Shoulder Pain: Causes, Diagnosis & Physiotherapy Treatment in Amsterdam

Shoulder pain can originate from muscles, tendons, ligaments or the shoulder joint itself. It may develop after a traumatic injury, such as a fall, or as a result of repetitive strain or overuse. Shoulder pain may be short-lived or become persistent over time. As we get older, degenerative conditions such as shoulder osteoarthritis or tendon disorders can also lead to shoulder pain.

Table of Contents

• Causes of shoulder pain
• Symptoms
• Diagnosis
• Physiotherapy treatment
• Shoulder rehabilitation after surgery
• When should you seek medical help?
• Frequently Asked Questions
• Book an appointment

Common causes of shoulder

• Rotator cuff tear – A tear of one or more rotator cuff tendons.
• AC joint pain – Pain or inflammation of the acromioclavicular (collarbone) joint.
• Frozen shoulder – A condition causing severe stiffness and loss of shoulder movement.
• Biceps tendon disorders – Inflammation or tearing of the biceps tendon.
• Shoulder nerve compression – Compression or irritation of a nerve causing pain, numbness or weakness.

Symptoms

Common symptoms of shoulder pain include:

• Pain when lifting your arm
• Night pain
• Stiffness
• Weakness
• Clicking or grinding sensations (crepitus)
• Shoulder instability

Diagnosis of shoulder pain

As mentioned above, shoulder pain can arise from several different structures around the shoulder.

A physiotherapist uses several methods to determine the most likely cause of your symptoms.

Medical history

Questions include:

• How did the pain start?
• Was there a fall or injury?
• Which movements are painful?
• How long have the symptoms been present?
• Do you experience pain at night?

Physical examination

The shoulder is examined to assess:

• Range of motion
• Muscle strength
• Shoulder stability
• Pain during specific movements

Musculoskeletal ultrasound

Ultrasound provides a clear view of the tendons, bursa, ligaments and shoulder joint. This makes it possible to diagnose many shoulder conditions quickly and accurately, allowing an appropriate treatment plan to be developed.

If a serious injury is suspected following trauma, you can be referred promptly to your GP or the emergency department for further assessment.

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➡️ Shoulder Ultrasound

Physiotherapy treatment

At Fysiotherapie Middenweg, we carefully assess your shoulder problem and the limitations you experience in daily life. Based on the findings, an individual treatment plan is developed together with you.

Treatment may include:

• Education – Advice on what you can do yourself to support recovery.
• Pain relief – Techniques to reduce pain and make movement more comfortable.
• Restoring mobility – Improving flexibility and restoring normal shoulder movement.
• Strengthening exercises – Targeted exercises to rebuild muscle strength around the shoulder.
• Return to sport – Sport-specific rehabilitation to help you safely resume your activities.
• Injury prevention – Advice and exercises to reduce the risk of future shoulder problems.

If your symptoms are mainly caused by stiffness, restoring mobility may be the first priority. If muscle weakness plays an important role, strengthening exercises will receive more attention. Often, treatment focuses on a combination of these factors.

After shoulder surgery, certain movements may need to be avoided during the early stages of rehabilitation. Your treatment programme will always be adapted to your diagnosis and stage of recovery.

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➡️ Shoulder Physiotherapy in Amsterdam

Shoulder rehabilitation after surgery

Physiotherapy is often essential after shoulder surgery to restore strength, mobility and function.

Common shoulder operations include:

• Shoulder replacement (shoulder prosthesis)
• Rotator cuff repair
• Shoulder stabilisation surgery after a shoulder dislocation

A structured rehabilitation programme helps you regain confidence, improve shoulder function and safely return to your daily activities or sport.

Read more about:

➡️ Rehabilitation after Shoulder Surgery

When should you seek medical help?

It is advisable to consult your GP or physiotherapist if you experience:

• Inability to lift your arm after a fall or injury
• Persistent shoulder pain with or without an obvious cause
• Night pain that does not improve

Frequently Asked Questions

1. What can cause shoulder pain without an obvious injury?

Shoulder pain does not always result from a specific injury. In many cases, it develops gradually due to repetitive movements, poor posture (for example, prolonged computer work), reduced tendon blood supply or age-related degeneration. Stress and neck problems can also contribute to shoulder pain that appears to develop “out of nowhere.”

2. When should I see a GP or physiotherapist for shoulder pain?

Seek professional advice if you experience persistent night pain, significant loss of movement, muscle weakness, pain following a fall or accident, or symptoms that do not improve within two to three weeks. Sudden severe shoulder pain combined with chest pain or shortness of breath requires immediate medical attention, as it may indicate a serious medical condition rather than a shoulder injury.

3. What is a frozen shoulder and how can I recognise it?

Frozen shoulder (adhesive capsulitis) is a condition in which the shoulder capsule becomes inflamed and stiff, leading to progressive pain and severe restriction of movement. It usually develops in three stages: a painful phase, a stiff phase and a recovery phase. Full recovery may take one to three years.

4. Why does my shoulder hurt when I lift my arm?

Pain while lifting the arm, particularly between 60 and 120 degrees, often increases the load on the rotator cuff tendons. This may result from tendon overload, reduced shoulder blade stability or age-related tendon degeneration.

5. Can shoulder pain originate from the neck?

Yes. Neck problems are a common cause of pain that radiates into the shoulder and arm. An irritated nerve or tight neck muscles can produce symptoms that resemble a shoulder injury. A thorough physical examination helps distinguish between shoulder disorders and pain originating from the neck.

6. What can I do about shoulder pain at night?

Try sleeping on your unaffected side while supporting the painful arm with a pillow. Alternatively, when lying on your back, place a pillow under the affected arm to reduce strain on the shoulder. Persistent night pain should always be assessed by a physiotherapist or doctor, as it may indicate an underlying inflammatory condition.

7. What is a rotator cuff injury and how does it occur?

The rotator cuff consists of four muscles and their tendons, which stabilise the shoulder and help control movement. Rotator cuff injuries may occur after a fall, lifting a heavy object or repetitive overhead activities. They become increasingly common after the age of 40 because tendon tissue gradually weakens with age.

8. How long does shoulder pain usually take to recover?

Recovery depends on the underlying diagnosis. Mild overuse injuries may improve within a few weeks, while rotator cuff tendinopathy often requires three to six months of rehabilitation. Frozen shoulder usually has the longest recovery period and may take one to three years. Appropriate physiotherapy can help reduce symptoms and optimise recovery.

9. Which exercises are best for shoulder pain?

The most appropriate exercises depend entirely on the underlying cause of your symptoms. Some shoulder conditions benefit from gentle movement within the pain-free range, whereas others require temporary protection during the early stages of recovery. Common exercises include pendulum exercises, rotator cuff strengthening with resistance bands and shoulder blade stabilisation exercises. A physiotherapist can develop an exercise programme tailored to your condition.

10. What is shoulder impingement?

The term shoulder impingement is now considered outdated.

For many years, it was believed that the rotator cuff tendons and bursa became trapped beneath the acromion when the arm was lifted, causing pain. This theory led to surgery aimed at creating more space beneath the shoulder roof (subacromial decompression).

However, research has shown that patients treated without surgery often recover just as well as those who undergo an operation. Today, most experts believe that persistent shoulder pain is usually related to tendon overload and reduced tissue capacity rather than a lack of space beneath the acromion.

Book an appointment

If you are experiencing shoulder pain and would like an accurate diagnosis and evidence-based treatment, feel free to contact Fysiotherapie Middenweg. We are happy to help you return to pain-free movement.