Shoulder Pain When Lifting Arm: Why Does It Hurt?

The most common causes are rotator cuff problems, shoulder bursitis and shoulder impingement, particularly if the pain is worse as you raise your arm. If your shoulder is also becoming increasingly stiff, frozen shoulder becomes more likely.

Sudden shoulder pain and weakness after an injury raises more concern about a rotator cuff tear. The exact movement that hurts, where you feel the pain and whether you have weakness or stiffness can help narrow down which problem is most likely.

Pain when lifting your arm out to the side is particularly common with rotator cuff-related shoulder pain, including supraspinatus tendonitis problems and subacromial bursitis. You may notice a painful arc, where the shoulder hurts through the middle part of the movement but feels easier again once your arm is fully raised.

If the pain is more when you lift your arm across your body, the most likely culprit is a collarbone problem at the AC joint between the clavicle and the shoulder.

If you have significant weakness, with or without pain, a rotator cuff tear becomes more of a consideration, particularly following an injury.

Pain when reaching overhead is commonly caused by rotator cuff-related pain, bursitis and shoulder impingement. These problems tend to become more painful when the arm is repeatedly raised above shoulder height, particularly with activities such as painting, swimming, throwing or lifting.

If overhead movement is becoming progressively restricted rather than simply painful, a frozen shoulder is another possibility. Pain following a significant injury, particularly with weakness, needs assessment for a possible rotator cuff tear or other injury.

Pain when raising your arm forwards can come from several structures, but rotator cuff problems and biceps tendon problems are common causes. Biceps tendon pain is usually felt at the front of the shoulder and may be aggravated by lifting, reaching or carrying. Rotator cuff pain is often felt around the outer shoulder or upper arm.

If lifting forwards is painful because the shoulder has become generally stiff, rather than simply painful, frozen shoulder should also be considered.

If you can't lift your arm because it is too painful, this can occur with conditions such as bursitis and rotator cuff problems. If you can't lift it because of stiffness, it is often due to a frozen shoulder.

If you suddenly cannot lift the arm because it feels genuinely weak, particularly after a fall, awkward movement or heavy lifting, a significant rotator cuff tear is a concern.

A fracture or dislocated shoulder can also prevent normal movement after an injury. Sudden loss of movement or strength should be assessed promptly.

A sharp pain during a particular part of the movement commonly comes from irritated tissues around the shoulder being compressed or loaded. Rotator cuff-related pain, bursitis and problems affecting the biceps tendon can all cause this pattern.

A sharp pain immediately following a fall or other significant injury raises different possibilities, including a fracture, dislocation or rotator cuff tear. Where the pain occurs and exactly when it catches during the lifting movement are particularly useful clues. Find out more in the Sharp Pain In Shoulder section.

If your shoulder pain is mild and improving, you can often start with activity modification and appropriate self-care such as relative rest, ice, medication and exercises.

However, I would get it assessed if the pain is severe, worsening, persistent or significantly restricting your movement. Urgent review is particularly important after a significant injury, if you suddenly cannot lift your arm, have marked weakness or if there is associated shortness of breath or chest pain.

Numbness or tingling extending down the arm can also indicate that the neck or nerves are involved rather than the shoulder alone.

Yes, many common causes of shoulder pain with lifting settle with the right combination of activity modification, pain relief and rehabilitation exercises. Rotator cuff-related pain and mild tendon irritation often respond well to progressive strengthening.

However, simply resting the shoulder indefinitely isn't usually the best approach. If your pain isn't improving, keeps returning or you are losing movement or strength, getting the shoulder assessed can help identify the underlying problem and make sure you are doing the right exercises.