Not being able to lift our arm because of shoulder pain is actually a very common problem. Some of you simply woke up and couldn’t move your shoulder.  Some of you may have had an injury yesterday and now find it hard to lift or move your shoulder.  There are many common reasons for this. We are going to walk through five of the most common reasons why you can’t lift or move your shoulder.  

calcific tendonitis and severe shoulder pain

Shoulder pain can be one of the more annoying and painful conditions.  For many of you, you simply woke one morning and your shoulder hurts.  Often that pain in on the top of the shoulder or the side of the shoulder. 

Some of you might have severe pain when trying to sleep and others might only have shoulder pain when trying to lift the arm.  These are not unusual issues when it comes to shoulder pain.  Most of you will not recall a shoulder injury. 

Shoulder pain at night

Most patients do not recall a change in their workouts or a more aggressive exercise regimen.  In most instances, you are 40-60 years old, and this might be your dominant or your non-dominant arm. 

There are three main reasons why you can’t lift your arm.

The first is pain.  A painful rotator cuff or bursa will make it very challenging to lift your arm because it hurts so much.  This is also the reason why you may have severe shoulder pain why trying to sleep.  

The second reason is that you injured something. If you had a severe fall or injury then you may have torn a tendon.  If the tendon tears are large enough that will cause significant weakness of the shoulder.  

The third reason is neurological.  Parsonage-Turner Syndrome is a rare cause of shoulder pain and weakness.  We are not sure what causes it, but if often follows a viral illness.  It starts off with very severe pain, but no loss of motion or weakness.  Within a few weeks of onset, you will notice significant weakness around the shoulder. That weakness can be so severe that you have difficulty lifting the arm.  

Losing the ability to move your shoulder is such a common problem. Because of that, we are going to review the most common reasons that will cause:

  • Pain on top of the shoulder
  • loss of shoulder motion
  • Shoulder pain and difficulty when lifting the arm
  • Causes of stiffness and difficulty in moving your shoulder.

 

There are many problems that can occur in the shoulder that can make it difficult or too painful to lift or move your shoulder. More often than not this is due to an issue with the rotator cuff or the “bursa” which sits above the rotator cuff. 

 

subacromial bursitis night pain

The rotator cuff and bursa are the most common cause of pain and loss of motion in the adult shoulder. Rotator cuff pain is the number one reason why you have pain on the outside or top of your arm.  It is also the main reason why you may not be able to lift or move your arm.

Shoulder pain could also be brought on by injury. Believe it or not, traumatic injuries are a less frequent cause of shoulder pain.  Rotator cuff injuries can be caused by chronic repetitive stress from working out,  throwing or overhead sports.  Rotator cuff injuries can also be caused by a fall, or perhaps even a long day gardening or painting your house. It is not unusual to lose the ability to move your shoulder after a long day of chores that you don’t typically perform.  

This should not be a cause for alarm.  Most people who woke up and can’t move their shoulder because of pain will recover uneventfully within a few days or weeks.  

The rotator cuff is a series of four muscles that are deep to or underneath your deltoid muscle. Together those four muscles control your shoulder motion and are critically important to the proper functioning of the shoulder.

5 Most Common Reasons You Cannot Lift Your Shoulder

Here are the most common reasons why you may not be able to move your arm.  While there can be neurological reasons, like Parsonage-Turner Syndrome, most of you cannot move the arm or shoulder because of pain.  The most common causes of shoulder pain and loss of motion are: 

  • rotator cuff tendonitis
  • rotator cuff tendinosis
  • rotator cuff tears
  • partial rotator cuff tears
  • calcific tendonitis
  • adhesive capsulitis or a frozen shoulder

Rotator cuff cant move my shoulderThe cause of your shoulder pain and the reason why it hurts will vary by age.  Some problems are more common in different age groups.  In younger athletes, tendonitis, or inflammation of the rotator cuff is more common. 

In middle age, rotator cuff tendinosis, calcific tendinitis, AC Joint arthritis, and a frozen shoulder are more common causes of pain. 

Let’s run through each of these individually.  

Rotator Cuff Tendinosis

In people over 30 rotator cuff tendonitis is rare and rotator cuff tendinosis starts to become a more common cause shoulder pain which hurts when we try to lift our arm or shoulder.

 

Rotator cuff tendinosis, by definition, implies some degree of rotator cuff degeneration.  With that degeneration comes an increase in the numbers of nerves and blood vessels.  That is the body’s response to the degeneration, and that is why the pain occurs.  

Too many nerves in the area produce pain with certain motions.  If the pain is severe enough you will be unable to raise your arm or unable to sleep on that side.

When patients have rotator cuff tendinosis, physical therapy is generally effective at managing the pain.  If the pain persists despite therapy, we now have a biological patch that may be able to alleviate the pain due to tendinosis.

Many people who cannot lift their arm due to shoulder pain from rotator cuff tendinosis will be told that they have impingement syndrome and a bone spur.  This video post discusses our current thoughts on bone spurs and shoulder pain.

Other posts about rotator cuff tendinosis:

What is Rotator Cuff Tendinosis

Rotator Cuff Tendinosis Biology

Rotator Cuff Tendinosis – is a cure possible?

Partial Rotator Cuff Tears

Rotator Cuff TendinosisAs the rotator cuff continues to age or degenerates, a portion of the rotator cuff might separate from the bone that it is normally attached to.  This is usually part of the natural progression of tendinosis. 

If enough of the rotator cuff starts to separate then we have a small cleft or defect in the rotator cuff attachment. We call that a partial tear. Partial tears are not large enough to cause weakness of the shoulder.  However, if you have a painful partial tear, you can have pain on top or on the side of the shoulder. In addition, you may find it very painful when trying to lift the arm overhead.

Some partial tears hurt, while others do not. Determining if your partial tear is painful is usually possible with a physical exam.   Most people with partial tears of the rotator cuff are going to respond to physical therapy.  If physical therapy and other non-surgical treatments do not improve your pain, then surgery to place a unique biological patch has a high likelihood of alleviating your night pain and pain with lifting your arm.  See this post for more information about the patch and how it works.  

Traumatic Shoulder Pain

Some of you are reading this because you fell on your shoulder and now you can not move your arm.  In acute traumatic situations like this, there is a chance that you ripped the rotator cuff off from the bone. If you fell, and now have significant weakness in your arm you should see an Orthopedic Surgeon soon. This post covers what to look for if you think you had a serious shoulder injury.

rotator cuff tear pain when lifting the arm

The rotator cuff controls how well the shoulder functions.  If your injury caused a rotator cuff tear, your complaints and symptoms may be related to the size of the rotator cuff tear.  If enough of the rotator cuff has torn then it might be impossible to move your arm due to severe weakness.  Many people with acute, large, traumatic rotator cuff tears will require surgery in order to restore function.   In general, the treatment of rotator cuff tears depends on the cause of the rotator cuff tear and I go into more detail in these posts here and here.

 

Calcific Tendonitis

Calcific tendonitis of the rotator cuff can be a VERY painful entity.  

What is calcific tendonitis of the shoulder?

You are usually very easy to diagnose in the office since the pain can at times be very significant.  In this situation, calcium crystals deposit inside the tendon itself.  That leads to a significant increase in the number of nerves in that area, and that causes severe pain.  

Luckily, a non-surgical approach with an ultrasound-guided injection to wash the calcium out of the rotator cuff often results in pain relief in the majority of cases.  Surgery is very rarely necessary for calcific tendonitis. For more in-depth information on calcific tendonitis please see these two articles here and here.

Frozen Shoulder

Adhesive capsulitis or a frozen shoulder is a very common cause pain and of loss of motion of the shoulder. A frozen shoulder causes pain all around the shoulder.  The pain can be on the top of the shoulder, or the pain can be underneath the shoulder in the axilla.

What is a frozen shoulder

In a frozen shoulder you cannot move the arm because the ligaments and capsule around the shoulder became very thick, tight and inflamed.  We have a very popular post here that goes into significant detail about how to manage a frozen shoulder. 

The diagnosis of a frozen shoulder is often straight-forward… since the definition of a frozen shoulder is loss of motion compared to the other shoulder.  

The treatment of a frozen shoulder is generally physical therapy.   On occasion, we might recommend an injection directly into the shoulder to diminish the inflammation. People who do not improve with physical therapy can consider an injection or an arthroscopy. During arthroscopy of the shoulder, the surgery is performed with small holes and cameras and the tight joint capsule is released.  During that surgery, we can also remove or lengthen the tight inflamed tissue which is stopping the shoulder from moving.

Rotator Cuff Tendonitis

In people under 30 years of age, including youngsters, the most common cause of shoulder pain is because of rotator cuff tendonitis.  This simply means that the rotator cuff is inflamed from performing too much activity.  Often times rotator cuff tendonitis can be considered a training error at any age.  A training error occurs if you add on a new activity or perform too many sets.  A training error occurs if you jump in the pool and swim a mile after not swimming for a few weeks or months.  In most cases of rotator cuff tendonitis due to over-training or improper training, the pain is going to go away within a few weeks as the shoulder gets used to your new routine.

In childhood (under 16), and particularly in overhead athletes, a stress fracture of the humerus is a possible cause of shoulder pain.  These stress fractures actually involve the growth plates of a growing child.  These fractures need to be identified early as rest results in healing.  If these fractures are not identified early a young athlete could have lifelong shoulder issues.  Usually, just an x-ray will suffice to diagnose these growth plate stress fractures.

In children and teenagers, rotator cuff tendonitis is usually associated with overhead sports and weight lifting.  In teenagers, rotator cuff tendonitis can be caused by instability issues where the shoulder is trying to slide out of place. Instability will occur if the ligaments have become loose over time because of pitching, swimming, etc.

This is a more subtle form of instability than a youngster who was tackled or hit and dislocated their shoulder.  Rotator cuff tendonitis due to instability is most commonly seen in children who are throwers, volleyball players and swimmers.   By addressing the underlying instability issue with physical therapy both the instability and the secondary rotator cuff tendonitis will resolve.  On occasion, surgery to address the instability can tighten the ligaments and this will also resolve the rotator cuff issue. 

AC Joint Arthritis:

The AC Joint is a small joint on top of your shoulder.  It is where your collar bone meets the shoulder blade.  Many people notice a small bump above their shoulder.  That is the AC joint. Over time that joint can suffer from arthritis.  Arthritis of the AC joint is the number one cause of pain on top of the shoulder.  If the pain from the AC joint is severe enough it will cause pain when trying to lift your arm or move your shoulder.  Ice, heat, anti-inflammatory medications can all help ease the pain from an arthritic AC joint.  Injections can be useful too.  For people who do not respond or improve after these treatments surgery might be the right answer.  The surgery involves clearing out the AC joint.  This article on my site goes into more detail about AC joint arthritis and its treatment.  

Shoulder pain when lifting the arm is very common.  Most of the time it is not due to a single injury.  We reviewed many of the most common causes of pain and treatments which are usually effective.  Hopefully, this has helped you determine why your shoulder hurts and why it’s painful to lift that arm overhead.

Disclaimer:  this information is for your education and should not be considered medical advice regarding diagnosis or treatment recommendations. Some links on this page may be affiliate links. Read the full disclaimer.

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About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

29 comments on “Shoulder Pain When Lifting The Arm : Causes and Cures

  • Had orthoscopic Sx 6 yrs ago. Lately R (same) shoulder dull pain – this morning hard to raise arm. Hot shower and Ibu 800 helped. Typically, towards evening pain increase Etc. Sad to read great info as I bet it’s my poor rotator cuff.

  • What happeneds when it’s your arm Pitt not your shoulders can you please help it really hurts

    • The armpit can hurt in the case of a frozen shoulder. The are other reasons too… see your doc so they can examine that area and check your shoulder range of motion.

  • Dr. Luks,

    On early Friday morning I had a nasty fall. I caught the brunt of the fall on the heel of my right hand. It took me several moments to recover to the point where my husband could help me to stand up. I had intense shooting pains from my right thumb all the way up into my shoulder. I have used ice, moist heat, and advil since the fall, and the shooting pains went away, but I still have very limited mobility in my arm (although my fingers and wrist seem to be fine), my right arm is very weak and I am not able to lift it to chest level without supporting it with my left hand, and even then it causes a lot of pain in my upper right arm and shoulder. I have had bursitis in my right shoulder previously (about 20 years ago), but this seems different. Do you have any ideas?

    • After a traumatic injury — if you lose the ability to lift the shoulder you want to be evaluated by a shoulder doc to be sure that you did not sustain a serious injury. Pain can cause loss of motion without there being a large tear… but a large tear can be caused by the fall — so I would suggest you be evaluated sooner rather than later

  • i had no injury , but all of a sudden today I have pain when i attempt to move, lift, use my shoulder in almost any direction, position. And if i move it in a certain way it hurts excruciatingly. As I type this, I used my left arm to get my right arm in position. And I can sense where the issue is as I type. In the front, near the surface. It feels like i injured it, but I did nothing memorable. Just started a couple hours ago, and I want to double over when it tweaks. Feels like a tendon is enlarged, and can’t slide over the muscle smoothly, so it seems to catch, and that is when i feel the most sharp pain. I am hoping this is just an brief acute thing. I think I had this happen before, in the recent year or so, but not nearly this painful. And it was short lived. But why? And what do I do? It almost makes me sick to my stomach it hurts so bad when it catches. And it happens with the most innocent of movement, not even a lift, but a slight cross wise move. And not even lifting anything. Just moving my arm.

    • Jill … I’m sorry it hurts so much :-( These are very common complaints from shoulder pain sufferers. The most common causes of pain like you describe include the rotator cuff itself (tendinosis),the subacromial bursa (bursitis) and the biceps tendon (which can become inflamed). Occasionally a very early frozen shoulder will present like this. If the pain persists despite stretching, perhaps Kirsch exercises and Tylenol then I would see a shoulder doc for a diagnosis. Then therapy can be prescribed — which is usually quite successful in the treating the pain of many conditions.

  • My mother of 79 yrs young has been recently told after an ultrasound that she has no tendons left in her shoulder. She had been complaining of her arm being very painful and not being able to raise her arm without the help of her other arm. She has an appt with her doctor next week but what does this mean. Is there anything that can be done?

  • My husband Can easily raise his entirearm over his head when laying Down.However during the Day he has to have the other hand assist him with raising the injured arm. He had a falland the only pain he feels is when HE LIFT IT… It is very weak … He Thinks it is the biceps ?? Coulis That be Right ? THANK you for your
    reply. G . Maier

    • It’s likely to be a large rotator cuff tear… but only a good examination and possibly an MRI can tell you for sure. Please see a shoulder doctor soon.

  • My wife developed a situation where it was very painful to move her shoulder. She did nothing noticeable to cause this. She went to the GP and he got her to move her shoulder through the full range of movements, which she was able to do, although with some pain.
    Less than 24 hours later, she had next to no movement in her shoulder. She went back to the GP, who declared it a “frozen shoulder”, and gave her an injection in the shoulder area. The pain vanished, but she still has no shoulder movement under muscle power. (She can lift it vertically with the other arm)..
    Is this more likely to be some sort of rotator cuff problem, rather than a frozen shoulder?…..or are they the same?
    Thanks for any advice you can offer.

  • Can a flu shot in the upper arm cause injury to the arm resulting in the pain (SIRVA)? I had a flu shot and arm pain started shortly after and has been gradually increasing. It has been about 4 to 5 months and now it realllly hurts.

    • A flu shot can result in a frozen shoulder with stiffness and pain. Any injection can. It’s not the medication being injected that causes it. A frozen shoulder can occur with incidental trauma, and most often people do not recall any injury.

  • hey
    actually my father is suffering pain in his shoulder from last 3 to 4 years…. he had seen many doctors here in india…did many physiotherapy…had homeopathic medicines…
    i am really tensed for him please tell me if there is a cure for it in america i would surely take my father there…
    MEHAK JAIN

    • The “cure” would depend on the diagnosis. Many shoulder conditions can be successfully treated.

  • Hi i have severe pain in my arm , i can move my shoulder , i can move my arm from the elbow down , its the top part of my arm that really hurts when i try to raise it or even twist it , this is my right arm , any help please

    • Sorry Rachel :-( Shoulder pain — pain on the outer part of the upper arm can be terrible. I good examination and an xray are necessary. Without a history of trauma one of the most common reasons is bursitis assoc with rotator cuff tendinosis. Also common in situations which come on suddenly is calcific tendonitis. But only an exam and an xray can tell you and your doctor what’s going on for sure. Good luck !

  • hi, i dont know what to do. I had no injury, but I can’t move or lift my arm, I have pain in my left shoulder. I can feel everything, but I cant move my fingers, so please help me. I have weak circulation, and I don’t have left a leg, can be there some connection or? I have 65 yeras. I went to hospital but they didnt know what to do, or how to help me, so I started to search the web, and I saw this site, so please if you know the answers it will save my life, because I cant go anywhere, I cant even go to bathroom.

    • Sounds like you need to see an Orthopedic doctor. They can help you determine why this is happening.

  • My 20 year old son did weights 2 days ago. Low weight, many reps. Late in the afternoon he started having back of the shoulder pain. He woke in the middle of the night with excruciating pain. He can’t move his shoulder at all. Took ibuprofen and is icing. Could this be from inflammation ? Rotator cuff? Thanks

    • I do not know… it’s possible. But without an examination by a doctor it’s hard to say. If the pain is that severe he should see his doctor.

  • I recently cannot raise my right arm like if im going to shake hands. Its very weak. my fingers are ok. my hand is functioning ok. No numbness on my arm, no swelling or redness on my shoulder. If I use my other arm to move it around. Its painless. Basically I dont feel any pain for all these. I could only swing it about 30 degrees sideways and doing that, my shoulder will raise too compensating for that action i guess. There is some heaviness when im sitting like driving a car and it will be gone soon. A couple of doctors and physiotherapists were clueless. Ultrasound is the only advise I got. Do you have any idea doctor? Please. Thank you.

    • There are many things that can cause this… without an examination I couldn’t give you a reason.
      Good luck !

  • Hi my daughter is 9 she fell of a bouncy castle friday and landed on her shoulder from her elbow to her hand its perfect but her shoulder she is having pain and cannot raise it ive been trying but there is pain

    • Fractures are the number one reason children will not move their arm. It would be wise to have her evaluated.

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