Shoulder Pain That Won’t Go Away? Causes, Treatment & When an Injection May Help
If you’ve had shoulder pain that won’t go away, especially for several weeks or months, it can start affecting almost everything, sleeping, reaching overhead, getting dressed, working, driving or exercising.
Shoulder pain can have several different causes, and the right treatment depends on what is actually causing your symptoms.
At Light Joints Physiotherapy, we assess and treat a wide range of shoulder problems across Leeds and Bradford, including rotator cuff-related shoulder pain, frozen shoulder, bursitis and other conditions affecting the shoulder.
For some people, physiotherapy and rehabilitation are all that is needed. For others, diagnostic ultrasound or a corticosteroid injection may be appropriate as part of a wider treatment plan.
This guide explains the common causes of persistent shoulder pain, when you should seek an assessment, and when a steroid injection may be considered.
Quick Answer: What Should You Do About Persistent Shoulder Pain?
If your shoulder pain has not improved with rest or self-care, the most useful first step is usually a proper clinical assessment.
Depending on your symptoms and examination, this may involve:
- Physiotherapy assessment and treatment
- Exercise-based rehabilitation
- Diagnostic ultrasound where clinically appropriate
- Advice about activity and load management
- A corticosteroid injection where clinically appropriate
- A combination of treatments
You do not necessarily need a scan or injection.
The purpose of an assessment is to establish the most appropriate treatment rather than automatically recommending an injection.
What Causes Shoulder Pain That Won't Go Away?
Persistent shoulder pain can come from a number of different structures and conditions.
Common causes include:
Rotator Cuff-Related Shoulder Pain
The rotator cuff is a group of muscles and tendons that help control shoulder movement.
Pain can develop around the shoulder and upper arm and may become worse with:
- Reaching overhead
- Lifting
- Gym exercises
- Sleeping on the affected side
- Repetitive activities
Treatment usually focuses on gradually restoring movement, strength and tolerance to load.
Shoulder Bursitis
A bursa is a small fluid-filled structure that helps reduce friction around the shoulder.
Irritation of the bursa can cause pain, particularly when lifting the arm or lying on the affected side.
Depending on the clinical findings, treatment may include physiotherapy, activity modification and, in selected cases, corticosteroid injection.
Frozen Shoulder
Frozen shoulder, also known as adhesive capsulitis, can cause significant pain and stiffness.
People may find it difficult to:
- Reach overhead
- Put on a coat
- Fasten clothing
- Reach behind their back
- Sleep comfortably
Frozen shoulder can take time to settle, and treatment is often focused on managing pain while gradually restoring movement.
A corticosteroid injection may sometimes be considered, particularly during the more painful stages.
Shoulder Impingement and Subacromial Pain
Pain associated with shoulder movement can sometimes be described as impingement or subacromial pain.
Symptoms may include pain when:
- Raising the arm
- Reaching above shoulder height
- Lifting
- Sleeping on the affected side
The important point is that shoulder pain is not always caused by one single structure, which is why a clinical assessment is valuable.
Other Causes of Shoulder Pain
Shoulder symptoms can also be associated with:
- Osteoarthritis
- Acromioclavicular (AC) joint problems
- Tendon-related problems
- Previous injury
- Referred pain from the neck
If your symptoms are unusual, severe or worsening, further medical assessment may be appropriate.
When Should You See a Physiotherapist About Shoulder Pain?
Consider booking an assessment if your shoulder pain:
- Has lasted several weeks
- Is affecting your sleep
- Is restricting normal movement
- Makes dressing or reaching difficult
- Is affecting work or exercise
- Keeps returning
- Has not improved with self-management
A physiotherapist can assess your shoulder movement, strength, symptoms and functional limitations and explain the likely causes of your pain.
You can then discuss the most appropriate treatment options.
Can Ultrasound Help With Shoulder Pain?
Diagnostic musculoskeletal ultrasound can be useful for assessing certain shoulder problems, particularly structures such as tendons, muscles, bursae and some joint-related abnormalities.
Ultrasound can also provide dynamic information because structures can be assessed while you move.
However, not every shoulder problem requires an ultrasound scan.
At Light Joints Physiotherapy, ultrasound is used when clinically appropriate alongside a clinical assessment.
If you are unsure whether you need an ultrasound, your clinician can discuss this with you.
When Can a Steroid Injection Help Shoulder Pain?
A corticosteroid injection may be considered for some shoulder conditions when pain or inflammation is significantly affecting daily life or preventing rehabilitation from progressing.
For example, an injection may sometimes be considered for:
- Frozen shoulder
- Subacromial pain or bursitis
- Some inflammatory shoulder conditions
- Selected joint-related shoulder problems
The purpose of an injection is generally to reduce pain and inflammation, potentially creating a window in which movement and rehabilitation can become easier.
A steroid injection is not a repair or cure for every shoulder problem.
The decision to proceed should be based on your symptoms, clinical assessment, medical history, risks and potential benefits.
What Happens During a Shoulder Injection Assessment?
If you are considering a steroid injection, your appointment begins with a clinical assessment.
This may include:
- Discussion of your symptoms and medical history
- Examination of your shoulder
- Assessment of movement and function
- Discussion of possible treatment options
- Discussion of the benefits and risks of injection
- Safety screening
- Injection treatment if clinically appropriate
- Aftercare and rehabilitation advice
Ultrasound may be used where clinically appropriate.
Not every patient requires an ultrasound-guided injection.
What If I Am Not Suitable for an Injection?
This is an important question to ask before booking.
An injection is not guaranteed simply because you book an injection appointment.
Your clinician will assess whether treatment is appropriate.
If an injection is not considered suitable, you will be advised of this and alternative management options can be discussed.
This may include:
- Physiotherapy
- Exercise rehabilitation
- Activity modification
- Load management
- Further investigation
- Referral for medical assessment where appropriate
The priority should always be appropriate clinical care rather than performing a procedure unnecessarily.
How Much Does a Shoulder Steroid Injection Cost?
Our current private corticosteroid injection pricing is:
Single corticosteroid injection: £195
Two injections in the same appointment: £295
Where an injection is clinically appropriate, the fee includes the relevant assessment, medication and consumables, injection procedure and aftercare advice.
How Quickly Does a Shoulder Steroid Injection Work?
The response to a corticosteroid injection varies between individuals and depends on the condition being treated.
Some people experience improvement relatively quickly, while others may take longer to notice a meaningful change.
You may also experience a temporary increase in pain following an injection.
Your clinician will explain what to expect, including appropriate activity modification and aftercare.
What Happens After a Shoulder Injection?
An injection should not be viewed as the end of treatment.
For many shoulder problems, the longer-term goal is to improve:
- Shoulder movement
- Strength
- Load tolerance
- Function
- Confidence using the shoulder
This is why rehabilitation may form an important part of the treatment plan.
Reducing pain can sometimes make it easier to start or progress rehabilitation, but the underlying problem still needs appropriate management.
Shoulder Pain at Light Joints Physiotherapy
We provide private physiotherapy and musculoskeletal services across Leeds and Bradford.
Our clinics are located in:
Our approach combines clinical assessment with practical rehabilitation, helping you understand what may be causing your shoulder pain and what you can do about it.
Frequently Asked Questions
How long should shoulder pain last?
There is no single timeframe because shoulder pain can have many different causes.
If your pain is persistent, worsening or interfering with sleep and normal activities, an assessment can help establish what may be contributing to your symptoms.
Can physiotherapy help shoulder pain?
Yes. Physiotherapy can be useful for many shoulder problems and may include exercise rehabilitation, movement work, load management and advice about returning to normal activity.
Can a steroid injection cure shoulder pain?
No. A corticosteroid injection is not a cure for every cause of shoulder pain.
It may reduce pain and inflammation in selected conditions and can sometimes help someone progress with rehabilitation.
Is ultrasound necessary for shoulder pain?
No. Ultrasound is not required for every shoulder problem.
It may be useful where clinically appropriate, depending on your symptoms and examination findings.
Can I have an injection without a GP referral?
Private patients can self-refer to Light Joints Physiotherapy. However, an injection is only provided where clinically appropriate and, currently, only once our CQC registration has been approved.
Will I definitely receive an injection if I book one?
No.
A clinical assessment is required first. If an injection is not appropriate, this will be explained and alternative options can be discussed.
When to Seek Urgent Medical Advice
Shoulder pain is not always a straightforward musculoskeletal problem.
Seek appropriate urgent medical assessment if you have severe or rapidly worsening symptoms, significant trauma, a visibly deformed shoulder, significant weakness following an injury, fever or other symptoms that make you concerned about infection or another serious condition.