Shoulder pain is one of the most common reasons people seek medical care and a leading cause of missed work and limitations in daily activity across the US. Research suggests that shoulder pain affects up to one in four adults at any given time, with lifetime prevalence estimates as high as one in three. For many people, shoulder pain interferes with sleep, lifting, sports, and even simple tasks like reaching overhead or fastening a seatbelt.

The good news is that physical therapy is often one of the safest and most effective treatments for shoulder pain–regardless of the specific diagnosis–provided no serious red flag conditions are present. Through targeted exercise, hands–on care, and education, physical therapy can reduce pain, restore mobility, and improve strength for most common shoulder conditions. In many cases, it can also help people avoid unnecessary imaging, injections, or surgery and return to normal activity more quickly.

Most Shoulder Conditions Involve the Rotator Cuff

While any structure in the shoulder can be injured through trauma or overuse, the majority of shoulder conditions involve the rotator cuff. The rotator cuff is a group of four muscles that surround and stabilize the shoulder joint. Each muscle originates from a different part of the shoulder blade (scapula) and attaches to the head of the upper arm bone (humerus), forming a “cuff” that helps control movement and maintain joint stability.

Problems affecting the rotator cuff–or nearby structures–can lead to pain, stiffness, weakness, and difficulty performing everyday movements. Below are six of the most common conditions associated with shoulder pain.

The 6 Most Common Shoulder Conditions

• Shoulder bursitis
  
  A bursa is a small, fluid–filled sac that cushions tissues and reduces friction between structures. The subacromial bursa in the shoulder is the largest bursa in the body. When it becomes inflamed–often due to repetitive overhead activity–shoulder bursitis can develop. Common symptoms include pain at the top, front, or outside of the shoulder that worsens with overhead use or while sleeping.

  
  



• Rotator cuff tendinitis (shoulder tendinitis)
  
  The most common cause of shoulder pain, rotator cuff tendinitis develops gradually due to irritation or inflammation of one or more rotator cuff tendons. Symptoms typically include pain and swelling in the front of the shoulder or along the side of the arm, especially when raising or lowering the arm.

  
  



• Shoulder impingement syndrome
  
  Shoulder impingement occurs when the rotator cuff tendons or bursa become pinched between the upper arm bone (humerus) and part of the shoulder blade known as the acromion. This is often associated with bony changes such as bone spurs. Symptoms include shoulder pain, weakness, and difficulty reaching overhead or behind the back.

  
  

  Note: Over time, shoulder impingement can contribute to bursitis and/or tendinitis, and these terms are sometimes used interchangeably in clinical settings.

  
  



• Rotator cuff tear
  
  A rotator cuff tear occurs when one of the rotator cuff tendons partially or completely detaches from the bone. This can happen suddenly due to trauma or develop gradually over time, which is more common in older adults. Typical symptoms include pain during the day and at night, discomfort when lying on the affected shoulder, and pain or weakness when lifting or lowering the arm.

  
  



• Frozen shoulder (adhesive capsulitis)
  
  Frozen shoulder develops when scar tissue forms within the shoulder capsule, a structure that helps stabilize the joint. As the capsule thickens and tightens, shoulder movement becomes increasingly restricted, eventually leading to a “frozen” joint. Symptoms include progressive pain and stiffness that can make shoulder movement difficult or impossible.

  
  



• Shoulder dislocation
  
  A shoulder dislocation occurs when the ball of the upper arm bone (humerus) comes out of the shoulder socket (glenoid). This injury is typically caused by a forceful movement or trauma and may be partial or complete. Symptoms include significant pain, swelling, and an inability to move the shoulder normally.

  
  

Red Flags: When Shoulder Pain Requires Urgent Attention

In most cases, a comprehensive course of physical therapy is the best first step for managing shoulder pain. Physical therapists are movement experts who focus on restoring strength, mobility, and function through individualized, exercise-based care. However, certain symptoms may indicate a more serious condition that requires prompt medical attention.

Be alert for the following red flags:

• Deep, intense pain


• Pain accompanied by unexplained weight loss and/or fever


• Constant pain, including pain at night when the shoulder is at rest


• Signs of infection or septic arthritis (redness, pus or fluid, fever, blisters, or rapidly worsening swelling)


• Severe trauma that may have caused a fracture or dislocation


• Known or suspected cancer (for example, significant bone pain that may suggest a tumor)


• Persistent swelling and pain without a recent injury


• Severe muscle spasms

If you experience any of these symptoms, contact your primary care physician as soon as possible or seek urgent or emergency care for traumatic injuries. In the absence of red flags, seeing a physical therapist early can help you start a comprehensive treatment plan and improve your recovery over time.

Take the Next Step for Your Shoulder

Shoulder pain is common, but it does not have to become your “new normal.” Most shoulder conditions–from rotator cuff irritation to frozen shoulder–respond extremely well to a structured physical therapy program focused on restoring motion, rebuilding strength, and helping you move with confidence again. By identifying red flags early and choosing the right care, you can address serious concerns promptly while using physical therapy as your primary tool for long-term recovery and prevention.

If you are experiencing shoulder pain or discomfort–whether it started recently or has been lingering for months–contact our physical therapy clinic today to schedule an appointment. A licensed physical therapist will take the time to understand your symptoms, perform a thorough evaluation, and develop a personalized plan to help you safely return to the activities you enjoy, with less pain and greater confidence.

References and Further Reading

1. A systematic review of the global prevalence and incidence of shoulder pain


2. Shoulder pain prevalence by age and within occupational groups


3. Epidemiology of Shoulder Pain


4. Study seeks to understand why the same shoulder injury can cause serious pain in some patients and no symptoms in others


5. Chronic shoulder pain: Part I. Evaluation and diagnosis


6. Epidemiology of Shoulder Injuries Presenting to US Emergency Departments


7. Current and future advances in practice: tendinopathies of the shoulder


8. The effectiveness of education for people with shoulder pain: A systematic review


9. Specific modes of exercise to improve rotator cuff-related shoulder pain: systematic review and meta-analysis


10. Rotator Cuff Tendinopathy Diagnosis, Nonsurgical Medical Care, and Rehabilitation: A Clinical Practice Guideline