ConditionBones, joints & muscles
Shoulder Stiffness: Causes and How to Loosen a Stiff Shoulder
Shoulder stiffness is a reduced ability to move the shoulder, making it hard to reach overhead, behind your back or out to the side. The most common causes are frozen shoulder (adhesive capsulitis), shoulder osteoarthritis, rotator cuff problems and stiffness after an injury or a period of not moving the arm. A key clue is whether someone else can move your arm further than you can: if not, the joint itself is tight. Gentle, regular movement helps most stiff shoulders, but the cause guides treatment.
Also called: Stiff shoulder, restricted shoulder motion, reduced shoulder range of motion
At a glance
- What it means
- Reduced shoulder movement, with or without pain.
- Common causes
- Frozen shoulder, osteoarthritis, rotator cuff tendinopathy or tear, stiffness after injury or surgery.
- Key clue
- If another person cannot move your arm further than you can, the joint itself is stiff.
- Other causes
- Polymyalgia rheumatica, inflammatory arthritis, calcific tendinitis, nerve problems.
- What helps
- Gentle daily movement, pain relief, physical therapy, injections, and occasionally surgery.
When to get help
Call 911 or go to the ER
- Left shoulder or arm pain with chest pressure, breathlessness, sweating or nausea (possible heart attack): call 911 or your local emergency number
See a doctor within a day or two
- A hot, red, swollen shoulder with fever (possible infection)
- Sudden inability to lift the arm after a fall or injury, or a visible deformity
- Stiffness in both shoulders and hips with morning stiffness over 45 minutes, especially over age 50, or with headache or jaw pain when chewing
Book a routine appointment
- Shoulder stiffness that is getting worse over weeks
- Stiffness and night pain that disturbs sleep
- Stiffness after a period of not moving the arm, such as after a fracture or surgery
- Shoulder stiffness with numbness or tingling down the arm
Usually safe to manage at home
- Mild stiffness after sleeping awkwardly or unusual activity that eases within a few days with gentle movement
Causes of shoulder stiffness
Frozen shoulder (adhesive capsulitis)
The joint capsule becomes inflamed and tight, causing pain followed by severe stiffness in all directions, especially rotating the arm outward. It most often affects people aged 40 to 60 and people with diabetes, and lasts 1 to 3 years. See adhesive capsulitis of the shoulder.
Shoulder osteoarthritis
Shoulder arthritis causes gradual stiffness, aching and grinding, usually in older adults or after old injuries. X-rays show joint narrowing.
Rotator cuff problems
Tendinopathy, impingement and tears of the rotator cuff cause pain and weakness lifting the arm, especially overhead. Movement is often painful but can usually be completed if someone else moves the arm. See rotator cuff tear and shoulder impingement.
Stiffness after injury or immobility
Keeping the arm still in a sling after a fracture, dislocation or surgery can lead to stiffness as the capsule and muscles tighten. Early guided movement prevents this.
Calcific tendinitis
Calcium deposits in the rotator cuff can cause sudden severe pain and stiffness.
Polymyalgia rheumatica
Polymyalgia rheumatica causes pain and stiffness in both shoulders and hips, worst in the morning, in people over 50. It responds quickly to steroids. It can be linked to giant cell arteritis.
Other causes
- Rheumatoid and other inflammatory arthritis
- Neck problems with nerve irritation (cervical radiculopathy), which cause pain spreading into the shoulder and arm but usually with full shoulder movement
- Stroke, Parkinson's disease and other neurological conditions
- Infection of the joint (rare, an emergency)
How to tell the causes apart
| Feature | Frozen shoulder | Osteoarthritis | Rotator cuff problem |
|---|---|---|---|
| Typical age | 40 to 60 | Over 60 | 40 and over |
| Movement you do | Limited | Limited | Painful, limited |
| Movement someone else does | Also limited | Also limited | Often nearly full |
| Weakness | Mild | Mild | Often marked |
| Grinding | No | Yes | Sometimes |
| X-ray | Normal | Joint narrowing, spurs | Usually normal |
How doctors find the cause
A clinician compares active and passive movement, tests strength, examines the neck, and asks about injuries, diabetes, thyroid disease and morning stiffness in other joints. Tests may include X-rays, ultrasound or MRI to look at the rotator cuff, and blood tests (inflammation markers, blood sugar, thyroid function) when indicated.
Treatment and how to loosen a stiff shoulder
At home
- Keep moving: gentle movement several times a day prevents further stiffness.
- Pendulum swings: lean forward, let the arm hang and swing it gently in small circles.
- Wall walks: walk your fingers up a wall in front of you and to the side.
- Towel stretch: hold a towel behind your back and gently pull the stiff arm upward with the other hand.
- Cross-body stretch: gently pull the arm across your chest.
- Heat before stretching, and ice afterward if sore.
- Pain relief: acetaminophen (paracetamol), or ibuprofen or a topical NSAID at the label dose.
- Sleep position: support the arm with a pillow and avoid lying on the stiff side.
Stretch within tolerable discomfort. Forceful stretching during a painful frozen shoulder can make it worse.
Medical treatment
- Physical therapy: a structured program of stretching and strengthening
- Steroid injections into the joint or around the rotator cuff
- Hydrodilatation for frozen shoulder
- Steroids for polymyalgia rheumatica
- Surgery: capsular release, rotator cuff repair or shoulder replacement in selected cases
Frequently asked questions
What causes a stiff shoulder?
Common causes include frozen shoulder, shoulder osteoarthritis, rotator cuff problems and stiffness after an injury, surgery or not moving the arm. Polymyalgia rheumatica, inflammatory arthritis and calcific tendinitis are other causes. Comparing how far you and another person can move the arm helps narrow it down.
How do I loosen a stiff shoulder?
Gentle, regular movement is best: pendulum swings, wall walks, towel stretches and cross-body stretches, ideally after a warm shower or heat pack. Use pain relief if needed. If stiffness persists or worsens over weeks, a physical therapist can guide a program.
Why is my shoulder stiff in the morning?
Morning stiffness that eases within minutes is common with osteoarthritis and minor strains. Stiffness lasting longer than 45 minutes in both shoulders, especially over age 50, can be polymyalgia rheumatica or inflammatory arthritis and should be checked by a doctor.
Is shoulder stiffness the same as frozen shoulder?
No. Frozen shoulder is one specific cause of shoulder stiffness, in which the joint capsule tightens and movement is lost in all directions. Stiffness can also come from arthritis, rotator cuff problems, injury, immobility or inflammatory conditions.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Orthopaedic Surgeons (OrthoInfo): Frozen shoulder; Shoulder arthritis; Rotator cuff tears
- MedlinePlus: Shoulder pain
- NHS: Shoulder pain
- American College of Rheumatology: Polymyalgia rheumatica
- American Physical Therapy Association: Shoulder pain and mobility