Shoulder pain commonly comes from the rotator cuff tendons, the joint itself, the biceps tendon, or referred pain from the neck. Rotator cuff problems and arthritis are the leading causes in adults over 50.
Because the shoulder trades stability for mobility, it is prone to overuse injuries that heal slowly. Night pain and loss of reach are the symptoms that most often bring people to care.
Common symptoms
- Pain reaching overhead or behind the back
- Night pain lying on that side
- Weakness when lifting or carrying
- Stiffness that limits range of motion
How interventional pain physicians treat it
Interventional pain physicians typically distinguish tendon, joint, and nerve sources with examination and imaging before targeting treatment. Care may include:
- Physical therapy
- Joint injections
- Nerve blocks
- Radiofrequency ablation
Treatment is always determined by a physician based on individual evaluation. This page is general information, not medical advice.
Frequently asked questions
Why is shoulder pain worse at night?
Lying on the shoulder compresses inflamed tendons and the bursa, and there are fewer distractions from pain at night. Night pain is a hallmark of rotator cuff problems and usually improves as the underlying issue is treated.
Do rotator cuff tears always need surgery?
No. Many partial and even full-thickness tears do well with therapy, injections, and activity modification, particularly in older adults. Surgery is typically considered for acute tears in active patients or persistent weakness.
Could my shoulder pain be coming from my neck?
It can. Nerve irritation in the cervical spine frequently refers pain to the shoulder blade and upper arm. An exam can usually distinguish the two, and sometimes both contribute.
Independent, physician-owned practices in the DxTx network provide this kind of care across 11 states. One call connects you to the practice closest to you.