Is Your Shoulder Pain Serious? 5 Common Symptoms You Shouldn’t Ignore

These shoulder pain symptoms could be signs of a serious problem that need treatment

Kimberly Goad,

Updated December 09, 2025

AARP

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Published July 22, 2021

/ Updated December 09, 2025

man sitting on the sofa and holding painful shoulder with another hand.

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Lifting your suitcase into the overhead compartment, stuffing your shoulder bag to capacity, allowing your 80-pound golden Lab to yank his way through a daily walk: None of these qualify as risky behavior, but now that you’re over 50, you’re paying the price. What gives? In short: Your shoulders.

“Think of it as driving a car — you’re given one set of tires and that’s it,” explains Dr. Akhil Chhatre, director of spine rehabilitation and assistant professor in the departments of physical medicine and rehabilitation and neurosurgery at the Johns Hopkins University School of Medicine. “The wear and tear that you experience on those tires depends on how much and how hard you use your body.”

Causes of shoulder pain

Pain in the shoulder typically comes from the joint itself or from the surrounding muscles, ligaments or tendons. And with age, “you’ll see changes in the lining of the joint, changes in the integrity of the bones and degeneration of the ligaments,” Chhatre says. “If you don’t participate in a strengthening or exercise routine, you’ll see some atrophy and loss of bulk (in the muscles) that surround and protect the stability and strength of the shoulder joint.”

While that sort of wear and tear is a natural consequence of living your life, it can make you more vulnerable to several shoulder issues. Various diseases and conditions affecting the structure of your chest or abdomen, like heart disease and gallstones, can also cause pain in the shoulder. It’s known as referred pain, and it’s pain that originates elsewhere but is felt in the shoulder.

Whatever is causing you shoulder pain, there’s plenty you can do to relieve it. But first you have to know which symptoms deserve your attention. Here are the causes of shoulder pain you should never ignore.

5 Common should pain symptoms explained

1. Chronically stiff shoulder

Osteoarthritis — known as “wear and tear arthritis” — is the most common type of arthritis. With shoulder osteoarthritis, the cartilage and other joint tissues that cushion the area gradually break down and, as a result, joints become painful, swollen and stiff. It might be more noticeable at night and in the morning, thanks to inactivity.

Although not as common as osteoarthritis of the hip or knee, shoulder osteoarthritis affects nearly 1 in 3 people over age 60, and more women have shoulder arthritis than men.

“Osteoarthritis is a chronic and progressive condition, meaning it will continue to progress at an unpredictable rate over time,” Chhatre says. “The way you manage that is with the help of a physical therapist, who can give you appropriate exercises to maintain a range of motion in your joints.” Doing so, he says, will help relieve your symptoms.

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2. Shoulder pain when reaching overhead

Imagine a relatively large ball on a small, shallow socket, says Dr. Leesa Galatz, professor and chair of the department of orthopedic surgery at the Icahn School of Medicine at Mount Sinai Health System. The rotator cuff is a group of “four small muscles that function to keep the ball centered on the socket. They glide between two bony surfaces, so they not only work hard, but they’re susceptible to tendinitis from both age-related and overuse injuries.”

Rotator cuff injuries are extremely common, especially in people over 50. A rotator cuff tear can happen suddenly — from, say, a fall — but more often it happens gradually over time, as the tendon wears down.

“There are degrees of rotator cuff injury,” Chhatre notes. “You could have a partial tear or a complete tear, resulting in loss of the function of the arm and excruciating pain.”

For partial tears, the go-to treatment is physical therapy (PT) with a focus on exercises that improve flexibility and strength of the muscles surrounding the shoulder joint.

More than 80 percent of patients who received supervised PT reported having less pain and improved function after six months to a year, according to a 2024 report in The New England Journal of Medicine.

For severe tears, however, surgery is common. A review of research published in 2023 in the journal Frontiers in Public Health found that people 75 and older who underwent rotator cuff surgery experienced significant improvements in quality of life.

3. Dull ache in the shoulder

When the fluid-filled pads that cushion the bones, tendons and muscles in your shoulder — called bursae — become irritated or inflamed, you may have bursitis. Shoulder bursitis is often the result of overuse or repetitive shoulder movements.

“Bursitis is typically something you see in conjunction with rotator cuff injuries,” says Dr. Andrew Rokito, professor of orthopedic surgery and chief of the division of shoulder and elbow surgery at NYU Langone Health.

Reducing the inflammation is the first step of any treatment plan. If rest, ice packs and over-the-counter pain medication don’t get the job done, then treatment may involve physical therapy or surgery.

Research suggests both are equally effective. In a study published in 2021 in the British Journal of Sports Medicine, researchers compared the treatment results of patients with shoulder bursitis. After five years, those who underwent physical therapy and those who had surgery reported having equally low levels of shoulder pain.

4. Shoulder pain in the front that radiates toward the elbow

If you’ve had tennis elbow or swimmer’s shoulder, you’ve had tendinitis — inflammation or irritation of the thick fibrous tendons that attach muscle to bone. Like other shoulder conditions, tendinitis can be caused by a sudden injury, but it’s more likely to come on gradually after years of doing a particular repetitive movement (such as swimming laps).

You may be able to treat tendinitis on your own (with ice packs and over-the-counter pain meds), depending on its severity. If not, physical therapy can help strengthen the muscles around the damaged tendon.

Surgery is an option if there’s a tear of the tendons (tendinitis is common with rotator cuff injuries). “Tendinitis, inflammation or degeneration of the tendons, can be due to age-related changes in the tendons and/or overuse secondary to sports or work activity,” says Galatz. “This can be associated with inflammation of the bursa, which is the tissue that absorbs the friction around the shoulder.”

5. Severe shoulder pain followed by stiffness

With adhesive capsulitis — or frozen shoulder — the capsule that surrounds the shoulder joint and rotator cuff tendons thickens and becomes stiff and tight. It develops in three stages, each of which lasts around three months, says Rokito.

Freezing stage: The pain sets in and as it worsens your shoulder loses range of motion.
Frozen stage: Your shoulder stiffens.
Thawing stage: Your range of motion gradually improves.

What causes frozen shoulder is not fully understood. People with certain conditions — diabetes, Parkinson’s and cardiac disease, among them — are at greater risk of frozen shoulder.

And research suggests mental stress can trigger inflammatory responses in the body that lead to the condition. One study published in 2023 found that people with depression and anxiety had a significantly greater risk of developing frozen shoulder than those without these conditions, suggesting it may be more than just a joint problem.

In any case, the go-to treatment is physical therapy centered on stretching exercises that improve shoulder flexibility.

“If you do nothing and just gut it out, frozen shoulder will run its course and you’ll get better,” says Rokito. “The problem with that is you’ll suffer for a much longer period of time because it can take a year or sometimes longer to work itself out. And the range of motion may not return to the normal.”

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Kimberly Goad is a New York-based journalist who has covered health for some of the nation’s top consumer publications. Her work has appeared in Women’s Health, Prevention, Health and Reader's Digest.