Stiff upper shoulder: what to know

Pain and tightness across the top of the shoulder can come from guarded muscles, irritation around the joint or referred discomfort from the neck. Frozen Shoulder usually restricts several directions, including reaching overhead and behind the back, and may disturb sleep. Rotator Cuff Tear can cause weakness or pain when lifting the arm, particularly after an injury, but stiffness may have other causes. Shoulder Osteoarthritis can produce aching, reduced range and grinding with use. These patterns overlap, so the ability to actively and passively move the arm is useful during examination.

Note when stiffness began, whether it followed a fall or new activity, and whether pain travels below the elbow. Numbness, neck pain or hand weakness may change the assessment.

Keep the shoulder gently active within a comfortable range and avoid repeatedly testing a painful movement. Change position during desk work and support the arm when resting if that reduces strain. Heat may ease muscular tightness before movement; a protected cold pack can calm soreness after activity. Avoid heavy overhead lifting until strength and movement are clearer. Do not force the arm behind your back or through sharp pain. A physiotherapist can tailor mobility and strengthening work after the cause has been assessed.

Seek emergency help for shoulder pain with chest pressure, breathlessness, sweating or faintness. Prompt assessment is needed after a fall if the shoulder looks deformed, the arm cannot be lifted, or the hand becomes numb, cold, pale or blue. Seek urgent care for fever with a hot, swollen shoulder. Arrange a clinical review when stiffness persists, worsens, limits dressing or sleep, or is accompanied by progressive weakness.

Ask whether the restriction is coming from the joint, tendon, muscle or neck, and whether imaging is needed. Ask which movements are safe, when strengthening can begin, and which changes require earlier review.