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Shoulder to elbow pain can come from the shoulder itself, from a biceps tendon or from a pinched nerve in the neck.[1][2][3] The most common cause of shoulder pain is a problem with the rotator cuff, the group of muscles and tendons that move the shoulder, and that pain can spread down the side of the upper arm.[1][4] Arm pain is also sometimes a warning sign of a heart attack.[5] If your pain starts at the elbow itself, see our guide to elbow joint pain.
In brief
- Where the pain stops is a useful clue. Rotator cuff tendinitis pain is usually at the front of the shoulder, may spread to the side of the arm, and stops above the elbow. Pain that goes on to the elbow and hand may point to a pinched nerve in the neck.[1]
- Most shoulder pain can be eased at home with gentle movement, cold or heat and over-the-counter pain relief. See a doctor if it isn’t better after 2 weeks.[6]
- Call 911 if arm or shoulder pain comes on suddenly, or comes with pressure or squeezing in your chest, or with shortness of breath. It may be a heart attack.[4][5]
Why shoulder pain can spread to the elbow
The shoulder is a ball-and-socket joint where three bones meet: the upper arm bone (humerus), the shoulder blade and the collarbone. Four small muscles and their tendons, together called the rotator cuff, cover the top of the upper arm bone and hold it in the socket.[7] Swelling or damage around the rotator cuff can cause pain when you lift your arm above your head or move it forward or behind your back.[4]
Not all arm pain starts where you feel it. Mayo Clinic notes that arm pain is often caused by a problem in the neck or upper spine.[5] Shoulder pain can also be referred from somewhere else in the body, such as the neck or lungs. MedlinePlus says referred pain is usually there even at rest and doesn’t get worse when you move the shoulder.[4]
Common causes of shoulder to elbow pain
Rotator cuff tendinitis and impingement
MedlinePlus calls this the most common cause of shoulder pain.[4] The rotator cuff tendons run under a bony ledge at the top of the shoulder blade called the acromion. When you raise your arm, the space under it narrows, and the bone can rub on the tendons and on the bursa, a small fluid-filled sac that helps them glide. That causes irritation and pain.[8] Inflammation of the bursa (bursitis) often happens along with rotator cuff tendinitis.[7]
The pain is usually at the front or side of the shoulder and may travel to the side of the arm. MedlinePlus says rotator cuff tendinitis pain always stops above the elbow.[1] It may hurt to lift your arm and reach overhead, and to bring it down again, and the pain is typically worst at night. Early on, it may be mild and present both when you use the arm and when you rest it.[8]
It’s common in people who use their arms overhead, in sports such as swimming, tennis and baseball or in work such as painting and construction.[8]
Rotator cuff tear
A rotator cuff tendon can tear suddenly, for example in a fall on an outstretched arm or when you lift something heavy with a jerk. More often it wears down slowly with age, and people over 40 are at greater risk.[9] AAOS describes the typical pain as starting at the front or side of the shoulder and traveling down the side of the arm. Other signs include:[9]
- pain at rest and at night, especially when you lie on that shoulder
- weakness when you lift or rotate your arm
- a crackling feeling when you move your shoulder in certain positions
- after a sudden tear, intense pain, a snapping feeling and immediate weakness in the upper arm
Some tears aren’t painful but may still weaken the arm.[9]
Biceps tendinitis
The biceps muscle at the front of the upper arm is attached to the shoulder blade by two tendons. Biceps tendinitis is inflammation or irritation of one of them, the long head, which attaches to the top of the shoulder socket. It usually comes from a lifetime of wear, made worse by repeating the same shoulder motions, and it usually happens alongside other shoulder problems such as rotator cuff damage or arthritis.[2] Symptoms include:[2]
- pain or tenderness at the front of the shoulder that gets worse with overhead lifting
- pain when you reach back, for example for a seatbelt or into a coat sleeve
- pain or an ache that moves down the upper arm bone
- an occasional snapping sound or feeling in the shoulder
Biceps tendon tear
A biceps tendon can also tear, either at the shoulder or at the elbow. A tear at the shoulder can cause sudden, sharp pain in the upper arm, sometimes with a pop or snap, bruising from the upper arm toward the elbow and a bulge in the upper arm, sometimes called a “Popeye” muscle.[10]
Tears at the elbow are uncommon. They usually happen when the elbow is forced straight against a heavy load, such as a box that’s heavier than you expected. There’s often a pop at the elbow, then swelling at the front of the elbow, bruising in the elbow and forearm, and weakness when you bend the elbow or turn your palm up.[11] See a doctor promptly. AAOS says surgery to reattach the tendon at the elbow is ideally done in the first 2 to 3 weeks after the injury.[11]
Pinched nerve in the neck (cervical radiculopathy)
Cervical radiculopathy happens when a nerve in the neck is squeezed or irritated where it branches off the spinal cord. It can cause pain that spreads into the shoulder or arm, along with muscle weakness and numbness. It’s often caused by wear-and-tear changes in the spine with age, such as arthritis. In younger people, it’s most often caused by a herniated disk after a sudden injury.[3]
The pain usually starts in the neck and travels down the arm along the path of the nerve. It’s often described as burning or sharp, and turning your head or tipping it back can make it worse. Other signs are pins and needles in the fingers or hand, weakness in the arm, shoulder or hand, and numbness. Some people find the pain eases when they rest a hand on top of their head.[3] With a herniated disk in the neck, MedlinePlus says pain can travel to the upper arm, forearm and fingers, with numbness along the shoulder, elbow, forearm and fingers.[12]
Most people with cervical radiculopathy get better over time without treatment.[3] For more on how nerve pain spreads, see our explainer on axial vs radicular pain.
Frozen shoulder
Frozen shoulder makes the shoulder painful and stiff for months, sometimes years. The pain can be worse at night, and the stiffness makes the shoulder hard to move.[13] Frozen shoulder is most common between the ages of 40 and 60 and in women, and people with diabetes or a thyroid condition are at higher risk. It sometimes follows an injury or surgery.[14]
Shoulder arthritis
Osteoarthritis is the most common type of arthritis in the shoulder. Pain and stiffness usually begin in middle age and get worse slowly. People often avoid moving the shoulder to ease the pain, which sometimes tightens the soft tissues of the joint and makes movement more painful and limited.[7] For arthritis pain in general, see our guide to how to treat joint pain.
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Other causes
Other possible causes of arm pain include sprains, fractures, shingles, a blood clot in a deep vein and thoracic outlet syndrome, where something presses on the nerves or blood vessels in the lower neck and upper chest.[5][15] Elbow problems such as tennis elbow cause arm pain too, and our elbow pain guide covers those.[15]
How to tell the causes apart
Where the pain starts and where it stops are useful clues. Use this table as a starting point, not a diagnosis. The NHS advises against diagnosing yourself and suggests seeing a doctor if you’re worried.[6]
| What it may point to | What you notice |
|---|---|
| Rotator cuff tendinitis, bursitis or impingement | Pain at the front or side of the shoulder that spreads to the side of the arm and stops above the elbow. Worse when you lift your arm overhead, or at night.[1][8] |
| Rotator cuff tear | The same pain plus weakness when you lift or rotate the arm, or a crackling feeling.[9] |
| Biceps tendinitis | Pain at the front of the shoulder, worse when you reach behind you, with an ache down the upper arm.[2] |
| Biceps tendon tear | A sudden pop, sharp pain, bruising toward the elbow or a new bulge in the upper arm.[10][11] |
| Pinched nerve in the neck | Pain that starts in the neck and runs past the elbow into the forearm or hand, sometimes with tingling, numbness or weakness.[1][3] |
| Frozen shoulder or arthritis | Pain and stiffness that make the shoulder hard to move and last for months.[6][13] |
| Possibly a heart problem. See the warning signs below. | Arm or shoulder pain with chest pressure, shortness of breath or sweating, or pain that comes on with activity and eases with rest.[4][5] |
AAOS notes that some shoulder conditions, trapped nerves at the elbow or wrist, and heart disease can all cause neck or arm pain that mimics a pinched nerve.[3]
How to ease shoulder to elbow pain at home
For pain that didn’t start with an injury or fall, self-care is the usual first step. The NHS says you usually need to keep it up for about 2 weeks before shoulder pain starts to ease.[6]
Keep the shoulder moving gently
Don’t stop using your shoulder completely, because that can stop it getting better. Move it gently and avoid things that make it worse.[6] MedlinePlus suggests taking it easy for the first few days, then slowly returning to your usual activities. A physical therapist can help you do this safely.[4] With frozen shoulder, keeping the shoulder still makes the pain worse.[13]
Try cold or heat
The NHS suggests either a pack of frozen peas wrapped in a kitchen towel for up to 20 minutes, 3 times a day, or a hot water bottle wrapped in a towel for up to 20 minutes, 2 to 3 times a day.[6] Never put ice straight on your skin, because it can cause frostbite.[4] For frozen shoulder, the NHS suggests a wrapped heat pack.[13]
Use over-the-counter pain relief
Over-the-counter pain relievers, including nonsteroidal anti-inflammatory drugs (NSAIDs), may ease pain and inflammation so you can keep moving.[4][6] They come as tablets, and as creams, gels or patches you put on the skin. A pharmacist can suggest the best one for you.[5][6]
Watch your posture
Stand up straight with your shoulders down and gently back. When you sit, put a cushion behind your lower back, rest your arm on a cushion in your lap and try not to slouch or push your neck forward.[6] If your neck seems to be the source, the NHS suggests a low, firm pillow and keeping your neck moving.[16]
Keeping shoulder and arm pain from coming back
- Avoid repetitive overhead movements, and keep your shoulder and arm muscles strong.[1]
- Keep good posture so the rotator cuff muscles and tendons stay in the right position. Try not to hunch your shoulders forward.[1][15]
- Take breaks during repetitive tasks, and mix up your activities so you aren’t repeating the same motions.[15]
- Stretch your arm muscles before and after physical activity.[15]
- Don’t overdo activities you don’t usually do.[7]
- If you’ve had shoulder pain before, MedlinePlus suggests using ice and a pain reliever after exercising.[4]
How a doctor finds the cause
A doctor will ask how and when the pain started, whether you’ve had it before and what makes it better or worse.[7] They’ll press on the shoulder to find tender spots, ask you to move your arm in different directions and test your strength. They may also examine your neck to make sure the pain isn’t coming from a pinched nerve.[8] If a nerve is suspected, they’ll check your arms and hands for weakness, numbness and changes in your reflexes.[3]
Tests depend on what the doctor suspects:
- X-rays show the bones. With rotator cuff pain, they’re usually normal or show a small bone spur.[8]
- MRI and ultrasound show soft tissues such as tendons, and can show a rotator cuff tear.[1][7]
- Electromyography (EMG) and nerve conduction studies check how well nerves are working. They help tell a pinched nerve in the neck from a nerve squeezed at the elbow or wrist.[3]
Treatment options
AAOS says most people with shoulder pain improve with simple measures, such as changing or resting from activities, physical therapy and medicine.[7]
Physical therapy
For rotator cuff pain, a physical therapist usually starts with stretches to bring back movement, adds strengthening for the rotator cuff once the pain is improving and works on your posture.[8] For a pinched nerve, specific exercises can help relieve pain, strengthen the neck muscles and improve range of motion.[3] How many sessions you need depends on the cause.[6] Ask your provider or physical therapist which exercises are right for you.[4] Our guide to physical therapy for chronic pain explains what sessions involve.
Medicines
Beyond over-the-counter pain relievers, a doctor may suggest other medicines. For a pinched nerve, a short course of an oral corticosteroid may help by reducing swelling around the nerve. Opioid painkillers are kept for severe pain that other options haven’t relieved, and only for a limited time, because they have side effects and can be highly addictive.[3]
Steroid injections
If rest, medicines and physical therapy don’t help, a doctor may inject a corticosteroid, usually with a numbing medicine. For impingement, the shot usually goes into the bursa under the acromion.[8] For a rotator cuff tear, AAOS says injections relieve pain in about two-thirds of people for at least 3 months on average, though not everyone gets relief, and repeated, long-term injections carry risks, so talk the pros and cons through with your doctor.[9] For a pinched nerve, an injection near the nerve doesn’t take the pressure off it, but it may calm the swelling long enough for the nerve to recover.[3]
Surgery
Surgery is an option when other treatments don’t work.[4] For a few problems, such as repeated dislocations and some rotator cuff tears, it may be recommended fairly early.[7] AAOS says nonsurgical treatment relieves pain and improves function in about 80 to 85% of people with a rotator cuff tear. Surgery is most often recommended for people who are active, relatively young or use the arm for overhead work or sports, because many tears won’t heal without surgery.[9]
When to get medical help
Call 911 if you have:[4][5]
- arm, shoulder or back pain that comes on suddenly, is severe, or comes with pressure, fullness or squeezing in your chest
- sudden pressure or crushing pain in your shoulder, especially if it runs from your chest to your left jaw, arm or neck
- shoulder pain with shortness of breath, dizziness or sweating
These can be signs of a heart attack. Don’t drive yourself to the hospital.[17]
Also have someone call 911 if neck pain follows a fall, blow or injury and you can’t move your arm or hand.[18]
Go to the ER if:[4][5][6][19]
- you’ve just had a severe injury and your shoulder is very painful, swollen, bruised or bleeding
- your arm, shoulder or wrist is at an unusual angle, or you can see bone
- you hurt your arm and heard a snap, or your arm has changed shape
- you have severe pain in your arm and it’s hard to move
- your arm suddenly tingles or feels numb, especially after an injury, or you have no feeling in your arm or shoulder
Get medical help the same day if:[5][6][18]
- arm or shoulder pain comes on when you’re active and eases when you rest, which can be a sign of heart disease
- you can’t move your arm, or have trouble moving it or turning your palm up and down as usual
- the pain started after an injury or accident, such as a fall
- your arm or shoulder is hot or cold to the touch, or you have severe pain in both shoulders
- you feel feverish or unwell, or your arm or shoulder is badly swollen
- you lose control of your bladder or bowels, or have trouble walking or keeping your balance
Make an appointment if:[4][5][6][9][16][18]
- shoulder pain is getting worse, or hasn’t improved after 2 weeks of self-care
- neck pain hasn’t gone away after a week of self-care
- you have neck pain with numbness, tingling or weakness in your arm or hand
- the skin over your shoulder turns red or blue, or redness, swelling or pain in an injured area gets worse
- you know you have a rotator cuff tear and the pain is getting worse or the arm weaker, which may mean the tear is getting bigger
Common questions
Can upper left arm pain be a sign of a heart problem?
It can be. Mayo Clinic says arm pain, especially pain that spreads into the left arm, can be a symptom of a heart attack. Cleveland Clinic says left arm pain along with chest tightness, trouble breathing and nausea can sometimes be one.[5][15] Some people, including older adults, people with diabetes and women, have little or no chest pain during a heart attack and may instead feel short of breath, tired or weak. If you have symptoms of a heart attack, call 911 right away.[17]
Can I keep exercising with shoulder to elbow pain?
Gentle movement is fine, but the NHS says not to make up your own strenuous exercises or use heavy gym equipment for shoulder pain.[6] With a rotator cuff tear, using the shoulder despite increasing pain may cause further damage, and AAOS advises checking with your doctor or physical therapist before trying any shoulder exercises.[9]
Should I wear a neck collar for a pinched nerve?
Only if a doctor tells you to. For neck pain, the NHS advises against a neck collar unless a doctor says otherwise, because it’s better to keep your neck moving.[16] For cervical radiculopathy, a doctor may suggest a soft collar to rest the neck muscles, but only for a short time, because long-term wear can weaken those muscles.[3]
How long does shoulder to elbow pain take to go away?
It depends on the cause. The NHS says recovering from shoulder pain can take 6 months or longer.[6] Rotator cuff tendinitis often improves with rest, exercise and self-care over weeks or months.[1] With a pinched nerve in the neck, the pain goes away in days or weeks for some people and takes longer for others, and it can come back later.[3] Frozen shoulder is slower: full recovery can take up to 3 years.[14]
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How we checked this article
Medical review: pending. A clinician hasn’t reviewed this article yet. We last checked it against the sources below on November 7, 2026.
Sources
- MedlinePlus. Rotator cuff problems. Review date September 2, 2025.
- American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo. Biceps Tendinitis.
- American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo. Cervical Radiculopathy (Pinched Nerve).
- MedlinePlus. Shoulder pain. Review date September 2, 2025.
- Mayo Clinic. Arm pain. April 27, 2023.
- NHS. Shoulder pain. Page last reviewed May 22, 2023.
- American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo. Shoulder Pain and Common Shoulder Problems.
- American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo. Shoulder Impingement/Rotator Cuff Tendinitis.
- American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo. Rotator Cuff Tears.
- American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo. Biceps Tendon Tear at the Shoulder.
- American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo. Biceps Tendon Tear at the Elbow.
- MedlinePlus. Herniated disk. Review date August 27, 2024.
- NHS. Frozen shoulder. Page last reviewed June 24, 2024.
- American Academy of Orthopaedic Surgeons (AAOS) OrthoInfo. Frozen Shoulder.
- Cleveland Clinic. Arm pain. Last updated February 19, 2024.
- NHS. Neck pain and stiff neck. Page last reviewed April 27, 2023.
- MedlinePlus. Heart attack. Review date July 14, 2024.
- MedlinePlus. Neck pain. Review date January 14, 2026.
- NHS. Elbow and arm pain. Page last reviewed January 26, 2024.
