Constant Aching Shoulder Pain

Constant Aching Shoulder Pain

In plain language: A steady ache may come from a tendon, bursa, joint, or the neck. Night pain is important, but it does not identify one diagnosis by itself.

Why it can happen

Rotator cuff tendinopathy, a rotator cuff tear, subacromial pain, arthritis, and frozen shoulder can all produce an ache that lingers after activity. Pain may feel deep in the joint or spread down the upper arm. Sleeping on the painful side often makes symptoms more noticeable.

An irritated neck nerve can also refer pain toward the shoulder. That becomes more likely when pain travels below the elbow or occurs with tingling, numbness, or neck-position changes. Several problems can overlap.

What to notice

Track what the ache interrupts. Can you reach a shelf, fasten clothing, wash your hair, sleep, or lift a familiar object? Notice whether the shoulder is also stiff, weak, swollen, warm, or unstable. These functional details often help more than a pain number alone.

Pain that steadily worsens, wakes you every night, or persists despite reasonable self-care should be evaluated. Constant pain with fever, unexplained illness, or a history of cancer also deserves prompt medical attention.

How it is evaluated

Your clinician compares active motion, which you perform yourself, with passive motion, which is tested while your arm is relaxed. Strength and specific movements help distinguish a stiff joint from a painful tendon or bursa. The neck and nerve examination may be included.

X-rays can show arthritis and bone changes. Ultrasound or MRI may be useful when the examination suggests rotator cuff or bursal disease. Imaging findings must still match the symptom pattern; many age-related findings are not the main pain source.

Treatment options

For many nonurgent causes, treatment begins with activity adjustment and physical therapy. Medication may help create a window for sleep and movement, but it does not replace diagnosis or rehabilitation. A targeted diagnostic or corticosteroid injection may be considered when the examination points to a specific joint or bursa.

When to seek urgent care

Seek urgent evaluation for a hot, red, swollen joint with fever; a deformed shoulder after injury; a cold or blue arm; or new major weakness or loss of feeling. Call emergency services for shoulder discomfort with chest pressure, shortness of breath, sweating, nausea, or jaw pain.

Sources

• American College of Radiology: Chronic Shoulder Pain
• AAOS: Glenohumeral Joint Osteoarthritis Plain Language Summary
• AAOS: Rotator Cuff Injuries Plain Language Summary

This information is educational and does not diagnose the cause of your symptoms.