Shoulder Pain & Rotator Cuff

Shoulder Pain That Limits What You Can Lift or Reach

Reviewed by Dr. Dustin Dukart, DC

Reaching for something on a high shelf, lifting a bag of groceries, fastening a seatbelt, sleeping on that side — all the things you don’t think about until one of them suddenly hurts. Most shoulder pain responds well to the right approach. A small number of cases need more than conservative care, and catching that early is part of the job.

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★★★★★

I went in with neck and shoulder pain. I had heard good things about him and it was close to my house (Cottage Grove)… He was able to help and was receptive to my needs and wants. My issues were fixed and I feel much better.

— Stephanie K. · Google

What’s Actually Causing It

“Shoulder pain” is a symptom, not a diagnosis, and several different problems produce it:

Rotator-cuff-related shoulder pain is the most common by a wide margin. It covers what used to be called “impingement” — irritation of the cuff tendons and the bursa as the arm moves — and partial cuff tendon wear. The American Academy of Orthopaedic Surgeons notes that most rotator-cuff problems are managed successfully without surgery.

Frozen shoulder (adhesive capsulitis) is a progressive loss of range in every direction, painful at first and stiff later. It tends to run a long course — often one to three years — and then largely resolves. Care doesn’t stop the clock, but it can make the painful and stiff phases more livable.

AC joint problems sit right on top of the shoulder, at the end of the collarbone, and hurt with reaching across the body or lying flat. Biceps tendon irritation shows up at the front. And pain that sits closer to the shoulder blade or the base of the neck often isn’t the shoulder at all — it’s referred from the neck, which is why the exam checks both.

Symptoms We See

• A “painful arc” — a band of pain partway up as you raise your arm out to the side, easier at the top and bottom
• Pain reaching behind your back (a back pocket, a bra strap, tucking in a shirt)
• Pain lying on that side at night, or being woken by it
• Weakness or a “dead arm” feeling lifting overhead or out to the side
• Catching, clicking, or a grinding sensation with certain movements
• Stiffness that’s getting worse — less range this month than last (points toward frozen shoulder)
• Pain at the very top of the shoulder with cross-body reaching (points toward the AC joint)

What the Evidence Supports

For rotator-cuff-related shoulder pain, the strongest lever is targeted exercise. A 2017 systematic review and meta-analysis in the British Journal of Sports Medicine found exercise to be the core of effective conservative care, with manual therapy providing a useful addition to exercise rather than a replacement for it. A Cochrane review of manual therapy and exercise for rotator cuff disease reached the same place. Corticosteroid injection can help in the short term but doesn’t change the longer-term picture much on its own.

For frozen shoulder, clinical practice guidelines from the Journal of Orthopaedic & Sports Physical Therapy support a conservative approach — managing pain, keeping as much range as the joint allows, and letting the condition run its course. Frozen shoulder specifically is also something I’m certified to treat through the Neil Asher Technique; it generally helps, though like any technique it doesn’t work the same for everyone, and I’ll tell you honestly where your case stands.

None of this is a claim that hands-on care “fixes” a shoulder. It’s that the right exercise approach, supported by manual therapy where it helps, is what the actual research points to — and the exam exists to find your approach, not hand you a generic shoulder routine.

The Exam Comes First

We start by sorting which of the above you actually have, and screening for the cases that need an orthopedic referral rather than a chiropractic plan (see the next section). The exam is a set of specific strength, range, and provocative tests — not just “does this hurt.” If it points to a full-thickness cuff tear with real weakness in someone who needs that shoulder for work or sport, or to instability from past dislocations, that’s the referral you’ll get. If it points to a case conservative care handles well, the plan is built around what your exam shows.

When to See a Doctor First

Most shoulder pain is not urgent. Get seen promptly — urgent care, your physician, or the ER for the trauma items — if you have:

• A recent significant injury and you now can’t lift the arm at all, or the shoulder looks deformed (possible fracture or dislocation)
• Fever, warmth, redness, or spreading swelling around the joint (possible infection)
• A lump or mass in the shoulder area, or night pain alongside unexplained weight loss or a history of cancer
• Sudden weakness, numbness, or pins-and-needles running down the whole arm into the hand (may be coming from the neck or a nerve, not the shoulder)
• Shoulder pain with chest pressure, shortness of breath, sweating, or nausea — call 911; left-shoulder pain can be referred from the heart

Common Questions

Can a chiropractor help shoulder pain?

For rotator-cuff-related shoulder pain — the most common kind — yes, and the evidence is clearest for exercise-based care with manual therapy as a helpful addition. We examine first to confirm that’s what you have and to catch the cases that need an orthopedic opinion instead.

Is it a rotator cuff problem or frozen shoulder?

They feel different on exam. Rotator-cuff pain is usually worst with specific movements (reaching overhead, behind the back) and your range is limited mostly by pain. Frozen shoulder progressively loses range in every direction, including when someone else moves your arm for you, and it tends to get stiffer over months. The exam tells them apart.

Do I need an MRI?

Usually not up front. Imaging changes the plan mainly when the exam suggests a significant structural tear that might need surgery, or when weeks of appropriate care haven’t helped. Many people have some cuff wear on MRI with no pain at all, so a scan without an exam can mislead.

How long does it take?

Rotator-cuff-related pain often improves meaningfully over several weeks of consistent exercise-based care. Frozen shoulder is slower by nature — measured in months to a couple of years — and the goal is a more comfortable, more usable shoulder along the way.

Ready When You Are

Most new patients are seen within a few days. New here? See what to expect on a first visit.

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Related reading: how screen posture drives neck and shoulder pain · neck pain (a common source of referred shoulder pain) · repetitive strain · all conditions we treat.