Physical Therapy · Shoulder Pain ·

Why Your Shoulder Pain Isn’t Going Away, And What You Can Do About It

We ask a lot of our shoulders, and for that reason shoulder pain is very common. Maybe you reached a little too high for something overhead. Maybe you lifted something a little awkwardly. Maybe you just slept on it wrong. A little dull ache or discomfort in a shoulder is something most of us have had to deal with at one point or another. It’s so common that it’s easy to ignore, sometimes for weeks or months.

Minor shoulder problems can easily worsen as we continue to engage the shoulder joint in several different movement patterns: lifting, reaching, pulling, throwing, etc. Persistent pain doesn’t always mean damage, but it can mean your body may need help recovering properly. Untreated and ignored, persistent shoulder pain may eventually lead to injections, pain medication, or surgery. It’s best to address the problem before it gets to that point.

Why Shoulder Pain Often Lingers

Because of the way our shoulders are designed to work, they are very mobile. They are also less stable than many other joints, making them vulnerable to irritation. The large range of motion that makes our shoulders so useful requires multiple muscles, tendons, and joints working together. This complexity increases the likelihood that something can become irritated or inflamed.

There are many simple potential causes of shoulder pain, including:

  • Repetitive overhead movement
  • Poor mechanics when reaching or lifting
  • Weakness in surrounding muscles
  • Sleeping position
  • Gradual wear-and-tear

The usefulness of our shoulders also increases the likelihood that we will keep using them while they are irritated or inflamed, and the pain can lead us to unconsciously compensate with poor movement patterns that can exacerbate the problem. Unfortunately, avoiding movement entirely can actually increase stiffness and weakness over time. In fact, inactivity following an injury has been linked to an increased risk of a painful condition known as “frozen shoulder”1.

It’s also important to remember that persistent shoulder pain doesn’t always indicate a serious injury, but treating the pain before it gets worse can sometimes mean the difference between a quick and complete recovery or a long and painful recovery, up to and including surgery.

Shoulder pain that eventually requires surgery isn’t always the result of a sudden injury. The American Academy of Orthopaedic Surgeons has suggested that conditions like shoulder impingement and rotator cuff tendinitis are commonly associated with irritation, inflammation, and repetitive overhead activity rather than a single traumatic injury2.

How Do You Know When You Should Seek a Medical Evaluation?

If continuing to push through shoulder pain can make it worse and too much rest can lead to additional problems, how can we know what the best course of action is? Sometimes, a professional evaluation may be the best option. You should consider medical help if you experience:

  • Pain lasting for several weeks
  • Difficulty reaching overhead or lost range of motion
  • Pain that interferes with your ability to sleep
  • Pain that is spreading into your arm

None of these situations necessarily means that you will need surgery, but they indicate that an evaluation from a medical professional like a physical therapist is in order. Shoulder conditions that are not improving are likely to get worse or contribute to other conditions. The sooner you address the underlying problem, the more likely you are to avoid surgery or dangerous medications.

How Physical Therapy Can Help

The best way to deal with shoulder pain is not to find some temporary relief, it’s to improve the long-term function of the shoulder. This is where physical therapy excels as a preferred intervention. A physical therapist can provide a thorough evaluation that identifies the underlying cause of your shoulder pain and can develop a personalized treatment plan that can help you:

  • Improve mobility
  • Reduce stress on irritated tissues
  • Strengthen supporting muscles
  • Correct movement patterns
  • Improve posture and mechanics
  • Return to normal activity safely

Physical therapy is not about treating symptoms or providing temporary relief. Physical therapists are trained to treat the underlying causes of pain, and to help patients build mobility, flexibility, strength, and confidence. By tailoring a treatment plan specifically to your needs and abilities, your PT can help you see results quickly, monitor your progress and adjust accordingly, and help you get back to your normal activities as quickly and safely as possible, preferably without the need for pain medication or surgery.

Importantly, physical therapy is an evidence-based, research-supported medical option. Physical therapists are highly trained, certified medical professionals. They are uniquely qualified to identify underlying conditions that may contribute to your pain, and to help you emerge from your treatment stronger, more mobile, and with a better understanding of how your body works and how to avoid pain and injury in the future. Physical therapy and exercise are often considered preferred treatment options for common sources of shoulder pain like rotator cuff tendinopathy3.

The Bottom Line: Shoulder Pain is Common and Treatment Options are Well-Understood

If you experience persistent shoulder pain, you are not alone. The good news is that many cases improve with conservative treatment options and don’t require prescription medications or surgery. Keep in mind, though, that ignoring the problem may allow stiffness and weakness to worsen. The key is to understand the real cause of the pain and to treat it without making it worse. Physical therapy can be a great option to help you identify the underlying cause and work to reduce pain, improve movement, and avoid more invasive treatment options.

If you find that shoulder pain is interfering with your sleep, work, exercise, or daily routine, a physical therapy evaluation may help you understand what’s causing it and what you can do to start moving comfortably again.

Our therapists at Strive! Physical Therapy Centers have been helping our friends and neighbors in and around Ocala treat pain for more than 40 years, and they would be happy to help you or a loved one overcome your shoulder pain. Call us at 352.351.8883 or email us today to schedule an evaluation.

Sources

  1. “Frozen Shoulder (Adhesive Capsulitis): Symptoms & Treatment.” Cleveland Clinic, 5 Sept. 2023, https://my.clevelandclinic.org/health/diseases/frozen-shoulder-adhesive-capsulitis.
  2. Armstrong, April. “Shoulder Impingement/Rotator Cuff Tendinitis - OrthoInfo - AAOS.” Aaos.org, 2010, https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-impingementrotator-cuff-tendinitis.
  3. François Desmeules, et al. “Rotator Cuff Tendinopathy Diagnosis, Non-Surgical Medical Care and Rehabilitation: A Clinical Practice Guideline.” Journal of Orthopaedic and Sports Physical Therapy, vol. 55, no. 4, 30 Jan. 2025, pp. 1–94, https://doi.org/10.2519/jospt.2025.13182.

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