Why does your shoulder hurt?

Shoulder pain can appear suddenly— after an accident or injury—or it can build up gradually over time. Gradual onset pain often results from repetitive movements (such as in certain jobs or sports), unaccustomed activities, or even being sedentary.

In the presence of trauma, fractures, dislocations or muscle-tendon tears may be cause of pain. However, with persistent pain which last beyond normal tissue healing time frame, it is often difficult to establish exactly the precise anatomical structure which is causing the pain.

Fortunately, we don’t always need to know the exact structure causing pain to manage it effectively. 

What matters is understanding why pain happens, what it means, and—most importantly—how we can take control of it.

Pain as a Protection Mechanism

Pain is your body’s built-in alarm system—a way to protect itself from harm.

When you sprain a joint or muscle, your body responds with swelling, pain, and inflammation—all part of the natural healing process. This temporary pain makes you instinctively protect the injured area by limiting movement. Over time, as the injury heals, the swelling and pain gradually reduce, and you can return to normal movement and activities.

Shoulder injuries follow the same principle. Initially, you might avoid certain movements. But as healing progresses, gradually reintroducing movement and weight-bearing is essential for recovery.

However, sometimes pain lingers—even after healing should have taken place. This is known as persistent pain. Other times, pain comes and goes unpredictably, known as recurring pain.

The Pain & Brain

Your brain constantly processes signals from your body, much like a super-computer. When you get injured, your nervous system sends ‘danger’ signals to your brain. If the brain interprets these signals as serious, it triggers pain—encouraging you to protect the injured area.

This is useful when dealing with high-impact injuries. But if this protective response lasts too long, it can lead to loss of strength, movement restrictions, and ongoing pain, even when the injury has healed. 

This is why progressive movement is key to recovery.

How Our Mind and Emotions Affect Pain

Pain isn’t just physical—our thoughts, emotions, stress levels, and overall health can influence how we perceive it.

For example, if you’re engaged in an activity you love—like competing in a sports event or chatting with friends—you might not even notice your shoulder pain. In this case, your brain prioritizes other sensory inputs, effectively dampening the pain response.

On the other hand, stress, anxiety, past injuries, fatigue, or pain in other areas of the body can make even a small movement feel extremely painful. This happens when the nervous system is in a state of increased sensitisation—or “high alert”—causing the brain to perceive minor issues as serious threats.

Training the Brain to Manage Pain

Just as the nervous system can become overly sensitive, it can also be trained to calm down. The goal is to shift from a “high alert” state to a more balanced, “low alert” state—where the body can tolerate safe and appropriate movement without excessive pain.

By understanding how pain works and addressing both physical and mental factors, we can take active steps to reduce sensitivity, regain movement, and improve overall well-being.