Last updated: October 2026
Most shoulder pain comes from the rotator cuff tendons, a frozen shoulder, arthritis or a problem in the neck, and new pain usually starts to settle within 2 to 6 weeks. Keep the shoulder gently moving, use heat or a wrapped ice pack, take pharmacy painkillers if needed and try simple exercises. Call 999 if it comes with chest pain.
Below: a “where it hurts” table of causes, how long it lasts, what to do today, a simple NHS exercise routine, shoulder pain at night and how to sleep, left shoulder pain and your heart, frozen shoulder stages, what the evidence says about physio, injections and surgery, and exactly who to call.
Need help now? Call 999 if shoulder or arm pain comes with chest pain or tightness, breathlessness, sweating or feeling sick, as these can be signs of a heart attack. Call NHS 111 or ask for an urgent GP appointment if the pain is sudden or very bad, you can’t move your arm, the shoulder has changed shape, it started after a fall or injury, or you feel hot and unwell. See all the red flags.
What’s causing my shoulder pain? Where it hurts
Shoulder pain is the third most common muscle and joint problem that GPs see, and about 1 in 100 adults goes to a GP with a new episode each year. According to NICE’s guidance for GPs, the four most common causes are rotator cuff problems, frozen shoulder or arthritis in the main joint, problems with the small joint at the top of the shoulder, and pain referred from the neck.
Where it hurts, and how it started, are the best clues. The NHS advises against diagnosing yourself, so use this table as a guide to what to do next.
| Where or when it hurts | Common cause | What to do |
|---|---|---|
| Top and outer side of the shoulder, worse lifting your arm (like a full kettle) or reaching overhead; may ache at night | Rotator cuff pain, also called subacromial pain, impingement, tendonitis or bursitis | Self-care and the exercises; physio if not better in 6 weeks |
| Pain that builds over weeks, then growing stiffness; hard to reach behind your back or turn your arm outwards; often worse at night | Frozen shoulder | See a GP for a diagnosis; read frozen shoulder |
| Ache and stiffness lasting months or years | Osteoarthritis or rheumatoid arthritis | See a GP; keep moving within comfort |
| Sudden pain and weakness, or you suddenly can’t lift your arm, after a fall or heavy lift | Torn rotator cuff tendon | Urgent: call 111 or ask for an urgent GP appointment |
| Changed shape and severe pain after a fall or blow | Dislocation or broken bone | Urgent: A&E or call 111 |
| Feels like it slips out of joint, clicks or locks, sometimes with tingling or weakness; often under 35 or with very flexible joints | Shoulder instability | See a GP or physio |
| On top of the shoulder, where the collarbone meets the shoulder | Acromioclavicular (AC) joint problem | Self-care; call 111 if it started after a fall or injury |
| Spreads from the neck into the shoulder and arm, with pins and needles or a sharp, hot or burning feeling | Referred pain from the neck | See our stiff neck guide; GP if numbness won’t go |
| Aching and stiffness in both shoulders (and often hips), stiff for more than 45 minutes in the morning, usually over 65 | Polymyalgia rheumatica | See a GP; urgent if you also get headaches, jaw pain or vision problems |
| Hot, red, swollen shoulder and you feel feverish or unwell | Joint infection (septic arthritis) | Urgent: call 111 |
| Left shoulder or arm pain with chest pain, breathlessness or sweating | Possible heart attack | Call 999 |
| Achy, tight shoulders after long days at a desk, or sore after lying on one side | Muscle tension, posture or sleeping position aggravating the shoulder | The posture tips and sleep tips below |
Rotator cuff pain is the most common cause seen in general practice. It typically affects people aged 35 to 75, often after repetitive work at or above shoulder height or heavy lifting. If aches are spread around your body rather than in one shoulder, see body aches or joint pain.
How long does shoulder pain last?
- New pain or a flare-up: NHS inform says it should begin to settle within 6 weeks without needing to see anyone. The NHS website says you usually need about 2 weeks of self-care before it starts to ease.
- Rotator cuff and other tendon problems: often improve over weeks to a few months, but the NHS says recovery can take 6 months or longer.
- Frozen shoulder: usually settles within 18 to 24 months, although some people have mild stiffness for longer.
- Arthritis: pain and stiffness can last months or years, so the aim is to manage it well and keep moving.
Shoulder pain can be stubborn. NICE’s guidance notes that about 40 to 50% of people who see a GP about it still have some pain 6 to 12 months later, and it often comes back. That’s why the NHS suggests keeping up your exercises for 6 to 8 weeks, even once it feels better.
What to do today: self-care that helps
In the first 24 to 48 hours, NHS inform suggests you:
- reduce your activities, but move as much as your symptoms allow
- rest your arm in a supported position if that’s comfortable, such as on a cushion in your lap
- move your shoulder gently for 10 to 20 seconds every hour while you’re awake
After 48 hours, use your shoulder more. Stopping using it completely can slow your recovery, and staying at or going back to work is one of the best ways to get better. Avoid sport and heavy lifting until you have less discomfort and good movement.
Heat or ice: both can ease pain, so use whichever feels better. The NHS suggests a bag of frozen peas wrapped in a tea towel for up to 20 minutes, up to 3 times a day, or a hot water bottle wrapped in a tea towel for up to 20 minutes, 2 to 3 times a day. Never put either straight on your skin, and skip both if you have poor circulation or reduced feeling.
Painkillers: paracetamol or ibuprofen, as tablets or a gel. A pharmacist can suggest the best option for you, especially if you take other medicines, as ibuprofen isn’t suitable for everyone. NICE’s guidance notes that paracetamol taken regularly works better than taking it now and then.
Posture at your desk: sit tall with your shoulders relaxed and gently back, with a cushion behind your lower back. Try not to slouch, round your shoulders or push your head forward towards the screen, and take regular breaks to stand up and move. The same habits help with tension headaches and a sore lower back. If long days and deadlines are making you tense, our guide to stress at work may help.
Shoulder exercises: a simple NHS routine
These six exercises come from NHS inform’s routine for new shoulder problems. Check with a GP or physio first if you’ve just been injured, had shoulder surgery or have any of the red flags. Don’t invent strenuous exercises or use heavy gym equipment while it’s sore.
- Pendulum swing, forwards and back. Stand next to a table and lean forward, with one hand on the table and your sore arm hanging straight down. Gently swing the arm forwards and back, making the swing a little bigger over time.
- Pendulum swing, side to side. In the same position, swing the arm slowly from left to right.
- Pendulum circles. Still leaning on the table, draw small circles with your hand, changing direction now and then. Let the circles grow as it eases.
- Lying arm lift. Lie on your back on the bed with your knees bent. Clasp your hands together, then lift your arms up over your body and on over your head as far as is comfortable. Bring them back down slowly.
- Side-lying rotation. Lie on your good side with a cushion under your head. Bend your top arm to a right angle in front of you. Keeping the elbow bent, lift your hand towards the ceiling, then lower it gently. A tin of beans makes a handy light weight once it gets easier.
- Wall slide. Stand facing a wall with your forearms resting on it, elbows bent at a right angle. Gently squeeze your shoulder blades back and together, then slowly slide both arms up the wall and back down.
The pain rule: rate your pain from 0 (none) to 10 (the worst ever). Aim to stay between 0 and 5 while you exercise. If it goes higher, do fewer, go slower or rest longer between movements. Some short-lived muscle soreness is normal, but your shoulder should be no worse the morning after. Stop if an exercise causes new pain or makes things worse overall.
How much: start with 2 or 3 repetitions at a time, little and often through the day. Add 1 or 2 every few days, then move to sets (for example 8 repetitions, a minute’s rest, then 8 more), 2 to 3 times a day, building up to a maximum of 2 sets of 15.
Keep up general activity too. NHS inform says staying active keeps your other muscles and joints strong and helps stop the problem coming back. For rest days, food and sleep, see muscle recovery.
Shoulder pain at night and how to sleep
Shoulder pain is often worse at night. Rotator cuff pain can ache in bed, and NHS inform says frozen shoulder pain is often worse at night and when you lie on the affected side. Being still for hours, with nothing to distract you, makes pain more noticeable too.
- On your side: lie on your good side, with a thick pillow in front of you to rest the sore arm on, so it doesn’t drop forward across your body. Let the shoulder sit slightly back rather than slumping forwards.
- On your back: put a pillow under each arm, or under the sore arm. Some people find a wedge pillow, raising the upper body, more comfortable.
- Stop yourself rolling onto it: NICE’s guidance for frozen shoulder suggests supporting the arm with pillows so you don’t roll onto the painful side.
- Warm up before bed: a wrapped heat pack for up to 20 minutes, then a few gentle pendulum swings, can take the edge off stiffness.
- Plan your painkillers: ask a pharmacist how to time them so they cover the night.
Our guide to the best sleeping position covers pillows and positions in more detail, and how to stay asleep helps if pain keeps waking you. Rarely, shoulder pain is a sign of something more serious. See a GP if night pain comes with a fever or feeling unwell, or if you have ever had cancer.
Left shoulder pain: could it be your heart?
Most left shoulder pain is a muscle, tendon or joint problem, just like on the right. It usually hurts more when you move your arm and eases with rest. But NICE lists the heart, lungs and diaphragm among the places shoulder pain can be referred from, so it’s worth knowing the warning signs.
Call 999 straight away if you have shoulder or arm pain with:
- chest pain that feels tight, heavy, crushing or squeezing
- breathlessness
- sweating, feeling sick or a feeling like indigestion
The NHS says heart attack pain may spread from the chest to your arm, neck and jaw. Don’t drive yourself to A&E.
Call 999 too if one arm suddenly becomes weak or numb, especially with a drooping face or slurred speech, as these can be signs of a stroke. If chest tightness comes with a racing heart during stress, our guide to anxiety chest pain explains the difference, but if you’re unsure, always get checked.
Frozen shoulder: stages, who gets it and how long it lasts
Frozen shoulder (adhesive capsulitis) happens when the flexible capsule around the shoulder joint becomes inflamed, thickens and tightens. It isn’t fully understood why. It can follow an injury, surgery or a spell when you couldn’t move your arm, or appear for no clear reason.
Who gets it: it typically affects people aged 40 to 60, and is more common in women and in people who have already had it in the other shoulder. NHS inform lists these risk factors:
- diabetes, heart disease, high cholesterol or a thyroid problem (see underactive thyroid symptoms)
- Parkinson’s disease, a stroke or a brain injury
- Dupuytren’s contracture, where thickened lumps form in the hand
- the perimenopause and menopause (see perimenopause symptoms)
- smoking, obesity and low levels of physical activity
The diabetes link: a 2016 analysis of 18 studies found people with diabetes were about 5 times more likely to develop frozen shoulder, with about 13% affected. Around 30% of people with frozen shoulder had diabetes. NICE’s guidance tells GPs to consider testing for diabetes in anyone diagnosed with frozen shoulder, and recovery can be slower if you have it.
| Stage | Typical length | What happens |
|---|---|---|
| Painful (“freezing”) | 2 to 9 months | Pain on movement that builds up, can be severe and often disturbs sleep |
| Stiff (“frozen”) | 4 to 12 months | Pain eases, but stiffness takes over and everyday tasks like dressing get hard |
| Recovery (“thawing”) | 12 to 42 months | Movement gradually returns and stiffness fades |
The stages overlap, so many clinicians now just talk about a “pain-dominant” and a “stiffness-dominant” stage. Most frozen shoulders get better on their own, but it can take more than 2 years.
Treatment steps up as needed: painkillers, especially early on; gentle exercises and physiotherapy, started as early as possible; and a steroid injection into the joint if progress is slow. NHS inform notes injections help with pain, but don’t cure the condition or reduce stiffness. For severe cases, hospital teams may offer a procedure. The UK FROST trial (503 people at 35 UK hospitals) found that manipulation under anaesthetic, keyhole surgery to release the capsule, and early structured physio plus a steroid injection gave similar results at 12 months. Keyhole surgery carried more risk, and manipulation was the best value.
Physio, injections and surgery: what the evidence says
Several large UK trials have tested the most common treatments. Here’s a plain summary for rotator cuff pain, the most common type.
| Treatment | What the research found |
|---|---|
| Physio advice and home exercise | The GRASP trial (708 people, 20 NHS trusts) found up to 6 physio sessions of progressive exercise did no better over a year than one advice session with a physiotherapist, suggesting good advice and a home programme can do much of the work |
| Manual therapy and exercise | A 2016 Cochrane review (60 trials, 3,620 people) found effects may be similar to steroid injection or surgery, but the evidence was mostly low quality and benefits over placebo were small |
| Steroid injection | Can ease pain in the short term, which may help you exercise. In GRASP it gave no long-term benefit over 12 months. NICE advises no more than 2 injections, because of the risk to tendons |
| Ultrasound, laser, TENS | A 2016 Cochrane review of 47 trials found low-quality evidence, with little or no extra benefit when added to other physio |
| Decompression surgery (shaving bone to make more space) | The CSAW trial (313 people, 32 UK hospitals) found it was no better than a placebo keyhole operation, and neither was meaningfully better than no surgery |
The takeaway: time, gentle movement and a steady home routine are the foundation. A physio can tailor the exercises, and a GP can talk through an injection if pain is stopping you moving. Surgery still has a place, for example for a torn tendon after an injury or a shoulder that keeps dislocating, so don’t put off getting those checked.
Supplements and creams: a pharmacist may suggest an anti-inflammatory gel. If you’re curious about supplements, our guides to glucosamine, collagen supplements and turmeric explain what the research does and doesn’t show. CBD isn’t a treatment for shoulder pain; CBD for pain covers the wider research honestly.
Red flags: when to call 999 or 111
Call 999 if shoulder or arm pain comes with chest pain or tightness, breathlessness, sweating or feeling sick, or if an arm suddenly goes weak with a drooping face or slurred speech.
Call NHS 111, use 111 online or ask for an urgent GP appointment if:
- the pain is sudden or very bad
- you can’t move your arm
- your shoulder has changed shape or is badly swollen
- the pain started after a fall or injury, such as a fall from height or a direct blow in the last 7 days
- you have pins and needles that won’t go away, or no feeling in your arm or shoulder
- your arm or shoulder feels hot or cold to touch
- you have severe pain in both shoulders
- you have a high temperature, feel hot and shivery, or feel unwell
Contact a GP promptly if you have shoulder pain and have ever had cancer or a joint condition such as rheumatoid arthritis, or your shoulder is hot, swollen or tender and you can’t remember injuring it. If you have aching shoulders with a new headache, a tender scalp, jaw pain when eating or problems with your sight, contact a GP immediately or call 111, as this can be a sign of giant cell arteritis.
When to see a GP or physio
See a GP if:
- your shoulder pain is getting worse, or hasn’t improved after 2 weeks of self-care
- it is very hard to move your arm or shoulder
- you think you may have a frozen shoulder, especially if you have diabetes
Physiotherapy without a GP: in many areas you can refer yourself to NHS community musculoskeletal (MSK) services, which include physiotherapy. Check your local NHS website or ask your GP surgery for a first contact physiotherapist. NHS waiting times can be long, so some people pay to see a physio privately.
What a GP may offer: an examination, stronger pain relief, a steroid injection, a physio referral or a referral to a specialist. Scans aren’t usually needed at first. X-rays are considered after an injury, when pain is severe or movement is very restricted, or when symptoms haven’t improved after a few weeks. NICE suggests a specialist referral if pain and function haven’t improved after 3 months of treatment, or sooner if the pain is having a big impact, the shoulder keeps dislocating, or there’s severe pain after an injury.
Where our products fit (honestly)
No supplement or balm is a treatment for shoulder pain, and nothing replaces gentle movement, a good exercise routine and proper medical advice. Here’s how our products can sit alongside a healthy routine.
Our CBD Balm, Muscle and Joint Support is a massage balm made with broad spectrum CBD, peppermint, eucalyptus and juniper. It feels cooling and non-greasy, and some people like to massage it into the shoulder and upper back before or after their exercises. CBD isn’t a treatment for shoulder pain. Read more in our CBD balm guide.
Our Magnesium Glycinate Sleep Complex is an evening drink with magnesium bisglycinate and citrate, glycine and L-theanine, which some people make part of their evening wind-down. Magnesium contributes to normal muscle function. For more, see magnesium for muscle pain.
If you also take CBD by mouth, keep the FSA’s advice in mind. The FSA’s 10mg a day figure is precautionary advice rather than a legal limit, set while longer-term safety research continues. At Evopure we think it is a very cautious figure, and many adults use more. If you go above it, increase slowly, and check with your GP or pharmacist first if you take any medication.
Our products are for adults (18+) only. We don’t recommend our products during pregnancy or breastfeeding. If you take prescribed medicines, check with your pharmacist before adding a supplement.
FAQs
What is the most common cause of shoulder pain?
Rotator cuff problems, sometimes called impingement, tendonitis or bursitis, are the most common cause seen by GPs. Pain is felt on the top and outer side of the shoulder and is worse when you lift your arm or reach overhead.
How long does shoulder pain take to heal?
New shoulder pain usually starts to ease after about 2 weeks of self-care and should begin to settle within 6 weeks. Some problems take 6 months or longer, and frozen shoulder usually takes 18 to 24 months.
Should I use heat or ice on a painful shoulder?
Either can help, so use whichever feels better. Wrap it in a tea towel and use it for up to 20 minutes, a few times a day. Don’t use heat or ice if you have poor circulation or reduced feeling.
How should I sleep with shoulder pain?
Lie on your back or on your good side, with a thick pillow supporting the sore arm. Use pillows to stop yourself rolling onto the painful shoulder.
Can left shoulder pain be a heart attack?
It can be. Call 999 if shoulder or arm pain comes with chest pain or tightness, breathlessness, sweating or feeling sick. Most left shoulder pain is a muscle or joint problem that changes with movement.
How do I know if I have a frozen shoulder?
Frozen shoulder causes pain that builds over weeks, often worse at night, followed by stiffness that makes it hard to reach behind your back or lift your arm. It is most common between 40 and 60 and in people with diabetes. A GP or physio can diagnose it.
When should I worry about shoulder pain?
Get urgent help if the pain is sudden or severe, you can’t move your arm, the shoulder has changed shape, it followed an injury, or you feel hot and unwell. See a GP if it isn’t improving after 2 weeks.
Sources
- NHS. Shoulder pain.
- NHS. Frozen shoulder.
- NHS inform. Shoulder problems, Exercises for shoulder problems and Frozen shoulder.
- NICE Clinical Knowledge Summaries. Shoulder pain. Last revised November 2022.
- NHS. Heart attack.
- NHS. Stroke: symptoms.
- NHS. Polymyalgia rheumatica.
- Arthritis Foundation. Arthritis pain at night: tips to position yourself.
- Zreik NH, et al. Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J, 2016. PMID 27331029.
- Rangan A, et al. Management of adults with primary frozen shoulder in secondary care (UK FROST). Lancet, 2020. PMID 33010843.
- Hopewell S, et al. Progressive exercise compared with best practice advice, with or without corticosteroid injection, for rotator cuff disorders (GRASP). Lancet, 2021. PMID 34265255.
- Page MJ, et al. Manual therapy and exercise for rotator cuff disease. Cochrane, 2016. PMID 27283590.
- Page MJ, et al. Electrotherapy modalities for rotator cuff disease. Cochrane, 2016. PMID 27283591.
- Beard DJ, et al. Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW). Lancet, 2018. PMID 29169668.
This guide is general information, not medical advice. If you’re worried about shoulder pain, speak to a GP, pharmacist or physiotherapist. Evopure makes the CBD Balm, Muscle and Joint Support and the Magnesium Glycinate Sleep Complex.
