Struggling with Shoulder Pain? Here's What You Need to Know by Mark Corry APA Physiotherapist
If you're dealing with nagging shoulder pain that just won’t go away, you're not alone. A common cause of this pain is rotator cuff tendinopathy — a condition that affects the muscles and tendons that help move and stabilise your shoulder.
The good news? A group of international experts recently released updated guidelines (2025) on how to best manage this type of shoulder pain. Here's what they found — in simple, easy-to-understand terms.
What Is Rotator Cuff Tendinopathy?
The rotator cuff is a group of four small muscles and tendons around the shoulder joint. They help you lift, reach, and rotate your arm. These tendons can become irritated over time from:
• Repetitive use (e.g. sports or physical jobs)
• Poor posture
• Natural wear and tear with age
Common symptoms include:
• Shoulder pain with lifting or reaching
• Weakness
• Difficulty sleeping on the sore side
• Clicking or stiffness
How Is It Diagnosed?
Physiotherapists usually diagnose this based on:
• A conversation about your pain and activity levels.
• Gentle movement and strength tests.
• Looking at lifestyle factors (like stress or work demands) that may be affecting recovery.
• Scans aren’t usually needed unless the problem is ongoing or unclear.
What Treatments Work Best?
The 2025 guidelines recommend starting with active, non-invasive care first:
Supervised Exercise + Hands-On Treatment
• Exercises to improve shoulder strength, control, and coordination.
• Can be tailored to your job, sport, or lifestyle.
• Adding manual therapy (hands-on physio treatment) may help reduce pain early on.
Pain Relief (Short Term)
• Paracetamol or anti-inflammatories may help manage pain short-term.
• Best used to help you stay active, not as a long-term fix.
Injections (If Needed Later)
• Steroid injections or PRP (platelet-rich plasma) might be considered after 12+ weeks if rehab isn’t helping.
• Not recommended as a first step.
Education and Support
• Understanding your condition helps reduce fear and uncertainty.
• Learning how to move safely and confidently is key to recovery.
What Might a Physio Plan Involve?
Your recovery plan might include:
• Initial assessment to understand your pain, movement, and goals.
• A home exercise program focusing on movement control, posture, and strength.
• Manual therapy if needed to reduce stiffness or tension.
• Progress tracking to make sure you're improving.
• Advice and reassurance to help you stay active and positive.
What You Can Do Right Now?
• Keep your shoulder gently moving — avoid total rest.
• Start light posture or shoulder blade exercises.
• Use heat or ice for comfort if helpful.
• Stay active in ways that don’t aggravate your symptoms.
• Chat to a physio if your pain is stopping you from working, training, or sleeping well.
Final Thoughts
Shoulder pain from rotator cuff tendinopathy is common, and it’s very treatable. With the right combination of movement, support, and guidance, most people recover well - and surgery is rarely needed.
If your shoulder pain is hanging around, don’t wait it out. Getting a clear plan from a physiotherapist can help you get back to doing what you love, pain-free.
Reference:
Dube M-O, Lewis J, Littlewood C, et al. Rotator Cuff Tendinopathy: Diagnosis, Non-
surgical Medical Care, and Rehabilitation. A Clinical Practice Guideline. J Orthop Sports
Phys Ther. 2025;55(5):CPG1-CPG36. doi:10.2519/jospt.2025.13182