Shoulder pain: your treatment options

What helps rotator cuff related shoulder pain and frozen shoulder: exercise-based physiotherapy first, changing how you do things, pain relief, steroid injections for some, and surgery for a few.

7 min read · last reviewed October 1, 2026

When your shoulder hurts, it can feel like you'll never reach overhead or sleep on that side again. But for most people, shoulder pain gets better, and there are clear, proven ways to help it along. This guide walks through the options for rotator cuff related shoulder pain and frozen shoulder, starting with the ones that help most people.

Rotator cuff related shoulder pain

1. Exercise-based physiotherapy: the main treatment

Exercise is the first treatment recommended for rotator cuff related shoulder pain. A physiotherapist will usually start with exercises that:

• Keep the shoulder moving within a comfortable range
• Strengthen the rotator cuff, often using a resistance band, with your elbow by your side to start
• Strengthen the muscles around your shoulder blade, which give the shoulder a steady base
• Slowly build up to lifting your arm higher and carrying more load, so you can get back to work, sport and daily tasks

A few things to know:

• It takes time. Tendons adapt slowly. Most people need at least 6 to 12 weeks of regular exercise, and sometimes longer, to feel a real difference.
• Some discomfort is okay. Mild to moderate pain during exercise that settles by the next day is usually fine. See our guide Pain during exercise.
• Consistency beats intensity. A few minutes most days is better than a big effort once a week.

Our Shoulder Conditioning Program video, based on the AAOS program, can help you get started. Check with your physiotherapist or doctor which exercises suit you.

Something you can do today: Try a gentle pendulum exercise: lean forward with your good hand on a table, let the sore arm hang, and swing it gently in small circles for 30 seconds.

2. Change how you do things, for now

You don't need to stop using your arm. But for a while, it helps to ease off the movements that flare it up.

• Use a step stool rather than reaching high overhead.
• Keep heavy items at waist height, and carry loads close to your body.
• Take breaks from overhead work, like painting or hanging laundry.
• At night, try lying on your back or your other side, with a pillow supporting the sore arm.

As your shoulder gets stronger, you can slowly bring these activities back.

3. Pain relief

• Heat or cold. Use whichever feels better, wrapped in a towel, for up to 20 minutes at a time.
• Medicines. Anti-inflammatory medicines (NSAIDs) as pills or gels, or acetaminophen (paracetamol), may help for a short time. They aren't safe for everyone. Ask your pharmacist or doctor which is right for you.

4. Steroid injections, for some

A steroid injection into the space around the rotator cuff can ease pain, often for several weeks. That can give you a window to get going with your exercises. Injections don't seem to change how people are doing in the long run, and doctors usually limit how many you have, partly because repeated injections may not be good for tendons.

5. Surgery, for a few

• "Making more space" (subacromial decompression). This keyhole operation shaves bone to make more room for the tendons. It used to be very common. Two large trials, including the UK CSAW trial, found it worked no better than a placebo operation, where surgeons looked inside but didn't remove anything. An international expert panel now recommends against it for most people.
• Rotator cuff repair. Surgery to stitch a torn tendon back to the bone may help some people, for example after an injury that causes sudden weakness, especially in younger, active people, or when a large tear is still causing pain and weakness after a good trial of exercise. A shoulder surgeon can talk through the pros and cons.
• Shoulder replacement may be an option for some people with severe shoulder arthritis or large tears that can't be repaired.

Frozen shoulder

Frozen shoulder nearly always gets better on its own, but it can take months to a couple of years. Treatment aims to ease the pain and help you keep moving while it runs its course.

• Pain relief. Heat, and medicines your pharmacist or doctor says are safe for you.
• A steroid injection, especially early on when pain is the main problem, can ease pain in the short term and make it easier to keep moving.
• Gentle exercises and stretches within a comfortable range help keep movement. Don't push hard into pain, and avoid making up your own strenuous gym routines, which can make it worse.
• Physiotherapy can guide your exercises and help you get movement back.
• For stiffness that isn't improving, a specialist may offer a procedure, such as stretching the joint lining with fluid (hydrodilatation), moving the shoulder under anaesthetic, or keyhole surgery to release the tight capsule. A large UK trial found these hospital treatments gave similar results to each other over a year.

If you have diabetes, keep up with your diabetes checks and care. It can help your shoulder, too.

Putting it together

For most people, the plan looks like this:

1. Weeks 1 to 2: keep moving gently, change painful tasks, use heat or cold, short-term pain relief if needed.
2. Weeks 2 to 12 and beyond: a structured exercise programme, ideally guided by a physiotherapist, building up slowly.
3. If pain is getting in the way of exercise: ask about a steroid injection.
4. If things aren't improving after several months, or you have sudden weakness after an injury: ask about seeing a shoulder specialist.

Something you can do this week: Book a physiotherapy assessment, or ask your doctor for a referral.

Questions to ask your care team

• What do you think is causing my shoulder pain?
• Which exercises should I start with, and how often?
• How long should I give exercise before we try something else?
• Would a steroid injection help me? What are the risks?
• Do I have a tear that might need surgery? How would we know?
• If I have frozen shoulder, what can I do to ease the pain while it gets better?

This article is general information, not medical advice. Talk with your health care team about your own situation. In an emergency, call 9-1-1 or your local emergency number.

In an emergency, call 9-1-1 or your local emergency number.

General information, not medical advice. It does not replace your own care team. If you think you or someone else is having a medical emergency, call 9-1-1 or your local emergency number. If you are in crisis or thinking about suicide, call or text 9-8-8 (Canada and the US).

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