Shoulder pain is one of the most common complaints we see in the clinic. It can develop gradually without an obvious cause or appear suddenly after a specific incident.
The shoulder is incredibly mobile. Its joint capsule — where the arm bone meets the shoulder blade — is quite shallow, with most stability coming from connective and soft tissues. This complex intersection of various muscles and tissues creates many potential points for impingement, irritation and strain.
Most shoulder irritations I encounter stem from tension, protective holding patterns and postural issues throughout the upper body. Whether you spend your days doing physical labour or sitting in an office chair or truck, your posture, breathing patterns and body maintenance all affect your risk of shoulder pain and injury.
Read Also
A rancher’s ‘bitin’ list’
This Saskatchewan rancher comes up with her ‘bitin’ list,’ channeling her inner Tyler Childers.
The shoulder’s exceptional range of motion demands significant stability. Our bodies can achieve this stability in several ways. Ideally, we want movement patterns that support the joint without creating tension. When this fails, the body’s backup plan involves using muscle tension to stabilize the joint — but this comes at the cost of comfort and full mobility. Adding factors like falls, trauma, chronic stress, hormonal changes, sleep issues or overuse injuries can cause the body to protect the vulnerable shoulder joint with even more tension.
Shoulder soreness, regardless of its root cause, typically responds well to manual therapies such as massage, combined with corrective postural exercises. I’ve worked with many people who’ve had shoulder pain for years — even those who’ve tried appropriate physiotherapy exercises without success. Once they receive manual therapy, their shoulder mobility often improves rapidly, and their prescribed exercises become much more effective.
A relatively rare condition called “frozen shoulder” can sometimes develop. This condition is characterized by shoulder pain and limited mobility (especially when reaching above 90 degrees, behind the back or behind the head) and progresses through three stages: the painful “freezing” stage lasting about six months, the less painful but mobility-limited “frozen” stage, and the “thawing” stage, which brings increasing range of motion despite some pain. While historically mysterious, recent research suggests a hormonal connection in women, particularly during perimenopause and menopause. In my experience, frozen shoulder can also relate to past trauma, autoimmune conditions and neurological factors. I’ve found targeted acupuncture treatments combined with nutritional guidance often help these cases.
People with shoulder pain are commonly referred for cortisone or similar joint injections. While these can provide relief — especially when combined with guided rehabilitation and manual therapies — the benefits are usually temporary. I always encourage those with shoulder discomfort to consult an experienced manual therapist and rehabilitation specialist, as this approach often addresses the root causes more effectively.
Shoulder pain may also indicate broader health issues. While left shoulder and arm pain can signal cardiovascular emergencies, right shoulder pain might suggest liver dysfunction, stomach issues or gallbladder problems. Any shoulder pain that doesn’t improve with conservative treatment — like manual therapy, anti-inflammatory medications or rest — or that appears suddenly without clear cause should be evaluated by medical professionals to rule out systemic issues.
