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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, for assessment and a treatment plan. Shoulder pain is diagnosed from the history plus a guided movement screen on video, with anti-inflammatory treatment prescribed and physiotherapy, imaging or an injection arranged; a deformed shoulder after injury or a hot feverish joint is urgent care.
- What it is: rotator cuff tendinopathy, impingement or tears (about 2 in 3 cases), frozen shoulder (about 1 in 20 adults, peaking at 40 to 60 and 3 times commoner with diabetes), acromioclavicular joint pain, instability, osteoarthritis, or pain referred from the neck, heart, lungs or gallbladder.
- How long: rotator cuff pain improves over 6 to 12 weeks of progressive loading, frozen shoulder runs 1 to 3 years through painful, stiff and thawing phases, and a simple strain settles in 2 to 4 weeks; most shoulder pain is managed without surgery.
- Night pain: shoulder pain that wakes you when lying on that side is typical of rotator cuff and frozen shoulder problems and is not a sign of damage; constant night pain unrelated to position, with weight loss or a lump, is the pattern that needs investigation.
- Injections: steroid injections reliably reduce shoulder pain for weeks to a few months, which helps the painful phase of frozen shoulder or lets rehabilitation start, but they do not repair tendons or restore movement, and more than 2 or 3 a year is avoided.
- Emergency: call 112 for shoulder or arm pain that comes on with exertion or arrives with chest pressure, breathlessness, sweating or nausea, which can be a heart attack, and for a shoulder that looks deformed after a fall or collision.
Call 112 if shoulder or arm pain comes on with exertion or arrives with chest pressure, breathlessness, sweating or nausea: pain spreading to the left shoulder or arm can be a heart attack. Call 112 too for a shoulder that looks deformed after a fall or collision (possible fracture or dislocation). Get same-day in-person care for a hot, swollen joint with fever, which can signal septic arthritis.
Can an online doctor treat shoulder pain?
Yes, in most cases. Shoulder problems are diagnosed mainly from your story and a guided movement screen (reaching up, behind your back, out to the side), and both work well by video.[1] Online care suits rotator cuff pain and frozen shoulder; trauma with deformity, or shoulder pain with chest symptoms, needs emergency care.
Listen: What Causes Pain Between the Shoulder Blade and Spine
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How an online consultation helps with shoulder pain
- The dangerous mimics screened first: Exertional or left-shoulder pain with chest symptoms is treated as cardiac and routed to 112; the musculoskeletal assessment starts only once that screen is clear.
- A movement screen that discriminates: Reaching overhead, behind the back and out to the side, watched on camera, separates rotator cuff pain from the global stiffness of frozen shoulder.
- An exercise-first plan with timelines: The strongest evidence for common shoulder pain is progressive loading, not rest. You leave knowing what to do, how often, and when to expect change.
- Honest referral when it matters: Suspected significant tears, first dislocations and shoulders needing injections are referred with a letter, not strung along online.
What the doctor checks in an online shoulder consultation
Wear a vest top or loose shirt and set the camera far enough back to show your whole upper body. In a shoulder consultation, the doctor will typically check:
- The cardiac and red-flag screen: pain linked to exertion, chest symptoms, fever, trauma, unexplained weight loss or a cancer history, asked first because a yes changes the destination.[3]
- How it began: a load spike (decorating, a new gym programme, lifting grandchildren), a specific injury, or no trigger at all, which is typical of frozen shoulder.
- The movement screen: reaching overhead, out to the side against gentle resistance, and up your back; a painful arc in mid-range points to the rotator cuff, loss of outward rotation points to frozen shoulder.[1]
- Night pain and sleep position: whether lying on that side wakes you, and whether the ache is positional or constant.
- The neck as a suspect: whether neck movements reproduce the pain, and whether pain or tingling runs below the elbow, which points to a nerve from the neck rather than the shoulder.
- Both sides, and your health background: stiffness and aching in both shoulders and hips in an older adult raises polymyalgia rheumatica; diabetes and thyroid disease raise the odds of frozen shoulder.
You leave with a working diagnosis, a staged exercise plan, medication where suitable, and a review threshold: if you are not clearly improving in four to six weeks, the plan is reassessed, not repeated.
What causes shoulder pain?
Most shoulder pain comes from the rotator cuff, the sleeve of tendons steering the joint, irritated by load it was not prepared for. Frozen shoulder, arthritis of the shoulder joints, and instability after dislocation follow. Some shoulder pain is referred from the neck, the diaphragm or, in exertional left-shoulder pain, the heart.[1]
Rotator cuff pain: the everyday workhorse injury
The rotator cuff is the group of tendons wrapping the top of the arm bone. When load outpaces its capacity (a weekend of hedge-cutting, a new overhead sport, simply decades of use), it becomes painful at the outer upper arm, classically in a mid-range painful arc when lifting the arm, worse reaching overhead or behind, and sore lying on that side at night. It is the most common shoulder diagnosis at every age from the thirties up, it usually responds to a graded strengthening programme over about twelve weeks, and most cases never need a scan or surgery.[1] Sudden loss of strength after a distinct injury is the exception that earns early in-person examination, because a significant acute tear is repaired best when caught early.
Frozen shoulder: stiffness that steals movement
Frozen shoulder (adhesive capsulitis) is inflammation and tightening of the joint capsule. It typically arrives between 40 and 60, more often in women and in people with diabetes or thyroid disease, and often without any injury. Its signature is progressive stiffness in every direction, with turning the arm outwards lost first: doing up a bra, reaching a back pocket or a seatbelt becomes the impossible move, and early on it aches badly at night. It moves through a painful phase, a stiff phase and a thawing phase, and the honest timescale is long: many months, sometimes one to three years untreated.[1][4] Treatment shortens the misery rather than the calendar: pain control and a corticosteroid injection help the painful phase, and stretching plus graded exercise restore movement through the rest. Persisting stiffness has effective specialist options, so a stuck shoulder is never simply left stuck.
Arthritis, instability and the acromioclavicular joint
Osteoarthritis affects the shoulder less often than knees and hips, but it happens, particularly after old injuries: deep ache with grinding and slowly shrinking movement, managed on the same exercise-first principles as arthritis elsewhere.[2] Pain localised to the bony point where collarbone meets shoulder blade, worst reaching across the body, is acromioclavicular joint trouble, common in gym athletes. A shoulder that has dislocated once, especially young, needs proper rehabilitation because repeat dislocation is common; a first dislocation is an emergency-department event, never something to manipulate back yourself.
Referred pain: when the shoulder is the messenger
Some shoulder pain does not come from the shoulder. Three patterns matter. Pain that changes with neck movement, or runs with tingling below the elbow into the fingers, usually starts in the neck; assessing it alongside neck pain addresses the true source. Pain felt at the very tip of the shoulder can be referred from the diaphragm and organs beneath it (gallbladder disease classically refers to the right shoulder tip), which is why the doctor asks about meals, tummy pain and fevers when the shoulder examination is normal. And pain in the left shoulder or arm that arrives with exertion, chest pressure, breathlessness, sweating or nausea must be treated as the heart until proven otherwise: that pattern is a 112 call, and the chest pain page covers it in detail.[3] A video consultation takes referred patterns seriously precisely because treating the messenger misses the message.
Why does my shoulder hurt at night?
Night pain is the signature of the two most common shoulder problems. Rotator cuff pain flares when you lie on the affected side, compressing the irritated tendons; frozen shoulder aches deeply at night regardless of position, especially in its early phase. Persistent night pain with weight loss, feeling unwell or a cancer history needs prompt in-person review.[1]
Practical fixes help while treatment works: sleep on the other side hugging a pillow, or on your back with a small cushion under the elbow so the arm rests slightly forward. Timed pain relief before bed, agreed with the doctor, breaks the cycle of broken sleep, which itself amplifies pain.
When should I worry about shoulder pain?
Worry about a shoulder that looks deformed after a fall or collision, a hot swollen joint with fever, sudden loss of the ability to lift the arm after an injury, or shoulder pain that arrives with chest pressure, breathlessness or sweating, which can be a heart attack: call 112 for that pattern, immediately.
- Left-shoulder or arm pain with exertion, chest pressure, breathlessness, sweating or nausea: call 112
- Deformed shoulder after trauma, or a suspected first dislocation: emergency department
- Hot, swollen shoulder with fever or feeling unwell: same-day in-person care (possible septic arthritis)
- Sudden inability to lift the arm after a distinct injury: prompt in-person examination (possible significant tear)
- Night pain with unexplained weight loss, a cancer history, or a growing lump: urgent review
- New stiffness and aching in both shoulders with prolonged morning stiffness, especially over 50: prompt blood tests (possible polymyalgia rheumatica)
Which shoulder treatment might the doctor recommend?
Treatment follows the pattern. This is the decision framework the doctors use, aligned with cited European and UK guidance:[1]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Outer-arm pain reaching overhead or lying on that side (rotator cuff) | Graded strengthening over about 12 weeks, pain relief where suitable | Usually yes | No improvement after a properly completed programme, or sudden weakness after injury |
| Progressive stiffness in all directions, 40–60 age band (frozen shoulder) | Explanation, pain control, stretching programme; injection referral for a severe painful phase | Usually yes for diagnosis and plan | Injections are an in-person procedure; persistent stiffness earns a specialist opinion |
| Pain changing with neck movement, or tingling below the elbow | Assess and treat as a neck problem | Usually yes | Progressive arm weakness or constant numbness: referral for nerve assessment |
| Deformity after a fall, or first dislocation | Emergency department now | No | Fracture and dislocation need X-ray and reduction; rehabilitation follows |
| Hot, swollen shoulder with fever, or exertional pain with chest symptoms | Same-day in-person care; call 112 for the chest pattern | No | Possible septic arthritis or heart attack; both are time-critical |
Not sure which row is your shoulder? A doctor can tell you in one consultation.
See available times →Treatment options for shoulder pain
What you can do yourself
Keep the shoulder moving within comfort: complete rest stiffens it and weakens the very muscles it depends on.[5] Trim the clearly provoking activities (long overhead work, heavy pressing) rather than stopping everything, and keep the arm working below shoulder height meanwhile. Start gentle range-of-movement exercises early (pendulum swings, wall crawls, assisted stretches with the other arm), then add resistance gradually: outward-rotation work with a band is the core rotator cuff exercise. Expect strengthening to change symptoms over six to twelve weeks, not days.[1] Heat before stretching and short-term pharmacy pain relief make the work possible; a pharmacist can advise what fits your other medicines.
Prescription treatment
A prescription is never issued without a consultation. Where suitable, the doctor may prescribe an anti-inflammatory (NSAID), as tablets or a gel, after checking your stomach, kidney and heart history, mainly to make sleep and exercise possible while the real treatment (loading) works. Opioids (such as codeine or tramadol), benzodiazepines and other controlled medicines are not prescribed through online consultations. Corticosteroid injections have a genuine role, especially in the painful phase of frozen shoulder and stubborn rotator cuff pain, and the honesty that goes with them: relief is often marked but temporary, they are an in-person procedure arranged by referral, and they buy a window for rehabilitation rather than replacing it.[1][4] Physiotherapy referral is frequently the most valuable prescription on this page; imaging and surgical opinions are reserved for the patterns that need them.
When shoulder pain is treated online, and when you need in-person care
Treated online: rotator cuff related pain with a graded loading plan; frozen shoulder, from diagnosis through the long game of stretching and staged goals; acromioclavicular and arthritic shoulder pain; neck-referred pain, treated at its source; tendon problems shared with the tendonitis pathway; and reviews at the four-to-six week mark when progress has stalled.
In-person care: exertional shoulder or arm pain with chest pressure, breathlessness, sweating or nausea means 112 now, from the consultation itself if that is where the story emerges. Trauma with deformity or a first dislocation goes to the emergency department; a hot, swollen, feverish joint goes to same-day in-person care because septic arthritis destroys joints in days; sudden post-injury weakness goes for prompt examination and imaging of a possible acute tear. Suspected polymyalgia rheumatica gets same-week blood tests. Injections are arranged in person by referral, and shoulders that have genuinely failed good conservative care over months earn an orthopaedic opinion with a referral letter, not another identical exercise sheet.
When to get in-person care
Call 112 for shoulder or arm pain with chest pressure, tightness, breathlessness, sweating or nausea, especially on exertion: this can be a heart attack. Call 112 or go to an emergency department for a shoulder that is deformed after a fall or collision, a suspected dislocation, or an arm you cannot feel or move after injury. Arrange same-day in-person care for a hot, swollen shoulder with fever or shivers (possible septic arthritis), and prompt review for night pain with weight loss, feeling unwell or a history of cancer.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Speak to a licensed doctor about shoulder pain: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Leave with your plan: everything agreed before you hang up: your plan, and a prescription to use at a pharmacy near you where medication is clinically right for you. If your doctor decides you need to be seen in person, you get a full refund.
No sign-up needed
Shoulder pain can have more than one cause. Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
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Not sure this is the right page? Look up any symptom in the full symptom checker, or book and describe it to a doctor.
Frequently asked questions about shoulder pain
What causes shoulder pain?
Most shoulder pain comes from the rotator cuff tendons and the bursa beneath the shoulder tip, irritated by overhead work, sport, a jolt or simply age, or from frozen shoulder, where the joint capsule inflames and tightens. Other causes are a torn tendon after a fall, arthritis, instability after dislocation, calcium deposits in a tendon, a trapped nerve in the neck, and pain referred from the heart, lungs, gallbladder or diaphragm.
What are the symptoms of a rotator cuff problem versus frozen shoulder?
Rotator cuff shoulder pain is felt on the outer upper arm, worst reaching up, behind the back or lying on that side, with movement mostly preserved and a painful arc halfway up. Frozen shoulder starts with severe aching pain that disturbs sleep, then progressive stiffness in every direction so that you cannot turn the arm outward or reach up even with help, which no rotator cuff problem causes.
Can an online doctor prescribe treatment for shoulder pain in Europe?
Yes, after a consultation: anti-inflammatory tablets or gels where suitable, alongside a structured exercise plan and physiotherapy referral, with prescriptions used at a pharmacy near you. Opioids and other controlled medicines are not prescribed through online consultations, and a steroid injection, an ultrasound scan or a surgical opinion for shoulder pain is arranged in person when the picture calls for it.
What is frozen shoulder, and how long does it last?
Frozen shoulder is inflammation and tightening of the joint capsule, causing pain and then progressive stiffness in all directions, typically between 40 and 60 and three times more often with diabetes or thyroid disease. Untreated it runs one to three years through painful, frozen and thawing phases; a steroid injection and a hydrodilatation procedure shorten the painful phase, and exercise keeps as much movement as possible.
How do I know if my shoulder pain is a rotator cuff tear?
You cannot reliably tell from pain alone, and many painful cuffs are irritated rather than torn, while many older adults have painless tears on scans. The pattern that earns early examination is a distinct injury followed by sudden weakness, for example being unable to lift the arm outwards against gravity, or a visible dent in the muscle; that combination needs an ultrasound and a surgical opinion within weeks, because early repair does better.
Is left shoulder pain a sign of a heart problem?
It can be. Treat left shoulder or arm pain as cardiac if it comes on with exertion or emotion, or arrives with chest pressure, breathlessness, sweating, nausea or faintness: call 112 immediately. Shoulder pain that is reproduced by moving the arm, pressing on the shoulder or lying on it, and unaffected by walking uphill, is almost always the shoulder itself, which the video screen can confirm.
Should I rest my shoulder in a sling or keep moving it?
Keep it moving, within comfort. Slings and strict rest stiffen shoulders quickly, and a stiff shoulder hurts more and takes longer to fix; slings belong mainly to fractures and post-operative protocols under a clinician's instruction. Relative rest means trimming the provoking overhead or heavy tasks for a while while keeping the shoulder moving daily and building strength back up gradually.
Do I need an X-ray or scan for shoulder pain?
Usually not at the start. Rotator cuff pain and frozen shoulder are diagnosed from the history and movement pattern, and early scans frequently show age-related findings that mislead and prompt unnecessary surgery. Imaging earns its place after a significant injury, with sudden weakness, when a dislocation or fracture is possible, when shoulder pain has not improved after 6 to 12 weeks of rehabilitation, or when the diagnosis is unclear.
Do steroid injections cure shoulder pain?
No. They reliably reduce shoulder pain for weeks to a few months, which is useful in the painful phase of frozen shoulder or when pain blocks rehabilitation, and that window is best used to build strength and movement. They do not repair tendons or restore movement by themselves, repeated injections can weaken tendon, and most people with rotator cuff pain do as well with exercise alone over three months.
What can I do at home for shoulder pain?
At home, keep the shoulder moving gently through its range several times a day, use heat before exercise and a cold pack after a flare, take paracetamol or an anti-inflammatory as advised, sleep on the other side hugging a pillow or on your back with the arm supported, sit upright with a cushion behind the lower back, trim overhead and heavy tasks for a while, and start the strengthening exercises a physiotherapist gives you.
How can I prevent shoulder pain coming back?
Prevent recurrent shoulder pain by strengthening the rotator cuff and shoulder blade muscles twice a week, warming up before overhead sport, building training gradually, setting up a desk so the shoulders stay relaxed and the mouse close, avoiding long periods with the arms raised, lifting loads close to the body, keeping diabetes and thyroid disease well controlled, and finishing the full rehabilitation course rather than stopping when the pain fades.
Is shoulder pain different in pregnancy, in older people or in sport?
In pregnancy, shoulder pain is usually postural or from lying on one side and is managed with movement, heat and paracetamol; sudden shoulder-tip pain with abdominal pain in early pregnancy is an emergency. In older people, painless rotator cuff tears are common, osteoarthritis and polymyalgia rheumatica enter the picture, and a fall can fracture the upper arm. In sport, instability after a dislocation and overuse tendinopathy dominate.
- Shoulder pain (Clinical Knowledge Summary), NICE, National Institute for Health and Care Excellence, 2022.
- Musculoskeletal health fact sheet, WHO, World Health Organization, 2022.
- Chest pain (Clinical Knowledge Summary), NICE, National Institute for Health and Care Excellence, 2024.
- Oral steroids for shoulder pain (adhesive capsulitis), Cochrane, Cochrane Library, 2006.
- Shoulder pain: causes, diagnosis and treatments, HSE, Health Service Executive (Ireland), accessed August 2026.
- Shoulder pain, NHS, National Health Service (UK), reviewed May 2023.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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