Shoulder Pain When Raising Your Arm: What Helps
By Nova Physical Therapy | North Hollywood, CA | Published October 2026
Reaching for a top shelf. Putting on a jacket. Washing your hair. If lifting your arm brings on a sharp or achy pain in your shoulder, everyday tasks start to feel like a chore.
Shoulder pain with arm raising is very common, and for many people it improves with the right kind of exercise. This article explains what it may be associated with, what tends to help, and which signs mean you should get your shoulder checked soon.
The short answer
Pain when raising your arm, especially between shoulder height and overhead, is often associated with irritation of the rotator cuff tendons or the tissues around them. Other possible causes include frozen shoulder, arthritis, and shoulder instability. Only an in-person evaluation can sort out the cause. For rotator cuff–related pain, the most recent physical therapy guideline names progressive exercise as the cornerstone of care. In California, you can see a physical therapist for an evaluation without a referral.
Important: Shoulder or arm pain that comes with chest pressure, shortness of breath, sweating, or nausea can be a sign of a heart attack. Call 911 right away.
Why does my shoulder hurt when I lift my arm?
Your rotator cuff is a group of four muscles and tendons that keep the ball of your shoulder centered in its socket as your arm moves. When you raise your arm, these tendons work hard, especially in the middle range, from about shoulder height to overhead.
If the tendons have been overloaded, for example by a sudden increase in overhead work, a new gym routine, painting a room, or simply weakness built up over time, they can become irritated and painful with that motion. This is one of the most common reasons for pain with arm raising, and it becomes more common after age 40.
Other things that may be associated with pain when lifting your arm include (NHS):
• Bursitis, irritation of the fluid-filled sac near the rotator cuff
• Frozen shoulder, which causes pain plus stiffness in many directions
• Arthritis of the shoulder joint, more common with age or past injury
• Shoulder instability, where the joint feels loose or slips, often in younger, active people
• Pain from the neck, which can be felt in the shoulder and upper arm
These are possibilities, not a diagnosis. Two people with pain in the same spot can have very different causes.
What is shoulder impingement, really?
"Impingement" is a term many people hear from a friend, a website, or a provider. The old explanation was that a tendon gets pinched under a bone at the top of the shoulder every time you lift your arm.
Researchers now know the picture is more complicated. Pain with arm raising usually has more to do with how well the rotator cuff tendons tolerate load than with a simple pinch. That's why many clinicians and researchers now use the broader term rotator cuff–related shoulder pain.
The practical takeaway is encouraging: if the main issue is that the tendons aren't yet strong enough for what you're asking of them, they can often be trained to handle more.
Should I stop using my arm?
Usually, no. Complete rest tends to make shoulders stiffer and weaker. The NHS advises people with shoulder pain to stay active and keep gently moving the shoulder (NHS).
A few general steps help many people while they figure out what's going on:
• Adjust, don't stop. Cut back for a short time on the tasks that clearly flare your shoulder, like heavy overhead lifting, and keep doing what you can tolerate.
• Keep things within reach. Move often-used items to lower shelves for a while.
• Keep the arm moving gently. Easy movement through a comfortable range helps prevent stiffness.
• Return gradually. When you go back to the gym, sports, or overhead work, build up a little at a time.
Questions about pain medication, injections, or imaging are best directed to your physician.
How can physical therapy help?
A physical therapist starts by finding out which movements bring on your pain and why. An evaluation may include:
• When the pain started and what makes it better or worse
• Shoulder motion in different directions
• Strength testing of the rotator cuff and shoulder blade muscles
• How your neck and upper back move
• Screening for signs that need a physician's evaluation
The 2025 rotator cuff tendinopathy guideline published in the Journal of Orthopaedic & Sports Physical Therapy gives its strongest recommendation to exercise therapy, including progressive resistance training and movement control exercises, adjusted to each person's pain tolerance and goals (Desmeules et al., JOSPT 2025). The same guideline supports education about the condition and self-management, and notes that manual therapy may reduce pain in the short term when combined with exercise. It recommends against therapeutic ultrasound for rotator cuff pain because it hasn't shown benefit.
A typical plan may include:
• Strengthening for the rotator cuff and shoulder blade muscles, progressed over time
• Exercises that gradually work back into the overhead range
• Hands-on treatment, when it helps you move and exercise more comfortably
• Guidance on sleep positions, work tasks, and returning to the gym or sports
• A home program you can keep doing on your own
Improvement with rotator cuff–related pain is usually gradual, often over several weeks to a few months. Physical therapy doesn't guarantee a specific result, and some shoulders need a physician's or surgeon's input. The guideline recommends referral to a musculoskeletal specialist when symptoms remain severe after about 12 weeks of good conservative care. Decisions about injections, imaging, or surgery are made with your physician.
When is shoulder pain serious?
Call 911 if shoulder, arm, jaw, or upper back pain comes with chest pain or pressure, shortness of breath, a cold sweat, nausea, or lightheadedness. These can be warning signs of a heart attack (American Heart Association).
Get medical care promptly if you notice (NHS):
• Sudden, severe pain after a fall, accident, or injury
• You can't lift or move your arm, or the shoulder looks out of place
• Sudden weakness when lifting your arm after an injury
• Numbness, tingling, or weakness spreading down the arm
• A fever, or a shoulder that is hot, red, and swollen
• Pain that starts in both shoulders, especially with morning stiffness
Schedule an evaluation if your pain hasn't improved after a couple of weeks of gentle activity, or if it keeps you from sleeping, working, or exercising.
We screen for these signs during every evaluation and refer you to a physician when findings call for medical assessment.
Do I need a referral for physical therapy in California?
Not to get started. California allows direct access to physical therapy. A physical therapist can evaluate and treat you without a referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage.
Frequently asked questions
Why does my shoulder hurt when I lift my arm to the side?
Raising your arm out to the side, especially between shoulder height and overhead, puts high demand on the rotator cuff. Pain in that range is often associated with rotator cuff–related shoulder pain, but an evaluation is needed to know for sure.
Why does my shoulder hurt at night?
Lying on the painful side compresses the shoulder, and many people with rotator cuff pain notice it more at night. Sleeping on the other side or on your back with a pillow supporting the arm may help. Night pain that doesn't change with position should be checked by a physician.
Do I need an MRI?
Not usually at first. The 2025 guideline advises against imaging at the start of care for most rotator cuff pain. Imaging decisions are made by your physician, often when symptoms don't improve or there's been an injury.
Is it a rotator cuff tear?
It might be, but many tears, especially in people over 50, cause no symptoms at all. A sudden loss of strength after an injury needs prompt medical evaluation. Otherwise, your physician and physical therapist can help sort out what's going on.
How long does shoulder pain take to get better?
It depends on the cause and how long you've had it. Rotator cuff–related pain often improves gradually over several weeks to a few months with consistent exercise.
Should I keep going to the gym?
Often, yes, with adjustments. Many people can keep training while temporarily changing or lightening exercises that flare the shoulder. A physical therapist can help you decide what to modify.
Do I need a referral to see a physical therapist?
No, not to start. California allows direct access within the limits described above.
Schedule an evaluation
If your shoulder hurts when you reach, lift, or get dressed, an evaluation can help sort out what's driving it and which next steps fit you.
Nova Physical Therapy | North Hollywood, CA | Serving Burbank, Studio City, Toluca Lake, and Valley Village
Call (818) 639-3402 | Book an appointment online
Disclaimer
This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Shoulder pain has many causes, and only an in-person evaluation can determine what's right for you. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.
References
1. Desmeules F, Roy J-S, Lafrance S, et al. Rotator Cuff Tendinopathy Diagnosis, Nonsurgical Medical Care, and Rehabilitation: A Clinical Practice Guideline. J Orthop Sports Phys Ther. 2025. Link
2. NHS. Shoulder Pain. Link
3. American Heart Association. Warning Signs of a Heart Attack. Link