Shoulder Pain: Rotator Cuff, Frozen Shoulder and What Helps

Shoulder pain is most often caused by the rotator cuff, the group of tendons that moves your arm, and mainly the supraspinatus tendon. Other causes are frozen shoulder, arthritis and pain that spreads from the neck. Most shoulder pain gets better in a few weeks with gentle movement and exercises. This guide is by Dr. Pedro Yelamo Vera, a GP licensed in Spain (Colegiado No. 484814280).

What causes shoulder pain?

• Rotator cuff: sore, swollen or torn tendons. This is the most common cause.
• Frozen shoulder: the joint lining gets inflamed and tight.
• Arthritis: wear in the joint, more common in older people.
• A dislocation or fracture: after a fall or a blow.
• Pain from somewhere else: the neck, or sometimes the heart, gallbladder or lungs.

What is supraspinatus tendinitis?

The supraspinatus is the tendon at the top of the rotator cuff. It gets sore when it rubs under the bony tip of the shoulder. That is why it is often called impingement.

• Pain on the outside of the shoulder that may spread to the elbow.
• Pain when you lift your arm out to the side, mostly at mid-height.
• Pain when you brush your hair, get dressed or reach a shelf.
• Pain at night when you lie on that side.

It is more common after 40 and in people who work or play sport with their arms above their head. If you cannot lift your arm after a strain or a fall, the tendon may be torn, so see a doctor soon.

What is frozen shoulder?

It is a painful stiffness of the shoulder in every direction, not just when you lift the arm. It tends to go through three stages: a painful stage, a stiff stage, then a stage where movement slowly comes back. The NHS says it can take months or years to get better, but it nearly always does.

It is most common between 40 and 60, in people with diabetes and after the arm has been kept still after an injury or surgery. In Spain it is called hombro congelado or capsulitis adhesiva.

Why does my shoulder blade hurt?

Pain in or around the shoulder blade is usually from the muscles. Posture, stress and long hours at a desk are common causes. It can also come from the neck. But sometimes it is a sign of something else:

• Left shoulder blade pain with chest pain, shortness of breath or sweating may be the heart. Call 112.
• Right shoulder blade pain after fatty meals, with pain under the right ribs, may be the gallbladder.
• Sharp pain that is worse when you breathe in, with shortness of breath, may be the lungs.

What helps shoulder pain?

• Keep moving the shoulder gently. Total rest makes it stiffer.
• For a while, avoid lifting heavy things above your head.
• Use an ice pack for the first few days, then heat, whichever feels better.
• Sleep on your back or the other side, with a pillow under the sore arm.
• Do the exercises a physio gives you.

For pain you can take paracetamol or an anti-inflammatory such as ibuprofen, following the leaflet. In some cases a doctor may suggest a steroid injection. A sore tendon often gets better in weeks; frozen shoulder takes much longer. Read how a physio referral works in Spain.

When should I see a doctor?

• The pain lasts more than two weeks despite home care.
• You cannot lift your arm, or it has gone weak.
• It wakes you every night.
• You have tingling in your arm or hand.

When should I go to A&E or call 112?

• Shoulder or arm pain, mainly on the left, with chest pain, sweating, feeling sick or shortness of breath: call 112.
• The shoulder looks out of shape, or you cannot move it after a fall.
• The shoulder is hot, red and swollen and you have a fever.
• Sudden, severe pain with no cause.

Frequently asked questions about shoulder pain

Getting a medical assessment

If you are in Spain and you have shoulder pain, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. You can also read about joint pain and back and neck pain. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.