Home / Health Conditions / Shoulder Pain (Rotator Cuff, Tendonitis & Frozen Shoulder)
Shoulder Pain (Rotator Cuff, Tendonitis & Frozen Shoulder)
Shoulder pain is one of the most common physical complaints, and the rotator cuff tendons are a frequent cause. Most shoulder problems are tendon irritation or tears, frozen shoulder, arthritis or injury — but shoulder pain with chest pain, shortness of breath or sweating can be a heart attack and needs 911. Many problems improve with time, exercise and patient rehabilitation.
Call 911 right away if shoulder pain comes with chest pain, pressure or heaviness, shortness of breath, heavy sweating for no reason, nausea, light-headedness, or pain or discomfort spreading to the arms, back, neck or jaw. These can be signs of a heart attack, and pain in one or both shoulders is on the list of symptoms. Heart attack symptoms can start slowly, can be mild, and can come and go over several hours (NHLBI (opens in a new tab)). Do not drive yourself; an ambulance is the best and safest way to get to the hospital (NHLBI (opens in a new tab)).
Get urgent medical care for:
- Sudden, very bad shoulder pain; an arm you cannot move or lift; or a shoulder that has changed shape or is badly swollen — especially after a fall, accident or heavy lift. The NHS in the UK says these can be signs of a broken or dislocated bone or a torn tendon (NHS (opens in a new tab)). A dislocated shoulder is usually very painful and may look deformed, with swelling, numbness and weakness (AAOS OrthoInfo (opens in a new tab)).
- Fever or feeling unwell with a hot, swollen, red or very painful joint can be septic arthritis, a serious joint infection that needs urgent treatment, usually in the hospital (NHS (opens in a new tab)).
- Numbness, pins and needles that do not go away, or loss of feeling in the arm or shoulder, or severe pain in both shoulders (NHS (opens in a new tab)).
- Sudden weakness or numbness on one side of the body, a drooping face, trouble speaking, confusion or trouble seeing can be a stroke — call 911 (NHLBI (opens in a new tab)). See our stroke guide.
Never wait for a chiropractic, acupuncture or massage appointment, or try a magnet, wrap or home remedy first, if you have any of these signs.
How the shoulder works
The shoulder is a ball-and-socket joint of three bones: the upper arm bone, shoulder blade and collarbone. The rotator cuff — four muscles whose tendons cover the top of the upper arm bone — holds the arm in the socket and helps you lift and rotate it, and a lubricating sac called a bursa lets the tendons glide under the bony tip of the shoulder (AAOS OrthoInfo (opens in a new tab)). Your shoulders are the most movable joints in the body, which also makes them easy to injure (MedlinePlus (opens in a new tab)).
Shoulder pain is one of the most common physical complaints, in people of all ages (AAOS OrthoInfo (opens in a new tab)). Most shoulder problems are tendon inflammation or tears, instability, arthritis or fractures; tumors, infection and nerve problems are much less common (AAOS OrthoInfo (opens in a new tab)). This guide also stands in for our “Rotator Cuff” topic; a separate MBHA Tendonitis guide is planned.
Rotator cuff tendinopathy, impingement and bursitis
The rotator cuff is a common cause of shoulder pain. The pain can come from tendinitis (inflamed tendons), bursitis (an inflamed bursa) or impingement, when the space between the top of the shoulder and the tendons narrows as you raise your arm and the bone rubs on the tendon and bursa (AAOS OrthoInfo (opens in a new tab)). Most are wear-and-tear problems from repeating the same arm movements, especially reaching overhead (MedlinePlus (opens in a new tab)).
- Symptoms: pain and tenderness at the front or side of the shoulder, pain and stiffness when you reach overhead, and pain that is typically worst at night. Over time you can lose strength and motion (AAOS OrthoInfo (opens in a new tab)).
- Who is at risk: young athletes who throw, swim or serve overhead, and people in repetitive lifting or overhead jobs such as painting or construction; it can also start with a minor injury or no clear cause (AAOS OrthoInfo (opens in a new tab)). See also our bursitis guide.
Rotator cuff tears
A partial tear goes part way through a tendon; a full-thickness tear detaches part or all of it from the upper arm bone. Almost 2 million people in the U.S. see a doctor for rotator cuff tears each year (AAOS OrthoInfo (opens in a new tab)).
- Two main causes. An injury — falling on an outstretched arm or lifting something too heavy with a jerk — or wear that builds slowly with age and overuse. Most tears are the wear type, so people over 40 are at greater risk (AAOS OrthoInfo (opens in a new tab)). By age 80, most adults have tears (MedlinePlus (opens in a new tab)).
- Symptoms: pain at rest and at night (especially lying on that shoulder), pain when lifting or lowering the arm, weakness and sometimes a crackling feeling. A sudden tear usually causes intense pain, sometimes a snap, and immediate weakness in the upper arm (AAOS OrthoInfo (opens in a new tab)).
- A tear on a scan is not always the cause of your pain. Some tears cause no pain, and a wear-type tear in one shoulder makes one in the other shoulder more likely, even with no pain there. A tear can also grow if you keep using the shoulder despite increasing pain (AAOS OrthoInfo (opens in a new tab)).
Biceps tendon tears
The biceps muscle attaches at the shoulder by two tendons, and the longer one is more often torn, from lifting something too heavy or from slow wear. Signs include sudden sharp pain in the upper arm, sometimes a pop or snap, bruising, weakness, and sometimes a bulge above the elbow (“Popeye muscle”). Because of the second attachment, most people can still use the muscle, and for most the pain goes away over time. Smoking and corticosteroid medicines can weaken tendons (AAOS OrthoInfo (opens in a new tab)). A tear near the elbow is more likely to need surgery (AAOS OrthoInfo (opens in a new tab)); see our elbow guide.
Frozen shoulder
In frozen shoulder (adhesive capsulitis) the tissue capsule around the joint thickens and tightens, so the shoulder becomes painful and very hard to move — by you or by someone else. It most commonly affects people between 40 and 60 and is more common in women (AAOS OrthoInfo (opens in a new tab)).
- Three stages. Freezing (6 weeks to 9 months): more pain and less motion. Frozen (4 to 6 months): pain may ease but stiffness stays. Thawing (6 months to 2 years): motion slowly returns. Full recovery may take up to 3 years (AAOS OrthoInfo (opens in a new tab)). The NHS says the pain and stiffness will usually go away eventually (NHS (opens in a new tab)).
- Who gets it: people with diabetes (more often, and with longer-lasting stiffness), thyroid conditions, Parkinson’s disease or heart disease, and after a shoulder has been held still because of surgery or injury; often the cause is unclear (AAOS OrthoInfo (opens in a new tab), NHS (opens in a new tab)). See our diabetes and thyroid guides.
Arthritis of the shoulder
Wear-and-tear osteoarthritis, rheumatoid arthritis, arthritis after an injury or a large long-standing rotator cuff tear, and avascular necrosis (loss of blood supply to the top of the upper arm bone) can all affect the shoulder. Pain that worsens with activity, night pain, limited motion and grinding or clicking are typical (AAOS OrthoInfo (opens in a new tab)). See our arthritis guide. Polymyalgia rheumatica can also cause aching and stiffness around the shoulders and neck, mostly in people over 65, with morning stiffness lasting longer than 45 minutes; a new headache, jaw pain when eating or vision problems with it need a doctor right away (NHS (opens in a new tab)). An MBHA Polymyalgia guide is planned.
When the pain is not from the shoulder
A pinched nerve in the neck (cervical radiculopathy) can send pain into the shoulder and arm, with weakness and numbness (AAOS OrthoInfo (opens in a new tab)); see our neck guide. Less often, shoulder pain is referred from organs in the abdomen: a 2022 scoping review, mostly of case reports, found abdominal pain was the most common warning sign alongside shoulder pain (Pennella et al., 2022 (opens in a new tab)). The heart can also send pain to the shoulder (NHLBI (opens in a new tab)); see our heart guide.
How it is diagnosed
Your provider will ask how and when the pain began, press on the shoulder, check your motion and strength, and often examine your neck (AAOS OrthoInfo (opens in a new tab), AAOS OrthoInfo (opens in a new tab)). X-rays show bone but not the rotator cuff, so they are often normal in rotator cuff pain and are used to rule out arthritis and other bone problems. MRI or ultrasound can show the tendons, though ultrasound depends on the skill of the person doing the scan (AAOS OrthoInfo (opens in a new tab)). Frozen shoulder is diagnosed by exam; scans are not required but may find another problem such as a tear (AAOS OrthoInfo (opens in a new tab)).
When to see a provider (not an emergency): the NHS says to get medical help if shoulder pain is getting worse, is not better after 2 weeks, or it is very difficult to move the arm; recovery can take 6 months or longer (NHS (opens in a new tab)). If an activity bothers your shoulder, stop it and check with your provider — early treatment can keep a mild rotator cuff injury from becoming more serious. If your arm feels weak right after a sudden injury, see your provider as soon as possible (MedlinePlus (opens in a new tab)).
Side by side
Six approaches compared
For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.
| Approach | What it involves | Estimated cost | What to expect |
|---|---|---|---|
| Conventional medicine (AMA) | Rest from what hurts, pain relievers (by class), physical therapy with stretching then strengthening, steroid injection if pain continues, and hydrodilatation for frozen shoulder. Surgery (tendon repair, joint release or replacement) is for selected cases. | Medicare Part B covers medically necessary outpatient physical therapy: after the deductible you pay 20% of the Medicare-approved amount. Other costs: being researched. | AAOS reports nonsurgical care relieves pain and improves function in about 80 to 85% of people with rotator cuff tears. Frozen shoulder can take up to 3 years. Large reviews found surgery for shoulder impingement no better than sham surgery. |
| Chiropractic | Manual therapy such as joint mobilization or manipulation of the shoulder, upper back or neck, soft-tissue work and exercise. | About $55 to $100 for a self-pay follow-up visit and $90 to $200 for a first visit, per The Pricer. Medicare covers only spinal adjustments for a subluxation. | Evidence is low to moderate quality. One trial found manipulation added to usual care sped recovery; trials against sham treatment often show no difference. Get a possible tear, break or heart symptoms checked first. |
| Acupuncture | Fine needles at acupuncture points, or dry needling of tight shoulder muscles, usually added to exercise or physical therapy. | About $90 to $185 per follow-up visit paying cash, per The Pricer. Medicare covers acupuncture (including dry needling) only for chronic low back pain. | An older Cochrane review found little evidence either way. Newer reviews of acupuncture or dry needling added to physical therapy report pain benefits, but the studies are mixed in quality. |
| Herbal medicine | No herb or supplement is proven for rotator cuff or frozen shoulder problems. Turmeric and arnica gel are covered below. | Cost estimate being researched. | We found little research on herbs for shoulder pain, and what exists for tendon problems is poor quality. Tell your doctor about every product, especially before surgery or with blood thinners. |
| Massage therapy | Hands-on work on the shoulder, neck and upper back muscles for tightness and comfort, alongside exercise. | One national chain: about $125 to $160 for a 60-minute massage for non-members and about $65 to $90 for members, per The Pricer. Prices vary by location. | NCCIH says massage may help shoulder pain, but benefits may last only a short time. We found no research showing it heals a tear. Avoid a hot, swollen or possibly broken shoulder. |
| MBHA Wellness Coach | Daily habits that support recovery: keeping the shoulder moving, doing your prescribed exercises, posture and desk set-up, pacing activity, sleep and tobacco. | Cost estimate being researched. | Supports — never replaces — a diagnosis and rehabilitation. Shoulder recovery is slow, often months, and steady habits matter more than any one treatment. |
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Conventional medicine (AMA)
Most shoulder problems are treated without surgery first. AAOS reports that nonsurgical treatment relieves pain and improves function in about 80 to 85% of people with a rotator cuff tear (AAOS OrthoInfo (opens in a new tab)), and for tendinitis and impingement many people improve gradually over weeks to months (AAOS OrthoInfo (opens in a new tab)).
First steps at home
- Keep gently moving. The NHS advises staying active, doing shoulder exercises for 6 to 8 weeks to stop pain returning, and not stopping use of the shoulder completely, which can slow recovery; it advises against making up strenuous exercises or using heavy gym equipment (NHS (opens in a new tab)). Avoid activities that cause shoulder pain (AAOS OrthoInfo (opens in a new tab)).
- Heat or cold. The NHS suggests a wrapped pack of frozen peas or a wrapped hot water bottle for up to 20 minutes at a time (NHS (opens in a new tab)).
- Pain relievers (by class). NSAIDs such as ibuprofen and naproxen reduce pain and swelling (AAOS OrthoInfo (opens in a new tab)); the NHS suggests paracetamol (acetaminophen) first for frozen shoulder (NHS (opens in a new tab)). NSAIDs can irritate the stomach lining and cause internal bleeding, so take them with food and check with your doctor if you have had ulcers or take a blood thinner (AAOS OrthoInfo (opens in a new tab)). We don’t list doses.
Physical therapy and exercise
A physical therapist first works on restoring motion, then adds rotator cuff strengthening and posture work (AAOS OrthoInfo (opens in a new tab)); for frozen shoulder, flexibility-focused therapy is the main recommendation (AAOS OrthoInfo (opens in a new tab)). What do studies say?
- Reviews are supportive of exercise for rotator cuff tendinopathy, though few studies exist (Littlewood et al., 2012 (opens in a new tab)). For impingement, one review rated the evidence very low quality but said exercise should be considered, with tape, shock-wave, laser or manual therapy possibly added (Steuri et al., 2017 (opens in a new tab)). A 2025 physical therapy guideline covers rotator cuff tendinopathy (Desmeules et al., 2025 (opens in a new tab)); we read only its abstract.
- A Cochrane review (60 trials) found one high-quality trial of manual therapy plus exercise against an inactive placebo with no clinically important difference; side effects were more frequent than with placebo but mild (short-term pain). It found low-quality evidence that exercise and manual therapy may be similar to steroid injection and to subacromial decompression surgery (Page et al., 2016 (opens in a new tab)).
- A 2024 meta-analysis of 16 trials of shock-wave therapy found better pain relief and function than control groups, but called the evidence limited (Xue et al., 2024 (opens in a new tab)). For other electrotherapy, a Cochrane review found low-quality evidence of short-term benefit from therapeutic ultrasound in calcific tendinitis and from low-level laser, but none for pulsed electromagnetic field therapy (Page et al., 2016 (opens in a new tab)).
Injections (categories, benefits and risks)
- Corticosteroid (cortisone) shots are used if rest, medicine and therapy do not help. AAOS says they do not work for everyone; on average they relieve pain in about two-thirds of people for at least 3 months, and repeated long-term injections carry risks (AAOS OrthoInfo (opens in a new tab)). Possible downsides: a pain “flare” for 1 to 2 days, temporarily higher blood sugar in people with diabetes, a very small infection risk, and cartilage damage over time. Doctors often set a practical yearly limit on the number of shots, and AAOS says a cortisone shot should generally not be used for tendinitis because it can increase the chance of a tendon rupture, especially in biceps, patellar and Achilles tendons (AAOS OrthoInfo (opens in a new tab)). AAOS’s shoulder pages still list a steroid shot as an option for rotator cuff tendinitis, so ask your doctor how this applies to you.
- Frozen shoulder. A 2020 review of 65 studies found only steroid injection into the joint clearly beat other treatments for short-term pain and function; adding a home exercise program added benefit later (Challoumas et al., 2020 (opens in a new tab)). A Cochrane review found manual therapy plus exercise gave less improvement than a steroid shot at 7 weeks, with differences no longer clinically important by 6 and 12 months (Page et al., 2014 (opens in a new tab)). Hydrodilatation — injecting a large volume of sterile fluid under imaging to stretch the joint capsule — is another option if other methods fail (AAOS OrthoInfo (opens in a new tab)).
- Platelet-rich plasma (PRP) and stem-cell shots are other injections a provider may consider (AAOS OrthoInfo (opens in a new tab)). A 2021 review of 8 trials found PRP safe and effective for long-term pain and function in rotator cuff disease, though methods and comparison groups varied widely (A Hamid et al., 2021 (opens in a new tab)). Joint lubricant shots, used for knee arthritis, have not been shown to work in shoulder arthritis and are not recommended (AAOS OrthoInfo (opens in a new tab)).
Surgery
- Rotator cuff tears. AAOS says surgery may be offered when pain does not improve with nonsurgical care; other signs include symptoms lasting 6 to 12 months, a large tear (over 3 cm) with good tissue, significant weakness, or a recent injury. Most repairs are arthroscopic, often as same-day surgery. Recovery: a sling for about 4 to 6 weeks, then guided exercise, strengthening from 8 to 12 weeks, and functional motion and strength by 4 to 6 months. Risks include nerve injury, infection, stiffness and re-tear; results are less likely to be satisfactory with poor tissue, large tears, age over 65, smoking or not following rehabilitation (AAOS OrthoInfo (opens in a new tab), AAOS OrthoInfo (opens in a new tab)). A Cochrane review of 9 trials was uncertain whether repair gives meaningful benefit over exercise (with or without steroid shots) for mostly small degenerative tears; it may not apply to traumatic tears, large tears or young people (Karjalainen et al., 2019 (opens in a new tab)).
- Impingement surgery (subacromial decompression). AAOS describes trimming the bursa and bone spurs when nonsurgical care fails (AAOS OrthoInfo (opens in a new tab)). But a Cochrane review found high-certainty evidence that, compared with placebo surgery, it gives no improvement in pain, function or quality of life up to a year (Karjalainen et al., 2019 (opens in a new tab)), and an international BMJ guideline panel made a strong recommendation against it for long-lasting shoulder pain without injury (Vandvik et al., 2019 (opens in a new tab)). Experts disagree, so ask a surgeon why they recommend it for you.
- Other surgery. Frozen shoulder: manipulation under anesthesia and/or arthroscopic release if therapy fails, usually in the “frozen” stage (AAOS OrthoInfo (opens in a new tab)). Shoulder arthritis: arthroscopic clean-out for mild cases or shoulder replacement (partial, total or reverse) for advanced cases (AAOS OrthoInfo (opens in a new tab)). Biceps tendon tears rarely need surgery (AAOS OrthoInfo (opens in a new tab)).
What it costs
Physical therapy: cost estimate being researched. Medicare Part B covers medically necessary outpatient PT; you pay 20% of the approved amount after the deductible (Medicare.gov (opens in a new tab)). Office visits, imaging, injections and surgery: MBHA cost estimate being researched.
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Chiropractic
Some chiropractors treat shoulder pain with joint mobilization or manipulation of the shoulder, upper back (thoracic spine) or neck, soft-tissue work and exercise. This is a field where the studies are modest in size and quality.
What the research says
- A 2017 systematic review written largely by chiropractic researchers (25 reviews and 44 trials) found low- to moderate-quality evidence supporting manual therapies for impingement, rotator cuff disorders, frozen shoulder and nonspecific shoulder pain (Hawk et al., 2017 (opens in a new tab)).
- In a Dutch trial of 150 people, adding up to 6 manipulative-therapy sessions to usual medical care raised full recovery at 12 weeks to 43%, versus 21% with usual care alone, with a similar gap at 52 weeks; the authors noted a small sample and subjective end points (Bergman et al., 2004 (opens in a new tab)).
- Reviews that look at thrust (quick, high-velocity) manipulation are less encouraging. All six studies of thrust manipulation for shoulder conditions involved impingement; pain dropped in every study, but three of the four randomized trials compared it with sham treatment and found no significant difference between groups, and the authors judged the evidence limited (Minkalis et al., 2017 (opens in a new tab)). A 2025 review of thoracic (mid-back) thrust manipulation for upper-body pain, based on very low to low quality evidence, found it more effective than general conservative therapy for shoulder pain, but not more effective than sham manipulation (Thoomes et al., 2025 (opens in a new tab)).
- For rotator cuff disease, a Cochrane review found little or no difference between manual therapy alone and placebo (Page et al., 2016 (opens in a new tab)).
Safety
Mild soreness, stiffness or headache after manipulation is common and usually passes within 24 hours. Serious problems are very rare. A neck-focused type of manipulation has been linked to rare tears in neck arteries that can lead to a stroke, though experts disagree on whether manipulation causes them (NCCIH (opens in a new tab)); see our stroke guide. MBHA suggests that any possible tendon tear, dislocation or fracture be examined by a medical provider before hands-on treatment, and that anyone with chest symptoms call 911 instead.
What it costs
The Pricer lists about $55 to $100 for a self-pay follow-up visit and about $90 to $200 for a first visit (The Pricer (opens in a new tab)). Medicare Part B covers only spinal adjustments by a chiropractor to correct a subluxation (Medicare.gov (opens in a new tab)).
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Acupuncture
Acupuncture uses fine needles at specific points. Dry needling, often done by physical therapists, places needles into tight, tender spots in muscles.
What the research says
- Cochrane review (2005): nine trials of varying quality. The authors concluded there was little evidence to support or refute acupuncture for shoulder pain, though there may be short-term benefit for pain and function, and called for better trials (Green et al., 2005 (opens in a new tab)).
- Frozen shoulder: a 2024 meta-analysis of 13 studies found acupuncture plus physical therapy reduced pain and improved motion more than physical therapy alone, with considerable variation between studies (Xu et al., 2024 (opens in a new tab)).
- Dry needling: a 2023 meta-analysis of 8 trials (538 people) found dry needling added to other conservative care reduced pain and disability more than conservative care alone in subacromial pain syndrome; 4 of the 8 trials had unclear or high risk of bias (Griswold et al., 2023 (opens in a new tab)).
- Chronic pain overall: an analysis of 39 trials with adequate allocation concealment, covering four chronic pain conditions, shoulder pain among them, found acupuncture beat no acupuncture and, by a smaller margin, sham acupuncture; the authors said effects cannot be explained by placebo alone (Vickers et al., 2018 (opens in a new tab)). NCCIH notes that part of acupuncture’s benefit comes from nonspecific effects such as belief in the treatment (NCCIH (opens in a new tab)).
Safety
Relatively few complications are reported; they have come from non-sterile needles and improper treatment, and the FDA requires sterile, single-use needles (NCCIH (opens in a new tab)). MBHA suggests telling your practitioner about any blood thinner and where you have numbness or weakness. Acupuncture is not a substitute for an exam if you may have torn a tendon.
What it costs
The Pricer lists about $90 to $185 per follow-up visit, up to about $230 for a first private visit, and community acupuncture around $50 to $90 (The Pricer (opens in a new tab)). Medicare Part B covers acupuncture, including dry needling, only for chronic low back pain (Medicare.gov (opens in a new tab)).
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Herbal medicine
We found no herb or supplement shown to heal a rotator cuff tear, resolve frozen shoulder or replace exercise, and we found little research on herbal remedies for shoulder pain.
Supplements for tendon problems
A systematic review of nutraceuticals used for tendon problems (including glucosamine and chondroitin, collagen, bromelain, curcumin and boswellic acid) found encouraging preclinical results but few clinical studies, of poor quality, often testing several products at once, so it could not make recommendations (Fusini et al., 2016 (opens in a new tab)). AAOS adds that little scientific evidence supports glucosamine and chondroitin for arthritis, the FDA does not test dietary supplements, and they may interact with other medicines (AAOS OrthoInfo (opens in a new tab)).
Turmeric
The turmeric research NCCIH summarizes is on fatty liver disease, osteoarthritis (mostly the knee) and cholesterol, not shoulder tendons. NCCIH says we do not know enough to conclude it helps any health purpose, and that highly absorbable curcumin products may harm the liver (stop and call your provider if you have fatigue, nausea, dark urine or jaundice) (NCCIH (opens in a new tab)).
Arnica gel
Some small trials suggest topical arnica may help osteoarthritis, but one small study found it increased pain after calf exercises, and its listed uses (bruises, sprains, muscle pain, osteoarthritis) do not specifically mention shoulder tendon problems. It can irritate the skin, should not be used if you are allergic to sunflowers, marigolds or ragweed, and may raise bleeding risk with warfarin (Memorial Sloan Kettering (opens in a new tab)).
Herbs and your other medicines
Ginkgo taken with warfarin is linked to a higher risk of major bleeding, and St. John’s wort has an overall high risk of drug interactions (NCCIH (opens in a new tab)). If you are having shoulder surgery, certain supplements can increase bleeding or affect anesthesia, so tell your care team about everything you take well ahead of time (NCCIH (opens in a new tab)). Also see our medication safety guide.
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Massage therapy
Massage can ease tight muscles in the shoulder, neck and upper back and may help you relax and move more comfortably. We found no research showing that massage heals a torn tendon.
What the research says
- NCCIH says massage therapy may be helpful for neck or shoulder pain, but the benefits may last only a short time (NCCIH (opens in a new tab)).
- The review NCCIH cites pooled 12 trials: massage gave immediate and short-term pain relief for shoulder pain compared with inactive treatments, was not better than other active therapies, and did not significantly improve shoulder function (Kong et al., 2013 (opens in a new tab)).
Safety and cost
The risk of harm from massage appears low, but rare serious problems — a blood clot, nerve injury or broken bone — have been reported, some with vigorous deep-tissue work or in older adults (NCCIH (opens in a new tab)). MBHA suggests skipping massage on a shoulder that is hot, red and swollen, deformed after an injury, or not yet examined after a fall. Prices vary by location. At one national chain, franchise price lists show about $125 to $160 for a 60-minute massage for non-members and about $65 to $90 for members, whose memberships run about $70 to $90 a month (The Pricer (opens in a new tab)). Tips are extra.
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MBHA Wellness Coach
Shoulder problems usually improve through small things done every day. An MBHA Wellness Coach can help you build those habits, alongside — never instead of — your medical care.
- Keep moving, gently. The NHS advises staying active and gently moving the shoulder, doing shoulder exercises for 6 to 8 weeks to stop pain returning, and not stopping use of the shoulder completely (NHS (opens in a new tab)). A coach can help you tie exercises to a routine. See Gentle exercises.
- Posture and set-up. The NHS suggests standing up straight with shoulders down and gently back, sitting with a cushion behind your lower back, resting your arm on a cushion in your lap, and not slouching or bringing your neck forward (NHS (opens in a new tab)). A coach can help you review your desk, chair and phone habits.
- Pace the activity. Repeated overhead work is a common risk (AAOS OrthoInfo (opens in a new tab)). Plan breaks and alternate tasks; AAOS advises stopping activities that cause shoulder pain (AAOS OrthoInfo (opens in a new tab)).
- Night pain. Pain is often worst at night, especially lying on the sore side (AAOS OrthoInfo (opens in a new tab), AAOS OrthoInfo (opens in a new tab)). MBHA suggests trying pillows to support the arm and a different sleeping position, and telling your provider if sleep is badly disrupted.
- Other health conditions. If you have diabetes and your blood sugar is high, a plan with your doctor to improve control can help speed recovery from frozen shoulder (AAOS OrthoInfo (opens in a new tab)). Nicotine can weaken tendons and lowers the chance of a good result after rotator cuff surgery (AAOS OrthoInfo (opens in a new tab), AAOS OrthoInfo (opens in a new tab)); a coach can support quitting.
- Patience. It can take 6 months or longer to recover from shoulder pain (NHS (opens in a new tab)), and frozen shoulder up to 3 years (AAOS OrthoInfo (opens in a new tab)). A coach can help you notice small gains and know when to call your provider.
Another approach
Gentle exercises
These are stretches AAOS describes for frozen shoulder and rotator cuff recovery. AAOS is clear that you should not attempt shoulder exercises without first consulting your doctor or physical therapist (AAOS OrthoInfo (opens in a new tab)), because the right exercises depend on your diagnosis. Stop if something causes sharp pain.
- Pendulum. Lean forward with one hand on a counter, let the other arm hang, and gently swing it forward and back, side to side, then in a small circle; do not round your back or lock your knees (AAOS OrthoInfo (opens in a new tab)).
- Crossover arm stretch. Gently pull one arm across your chest, just below your chin, as far as you can without pain, and hold for 30 seconds (AAOS OrthoInfo (opens in a new tab)).
- Doorway rotation. Stand in a doorway, elbow bent to 90 degrees, hand against the door frame; keep the hand in place and turn your body away, holding for 30 seconds (AAOS OrthoInfo (opens in a new tab)).
- Lying forward lift. Lie on your back and use your good arm to lift the sore arm overhead until you feel a gentle stretch, holding for 15 seconds (AAOS OrthoInfo (opens in a new tab)).
AAOS suggests a 5 to 10 minute low-impact warm-up, stretching before strengthening, and a conditioning program of 4 to 6 weeks, then 2 to 3 days a week to maintain strength; you should not feel pain during an exercise (AAOS OrthoInfo (opens in a new tab)).
Another approach
Magnets, wraps and other devices
MBHA hears from people who use hand-held magnetic devices and wraps on sore shoulders and tendons (see the personal experience below). Here is what the research says, so you can weigh it for yourself.
- Static magnets: a 2007 systematic review of placebo-controlled trials of static magnets for pain from any cause found no significant difference in pain reduction and concluded the evidence does not support them, while noting the evidence for osteoarthritis was insufficient to rule out a benefit (Pittler et al., 2007 (opens in a new tab)).
- Pulsed electromagnetic field (PEMF) therapy is a different, powered device. For rotator cuff disease, Cochrane found only single, small trials, with no clinically important benefit over placebo and low-quality evidence (Page et al., 2016 (opens in a new tab)).
- We found little research on hand-held magnetic devices for tendon tears specifically. MBHA makes no claim that any product treats a tendon injury, and none should delay an exam for a possible tear.
- Magnets can interfere with pacemakers and insulin pumps — see our magnet tolerance guide and pacemakers, pumps and ventilators guide before using one.
Slings are used for short periods: a doctor may recommend one briefly after a biceps tendon tear (AAOS OrthoInfo (opens in a new tab)) or for several weeks after rotator cuff repair (AAOS OrthoInfo (opens in a new tab)), but staying completely still is not the goal for most shoulder problems (NHS (opens in a new tab)).
In their own words
Wellness and lifestyle testimonials
Please read first. This is one person’s personal experience, not medical advice. MBHA makes no medical claims and does not claim any product treats a tendon injury. A possible tendon tear needs an exam. If your pain follows a fall or a heavy lift, or you cannot raise your arm, get it checked. Magnets can interfere with pacemakers and insulin pumps — ask your doctor first if you use one.
A musician who partly tore a biceps tendon moving heavy equipment told us he used a hand-held magnetic device for short sessions several times a day plus a wrap for two weeks, and felt his function return quickly.
Shared with first names only. Lightly edited for length and spelling.
Member stories
Living with Shoulder Pain (Rotator Cuff, Tendonitis & Frozen Shoulder)? Share your experience
Real experiences help others choose. Tell us what you tried — conventional medicine, chiropractic, acupuncture, herbs, massage or coaching — what it cost and what changed.
Sources
- AAOS OrthoInfo — Shoulder pain and common shoulder problems (opens in a new tab)
- AAOS OrthoInfo — Shoulder impingement / rotator cuff tendinitis (opens in a new tab)
- AAOS OrthoInfo — Rotator cuff tears (opens in a new tab)
- AAOS OrthoInfo — Rotator cuff tears: surgical treatment options (opens in a new tab)
- AAOS OrthoInfo — Biceps tendon tear at the shoulder (opens in a new tab)
- AAOS OrthoInfo — Frozen shoulder (opens in a new tab)
- AAOS OrthoInfo — Arthritis of the shoulder (opens in a new tab)
- AAOS OrthoInfo — Dislocated shoulder (opens in a new tab)
- AAOS OrthoInfo — Cervical radiculopathy (pinched nerve) (opens in a new tab)
- AAOS OrthoInfo — Cortisone shot (steroid injection) (opens in a new tab)
- AAOS OrthoInfo — Rotator cuff and shoulder conditioning program (opens in a new tab)
- NHS — Shoulder pain (opens in a new tab)
- NHS — Frozen shoulder (opens in a new tab)
- NHS — Septic arthritis (opens in a new tab)
- NHS — Polymyalgia rheumatica (opens in a new tab)
- MedlinePlus — Shoulder injuries and disorders (opens in a new tab)
- MedlinePlus — Rotator cuff injuries (opens in a new tab)
- National Heart, Lung, and Blood Institute (NHLBI) — Heart attack: symptoms (opens in a new tab)
- NHLBI — Stroke: symptoms (opens in a new tab)
- NCCIH — Acupuncture: effectiveness and safety (opens in a new tab)
- NCCIH — Spinal manipulation: what you need to know (opens in a new tab)
- NCCIH — Massage therapy: what you need to know (opens in a new tab)
- NCCIH — Turmeric: usefulness and safety (opens in a new tab)
- NCCIH — Herb-drug interactions: the science (opens in a new tab)
- NCCIH — Using dietary supplements wisely (opens in a new tab)
- Memorial Sloan Kettering — Arnica (About Herbs) (opens in a new tab)
- Medicare.gov — Physical therapy services (opens in a new tab)
- Medicare.gov — Acupuncture (opens in a new tab)
- Medicare.gov — Chiropractic services (opens in a new tab)
- The Pricer — How much does a chiropractor cost? (opens in a new tab)
- The Pricer — How much does acupuncture cost? (opens in a new tab)
- The Pricer — How much does Massage Envy cost? (opens in a new tab)
- Page et al. — Manual therapy and exercise for rotator cuff disease, Cochrane Database of Systematic Reviews, 2016 (PubMed) (opens in a new tab)
- Page et al. — Electrotherapy modalities for rotator cuff disease, Cochrane Database of Systematic Reviews, 2016 (PubMed) (opens in a new tab)
- Page et al. — Manual therapy and exercise for adhesive capsulitis (frozen shoulder), Cochrane Database of Systematic Reviews, 2014 (PubMed) (opens in a new tab)
- Hawk et al. — Systematic review of nondrug, nonsurgical treatment of shoulder conditions, Journal of Manipulative and Physiological Therapeutics, 2017 (PubMed) (opens in a new tab)
- Minkalis et al. — A systematic review of thrust manipulation for non-surgical shoulder conditions, Chiropractic & Manual Therapies, 2017 (PubMed) (opens in a new tab)
- Bergman et al. — Manipulative therapy in addition to usual medical care for patients with shoulder dysfunction and pain, Annals of Internal Medicine, 2004 (PubMed) (opens in a new tab)
- Thoomes et al. — Effectiveness of thoracic spine manipulation for upper quadrant musculoskeletal disorders, Journal of Manipulative and Physiological Therapeutics, 2025 (PubMed) (opens in a new tab)
- Green et al. — Acupuncture for shoulder pain, Cochrane Database of Systematic Reviews, 2005 (PubMed) (opens in a new tab)
- Xu et al. — Efficacy of combining acupuncture and physical therapy for patients with frozen shoulder, Pain Management Nursing, 2024 (PubMed) (opens in a new tab)
- Vickers et al. — Acupuncture for chronic pain: update of an individual patient data meta-analysis, Journal of Pain, 2018 (PubMed) (opens in a new tab)
- Griswold et al. — Dry needling for subacromial pain syndrome, Pain Medicine, 2023 (PubMed) (opens in a new tab)
- Kong et al. — Massage therapy for neck and shoulder pain, Evidence-Based Complementary and Alternative Medicine, 2013 (PubMed) (opens in a new tab)
- Fusini et al. — Nutraceutical supplement in the management of tendinopathies: a systematic review, Muscles, Ligaments and Tendons Journal, 2016 (PubMed) (opens in a new tab)
- Pittler et al. — Static magnets for reducing pain, Canadian Medical Association Journal, 2007 (PubMed) (opens in a new tab)
- Karjalainen et al. — Subacromial decompression surgery for rotator cuff disease, Cochrane Database of Systematic Reviews, 2019 (PubMed) (opens in a new tab)
- Vandvik et al. — Subacromial decompression surgery for adults with shoulder pain: a clinical practice guideline, BMJ, 2019 (PubMed) (opens in a new tab)
- Karjalainen et al. — Surgery for rotator cuff tears, Cochrane Database of Systematic Reviews, 2019 (PubMed) (opens in a new tab)
- Challoumas et al. — Comparison of treatments for frozen shoulder, JAMA Network Open, 2020 (PubMed) (opens in a new tab)
- A Hamid et al. — Platelet-rich plasma for rotator cuff tendinopathy, PLoS ONE, 2021 (PubMed) (opens in a new tab)
- Littlewood et al. — Exercise for rotator cuff tendinopathy: a systematic review, Physiotherapy, 2012 (PubMed) (opens in a new tab)
- Xue et al. — Effect of extracorporeal shockwave therapy for rotator cuff tendinopathy, BMC Musculoskeletal Disorders, 2024 (PubMed) (opens in a new tab)
- Steuri et al. — Effectiveness of conservative interventions in adults with shoulder impingement, British Journal of Sports Medicine, 2017 (PubMed) (opens in a new tab)
- Desmeules et al. — Rotator cuff tendinopathy diagnosis, nonsurgical medical care, and rehabilitation: a clinical practice guideline, Journal of Orthopaedic & Sports Physical Therapy, 2025 (PubMed abstract) (opens in a new tab)
- Pennella et al. — Red flags useful to screen for gastrointestinal and hepatic diseases in patients with shoulder pain: a scoping review, Musculoskeletal Care, 2022 (PubMed) (opens in a new tab)
This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.
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