You might not think much about your shoulders until you get shoulder pain. Suddenly brushing your hair or reaching to grab something from a high shelf hurts. It could feel like a dull ache or a sharp pain. What’s going on?

Shoulder pain and stiffness are common, especially as you get older. Learn how your shoulders work, why they might hurt and what you can do about it.

Discover the better choice for your health care.

At Optum, you get personalized care to help you meet your health goals. That's why more than 4 million people trust our doctors and Medicare Advantage.

Find an Optum doctor

How exactly does the shoulder work, anyway?

The shoulder is a complex body part. It has several bones that combine with muscles and tendons to give your arms a wide range of motion.¹

Each shoulder is a ball and socket joint, and has three bones:

• Clavicle, or collarbone
• Scapula, or shoulder blade
• Humerus, or upper arm bone

Your rotator cuff muscles and tendons cover the top of your upper arm bone. They attach it to your shoulder blade. They also keep the ball centered in the shoulder socket.

When one or more parts aren’t working right, you might get pain and stiffness in your shoulder. Here are six common causes:

1. Rotator cuff tendinitis

The rotator cuff is a group of muscles and tendons. They attach to the bones of the shoulder joint.¹ This allows your shoulder to move freely in different directions.

When you have tendinitis, it means some of those tendons are irritated or inflamed. Many daily activities become difficult.²

What causes rotator cuff tendinitis? Common causes include:¹

• Sports with repetitive lifting over your head, such as swimming, tennis, baseball and weightlifting
• Working with your arm overhead for many hours at a time. Examples include painting or carpentry.

How to care for rotator cuff tendinitis: Your doctor may suggest several of these recommendations:²

• Rest your shoulder. Stop doing activities that cause it to hurt.
• Ice your shoulder three or four times a day.
• Take nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines include ibuprofen, aspirin and naproxen.
• Go to physical therapy. Physical therapy can help improve shoulder strength and flexibility. That can reduce pain. It can also stop injuries from happening in the future.
• Get steroid shots (injections). This can also help lessen your pain..

It’s a good idea to talk to your doctor about the safe amount of icing to do and NSAIDs to take. And if none of the steps above help, your doctor may even suggest surgery.

Looking for a doctor who gets you? We have more than 60,000 doctors at over 2,000 locations. Our team will help you get the care you need, when and where you need it. Find care near you.

2. Rotator cuff tear

Your risk of getting this injury tends to increase as you get older.² In fact, about 50% of people over the age of 60 will have some thinning or a partial tear of the rotator cuff, says Robert M. Orfaly, MD. He is a professor at Oregon Health & Science University in Portland.

What causes rotator cuff tears? Tears are often the result of athletic injuries or certain jobs.^3,4 People who do construction work or painting sometimes have rotator cuff injuries.^5,6 They can be the result of a freak injury, like falling on an outstretched arm. And they can also happen over time, because of repetitive lifting or overhead work.⁵

How to care for rotator cuff tears: Your doctor might recommend resting your shoulder, icing it, taking NSAIDs and doing physical therapy. For a large rotator cuff tear, they may recommend surgery. (Sometimes, partial tears don’t heal on their own. They might need to be operated on.)^5,6

3. Labral tear

The rubbery tissue that lines the shoulder socket is called the shoulder labrum. It helps keep your shoulder joint stable, Dr. Orfaly says.

What causes a labral tear? This painful injury has many possible causes, including:⁷

• Trying to lift something that’s too heavy with a sudden pull
• Falling with your arm outstretched
• Sudden overhead force, like serving in tennis

How to care for labral tears: For a labral tear, your doctor might recommend taking ibuprofen or another NSAID to help ease your pain. In some cases of labral tears, surgery may be in order. Talk with your doctor to decide the best way to care for your injury.

4. Biceps tendon tear

Biceps tendons attach the biceps muscle to the bones in your shoulders and elbows.⁸ Biceps tendon injuries are another type of shoulder injury. The tendon can fray when it gets overused. A biceps tendon tear causes pain, most often in the front of the shoulder. If the tendon frays enough, it can even rupture.⁸

What causes a biceps tendon tear? If you overuse the tendon, it can wear down. Activities like swimming, tennis or lifting too much weight can make the tear worse. You can also tear your biceps tendon if you fall with your arm outstretched.⁸

How to care for biceps tendon tears: “This one rarely needs surgery,” says Dr. Orfaly. “It will settle down over time.” At home, your doctor may recommend you apply ice, rest your shoulder and take an NSAID. They may even advise you to work with a physical therapist.⁸

Get health tips you can trust delivered straight to your inbox. Sign up for our health and wellness newsletter today.

5. Frozen shoulder

Frozen shoulder causes pain and stiffness. When you have frozen shoulder, your shoulder becomes very hard to move, even when the pain eases.⁹ It can last for a long time, Dr. Orfaly says. But it does usually get better.

“The freezing phase lasts for two to six months. It hurts when you try to move your arm in any direction,” he says. “The thawing phase can take six months to two years. The pain decreases and the stiffness improves.”

What causes frozen shoulder? Sometimes there is not a specific cause of frozen shoulder.⁹ It happens most often between the ages of 40 and 70. And women are more likely than men to get it. People with diabetes and thyroid disease have a higher risk of frozen shoulder. And for women, menopause raises the likelihood of getting it.⁹

How to care for frozen shoulder: Your doctor may advise putting a heat pack on your shoulder a few times a day.⁹ They may also recommend NSAIDS to ease your pain. And gentle stretching over a long period of time can also help, says Dr. Orfaly. But it’s a good idea to consult with your doctor first before trying any of these treatments. If frozen shoulder continues, your doctor may give you exercises to do at home, send you to a physical therapist or recommend a steroid shot.⁹

6. Osteoarthritis

This is the most common form of arthritis. It happens most often in your hands, hips and knees.¹⁰ But it can also affect your shoulders. In fact, about 1 in 3 adults older than age 60 has osteoarthritis in their shoulder, according to the Arthritis Foundation.¹¹ Shoulder arthritis can happen as you get older and start losing cartilage. It can happen to anyone. But it is more common in women than in men.

What causes osteoarthritis? Osteoarthritis is caused by damage or breakdown of the joint tissue between your bones. As your joint tissue breaks down, the bone begins reshaping.¹⁰ It can lead to pain, stiffness and swelling. People sometimes start to avoid shoulder movements to try to ease the pain. That can lead to tightness in the shoulder joint, says Dr. Orfaly. And that can lead to more pain.

How to care for osteoarthritis: Arthritis is a chronic (long-term) disease. Your doctor may recommend these options for easing arthritis pain:

• Ice or heat therapy
• Strength training
• Flexibility exercises (working out)
• Massage
• Over-the-counter pain relievers can also help.¹¹

It’s always a good idea to consult your doctor before trying any treatment.

Bottom line: Your doctor may recommend some or all of these self-care remedies if you have shoulder pain. And if your pain doesn’t go away, they’ll be able to help you decide on next steps.

You can use your health account, like a health savings account (HSA) or flexible spending account (FSA), to save on hundreds of health expenses from medical copays to pain relievers. See if your health expenses qualify with our free medical expense tool.

© 2024 Optum, Inc. All rights reserved. Do not reproduce, transmit or modify any information or content on this website in any form or by any means without the express written permission of Optum.

The information featured in this site is general in nature. The site provides health information designed to complement your personal health management. It does not provide medical advice or health services and is not meant to replace professional advice or imply coverage of specific clinical services or products. The inclusion of links to other web sites does not imply any endorsement of the material on such websites.

No medicine is risk-free. Some over the counter (OTC) medications can interfere with other medications or affect certain medical conditions. As with all medicine, OTC medications can also have side effects. Read package directions and be sure you understand all directions and precautions before taking. Follow your doctor’s advice about medicine use — and ask your doctor or pharmacist if you have any questions or concerns.

Stock photo. Posed by model.