
One thing worth knowing from the outset is that not all shoulder pain starts in the shoulder. Sometimes the neck or upper back is the true source, and the shoulder is simply where you feel it. This is one reason why a proper assessment matters more than trying to diagnose yourself from a list of symptoms, which we’ll come back to.
Common Causes of Shoulder Pain: It’s Not Always Frozen Shoulder
When people search online about shoulder pain, frozen shoulder often comes up first. It’s a real and relatively common condition, but it’s far from the only explanation. Here are the causes we most frequently see in the clinic.
Frozen Shoulder (Adhesive Capsulitis)
Frozen shoulder, known clinically as adhesive capsulitis, occurs when the capsule surrounding the shoulder joint becomes inflamed, then gradually thickens and tightens. This progressive tightening is what makes the shoulder feel increasingly stiff and restricted over time.
The condition typically moves through three phases:
- The freezing phase: pain is the dominant symptom, often worse at night. Movement starts to become limited.
- The frozen phase: pain may ease slightly, but stiffness becomes the main problem. Range of movement is significantly reduced.
- The thawing phase: movement gradually returns, though this can take many months.
The full cycle can last anywhere from 18 months to three years, though many people recover well before the upper end of that range. Frozen shoulder is more common in adults between 40 and 60, slightly more common in women, and is associated with diabetes and thyroid conditions.
The key distinguishing feature is that movement is restricted even when someone else tries to move your arm for you. This is what separates frozen shoulder from other conditions where movement may be painful but the range itself is not greatly reduced.
A 2024 research review (Hill JL, 2024, The Ochsner Journal) confirmed that frozen shoulder is characterised by progressive loss of both active and passive shoulder range of motion, and noted that conservative management, including physiotherapy, remains the recommended first-line approach, often in combination with other interventions depending on the stage, like steroid injections which our GP does here at Sundial.
The reassuring news: frozen shoulder does generally resolve. It is uncomfortable and the timeline is frustrating, but with appropriate management, most people make a good recovery.
Rotator Cuff Problems
The rotator cuff is a group of four muscles and their tendons that work together to stabilise the shoulder and allow it to move. Rotator cuff problems are extremely common. In fact, studies suggest that partial or full tears are present in around 30–60% of adults over the age of 60, often without causing symptoms. (Fahy et al., HRB Open Research, 2021)
When the rotator cuff does cause pain, it typically feels like a deep, dull ache in the shoulder, often worsening with overhead movements or when lying on the affected side at night. The pain can also radiate down the upper arm.
Rotator cuff problems range from mild tendinopathy (irritation of the tendon) to partial or full tears. Not all of them require surgery. In fact, the evidence strongly supports exercise-based rehabilitation as a highly effective approach for most rotator cuff conditions. A 2023 systematic review in Healthcare found that both exercise alone and exercise combined with joint mobilisation produced significant improvements in range of motion and pain levels for people with adhesive capsulitis; and similar findings apply across rotator cuff-related conditions more broadly. (Lee JH et al., Healthcare, 2023)
The right exercise programme, guided by our Sundial physiotherapists here in Brighton, is usually the most important part of recovery.
Shoulder Impingement
Shoulder impingement happens when the tendons or the small fluid-filled sac (bursa) in the shoulder become compressed in the narrow space beneath the bony arch of the shoulder. This causes pain, particularly when lifting the arm to the side or reaching overhead.
It’s common in swimmers, golfers, tennis players and anyone doing a lot of overhead activity. It also frequently develops in people who spend many hours sitting at a desk with rounded shoulders, where altered posture changes the mechanics of the shoulder joint over time.
The good news is that impingement tends to respond well to the right rehabilitation approach: specifically, exercises that target the muscles that control the position of the shoulder blade and the head of the upper arm bone. Posture and ergonomics are also worth reviewing, particularly for those working from home.
Referred Pain from the Neck
This is one of the most important (and most frequently missed) explanations for shoulder pain, and it’s one of our specialities here at Sundial. The cervical spine in the neck can refer pain directly into the shoulder, upper arm and sometimes all the way down into the hand, without the neck itself necessarily feeling sore.
Referred pain patterns from the cervical spine including from the joints, discs and surrounding muscles, can convincingly mimic shoulder pathology. Crucially, directing treatment only to the shoulder when the cervical spine is the true source of pain is likely to compromise recovery. (Roldán-Ruiz et al., J Clin Med, 2025)
Clues that the neck may be involved include:
- Pain that travels down the arm or into the hand
- Tingling or numbness in the fingers
- Neck stiffness accompanying shoulder pain
- Shoulder pain that came on around the same time as neck symptoms
This is one of the key reasons why a proper clinical assessment matters. If your neck is the source of the problem, treating the shoulder alone is unlikely to give you lasting relief.
Osteoarthritis of the Shoulder
Although less common than arthritis of the hip or knee, osteoarthritis does affect the shoulder joint, particularly in older adults or those with a history of previous shoulder injury. Symptoms include a deep, aching pain, stiffness (often worse first thing in the morning) and sometimes an audible or felt clicking or grinding sensation with movement.
Conservative management, including appropriate exercise, hands-on therapy and lifestyle adjustments, can be very effective in managing symptoms and maintaining function, often for many years before any surgical intervention might be considered. Here at Sundial we do laser therapy and steroid injections which help too.
Other Causes Worth Knowing About
Shoulder pain can also arise from the acromioclavicular (AC) joint (the small joint at the top of the shoulder, often aggravated by falls or contact sport) as well as from biceps tendon irritation or shoulder instability, which is more common in younger or hypermobile adults.
In rare cases, pain felt in the shoulder can be referred from internal structures, including the diaphragm or heart. This is why the red flags section below is worth reading, even briefly.
Simple Things You Can Do at Home
If your shoulder has been sore for a week or two, there are some sensible steps you can take while you decide whether to seek further advice.
Keep moving gently. Complete rest tends to make shoulder stiffness worse. The aim is to maintain comfortable movement without pushing into sharp pain. Walking, light daily activity, and gentle pendulum exercises, where you let your arm hang and swing slowly in small circles, can help maintain mobility. You could look at one of our videos to help you
Review how you sleep. Lying on the affected shoulder often aggravates pain significantly. Try sleeping on your back or the other side, with a pillow supporting the painful arm if needed.
Apply heat for stiffness, cold for acute flare-ups. A warm pack or heat pad can ease muscle tension and joint stiffness. If the shoulder feels hot or acutely inflamed, a covered ice pack for 10–15 minutes may be more helpful.
Look at your posture and workspace. If you work from home or sit at a desk for long periods, check your screen height, chair position and whether your arm has adequate support. Rounded, hunched posture places significant extra load on the shoulder and neck over time.
Consider over-the-counter pain relief. Anti-inflammatory medication such as ibuprofen may help manage pain and inflammation in the short term, if appropriate for you. Always check with a pharmacist or GP if you’re unsure.
Don’t stop all activity. If you enjoy walking, gentle gardening or swimming, staying active in ways that don’t aggravate the shoulder is generally beneficial, both physically and for your general wellbeing.
Red Flags: When to Seek Urgent Medical Advice
The following symptoms need prompt medical attention rather than a physiotherapy or chiropractic appointment. Please contact your GP urgently, or call 999 if needed:
- Sudden, severe pain following a fall, impact, or collision: possible fracture or dislocation
- Chest tightness, shortness of breath, or sweating alongside shoulder or arm pain: this can indicate a cardiac problem and requires immediate emergency care (call 999)
- Rapidly worsening weakness or loss of arm function: particularly if it develops quickly
- Unexplained weight loss, persistent night pain that is unaffected by position or a noticeable lump around the shoulder or upper arm
- Signs of infection: the shoulder feels hot, looks red or swollen, and you have a fever
These situations are uncommon, but it’s important to know about them. If any of these apply, please seek medical attention rather than booking a clinic appointment.
When Is a Professional Assessment Worth Considering?
Most shoulder pain doesn’t fall into the urgent category above but that doesn’t mean it should simply be ignored. A professional assessment is sensible if any of the following apply:
- Your shoulder has been painful for more than four to six weeks without improving
- You’re regularly waking in the night because of pain
- Stiffness or restricted movement is affecting everyday activities like getting dressed, reaching a shelf, putting on a seatbelt or driving
- The pain keeps returning after a brief improvement
- You’re genuinely unsure what’s causing it and the uncertainty is making it harder to manage
An assessment doesn’t commit you to a course of treatment. Its purpose is to give you a clearer picture of what’s happening and what your options are. For many people, that clarity alone is genuinely helpful.
How Sundial Clinics Can Help
At Sundial, our starting point is always the same: understand what’s actually going on before recommending anything. That means a thorough assessment: taking time to listen to your history, examine your shoulder and, where relevant, your neck and upper back and explain our findings to you in plain terms.
We have physiotherapists, chiropractors and massage therapists working together under one roof, which means we can match you to the right approach based on what we find, rather than applying the same treatment to everyone who walks in with shoulder pain.
Physiotherapy focuses on exercise rehabilitation, movement retraining, postural correction and home exercise programmes. For rotator cuff problems, impingement and frozen shoulder, a well-designed exercise programme is often the most important element of recovery.
Chiropractic care is particularly useful when the neck or upper back is contributing to shoulder symptoms and for addressing joint mobility and mechanical function more broadly.
Massage therapy can help manage muscle tension, improve circulation to the affected area and support comfort and recovery alongside other treatments.
We’ll also be honest with you about what we can and can’t help with. If we find something that’s outside the scope of conservative care, for example, a suspected significant tendon tear that may need imaging or a red flag, we’ll tell you, and we’ll help you understand the next appropriate step.
If you’d like to find out whether our team can help with your shoulder, you’re welcome to book an initial assessment online or give us a call. No referral needed, and no obligation to continue.
Frequently Asked Questions
How do I know if I have frozen shoulder?
Frozen shoulder typically causes a progressive loss of shoulder movement: lifting the arm, rotating it or reaching behind your back all become increasingly difficult. The pain is often worse at night, particularly in the early stage. The key distinguishing feature is that movement is restricted even when someone else tries to move your arm for you. A clinical assessment is the most reliable way to confirm this.
Will frozen shoulder get better on its own?
In the majority of cases, yes: frozen shoulder does naturally resolve, though the timeline varies considerably. Research suggests the full cycle can take anywhere from 18 months to three years. The right treatment can help manage pain, maintain as much movement as possible during the process, and potentially speed recovery in the earlier stages. Getting assessed helps clarify where you are in the cycle and what’s likely to help.
Can a chiropractor or physiotherapist help with shoulder pain?
It depends on the cause. Many shoulder conditions, including impingement, rotator cuff-related pain, referred neck pain and frozen shoulder, all respond well to physiotherapy or chiropractic care. The first step is a proper assessment to identify what’s going on and whether conservative care is the right route for you.
How long does shoulder pain usually last?
This varies widely. Mild muscle or tendon irritation may settle in a few weeks with appropriate self-care. Frozen shoulder can take one to three years. Rotator cuff problems vary depending on severity and how well the underlying cause is addressed. Early assessment generally helps shorten recovery time by pointing you towards the right approach sooner.
Could my shoulder pain actually be coming from my neck?
It’s a real possibility. Neck problems can refer pain convincingly into the shoulder, upper arm and hand. If your pain travels down your arm or you have any tingling or numbness in the fingers or you’ve noticed neck stiffness alongside the shoulder discomfort, this is worth investigating. Treating the shoulder when the problem is in the neck is unlikely to give lasting results, which is exactly why a thorough assessment is so valuable.
Can I exercise with a sore shoulder?
In most cases, yes, alongside care and guidance. Complete rest tends to make shoulder stiffness worse over time, not better. The right exercises depend entirely on the cause, though, which is why professional advice is helpful before you commit to a specific programme. A physiotherapist or chiropractor can design a plan that keeps you moving safely and supports recovery.
Do I need a GP referral to see a practitioner at Sundial Clinics?
No, you can self-refer directly. Simply contact us to book an initial assessment or preliminary phone call at a time that suits you.
Do you treat other conditions alongside shoulder pain?
Yes. Our team regularly sees patients with neck pain, back pain, headaches, hip and knee problems and a range of other musculoskeletal conditions. If your shoulder pain is part of a wider picture, we’ll take that into account. We also offer dry needling, low level laser therapy and corticosteroid injections, if appropriate.
A Final Word
Living with shoulder pain, whether it’s been there for a few weeks or considerably longer, is tiring. It affects sleep, daily activities and the things you enjoy doing. If you’re not sure what’s causing it, or you’ve been managing it quietly and wondering whether it’s time to get it looked at, we’d encourage you to take that step.
Our team at Sundial will take the time to assess properly, explain what we find and recommend the right next step for you, whether that’s treatment with us, home exercises, referral for imaging or onward to another specialist. We’re here to give you an honest picture, not just to fill an appointment.
You can book an assessment online or give us a call — no referral needed, and no pressure.
Matthew Bennett is the founder and principal chiropractor at Sundial Clinics, bringing over 35 years of clinical excellence to patient care since qualifying in 1987. As former President of the British Chiropractic Association and a Fellow of the Royal College of Chiropractors, Matthew combines the highest professional credentials with proven expertise in sports chiropractic, having served as team chiropractor for Brighton and Hove Albion Football Club and the British Alpine Ski Team. His commitment to evidence-based practice, continuous professional development, and patient-focused care has established him as a trusted authority in musculoskeletal health. As former UK Director of Training for the Royal College of Chiropractors and a regular lecturer across healthcare disciplines, Matthew has shaped professional standards while serving as an expert witness and spokesperson for the profession. A dedicated athlete himself— achieving his karate black belt 2nd Dan in 2024—Matthew understands sports injuries and performance from personal experience, combining this insight with cutting-edge techniques to deliver rapid, lasting results for patients at his established Brighton practice.
Sources and Further Reading
The clinical information in this article is supported by current peer-reviewed research. Key sources include:
Hill JL (2024). Evidence for Combining Conservative Treatments for Adhesive Capsulitis. The Ochsner Journal, 24(1). PMC10949050.
This review confirms frozen shoulder is characterised by progressive loss of active and passive shoulder range of motion and that conservative management — including physiotherapy — is the recommended first-line approach.
Lee JH, Jeon HG, Yoon YJ (2023). Effects of Exercise Intervention (with and without Joint Mobilisation) in Patients with Adhesive Capsulitis: A Systematic Review and Meta-Analysis. Healthcare, 11(10):1504. PMC10218666.
This meta-analysis found that exercise, and particularly exercise combined with joint mobilisation, produced significant improvements in shoulder range of motion and pain levels.
Roldán-Ruiz A, Bailón-Cerezo J, Falla D, Torres-Lacomba M (2025). Cervical Spine Screening Based on Movement Strategies Improves Shoulder Physical Variables in Neck-Related Shoulder Pain Patients. Journal of Clinical Medicine, 14(7):2433. PMC11989710.
This study confirmed that the cervical spine frequently contributes to shoulder pain, and that directing treatment only to the shoulder when the neck is involved compromises recovery outcomes.
This article is for information purposes only and does not constitute medical advice. If you have concerns about your health, please consult a qualified healthcare professional.