Shoulder Pain Therapy for Persistent Pain
Shoulder pain is common — but when it persists or becomes restrictive, it can be deeply frustrating.
Many of the people I see in my London clinic are dealing with ongoing shoulder pain or stiffness that hasn’t settled as expected.
They may have tried rest, exercises, or hands-on treatment, yet the shoulder still feels painful, restricted, or unreliable.
You may have been told you have a rotator cuff problem, a frozen shoulder, or simply something that should improve with time — without a clear explanation of why it hasn’t.
This page is for people with persistent shoulder pain or restriction who are deciding whether this type of hands-on therapy is right for them.
When shoulder pain or restriction doesn’t settle
Shoulder problems don’t always present as pain alone. Many people notice stiffness, restriction, weakness, or a sense that the shoulder no longer moves freely or confidently.
You may find that:
- Certain movements feel limited or guarded
- The shoulder feels tight, heavy, or easily irritated
- Pain comes and goes rather than fully resolving
- Scans or tests don’t fully explain what you’re experiencing
Persistent shoulder pain or restriction doesn’t necessarily mean serious damage. More often, it reflects how the shoulder — and the system supporting it — has adapted over time.
Why shoulder pain or restriction can persist
Shoulder problems don’t always present as pain alone. Many people notice stiffness, restriction, weakness, or a sense that the shoulder no longer moves freely or confidently.
When a shoulder has been irritated or overloaded, the body often responds protectively.
This commonly involves:
- Increased nervous system guarding
- Tight or restricted soft tissue and fascia
- Reduced confidence in movement
The shoulder’s stabilising muscles (often described as the rotator cuff or SITS muscles) don’t work in isolation. Ongoing restriction in surrounding tissues — such as the chest, upper back, or latissimus muscles — can influence how the shoulder feels and moves.
Life factors can also play a role. Periods of stress, bereavement, illness, or hormonal change (including perimenopause and menopause) can affect recovery and resilience, even when the original shoulder problem seemed relatively minor.
What this means for treatment
When shoulder pain or restriction has become persistent, treatment often needs to address more than the painful spot alone.
This usually involves:
- Reducing protective nervous system responses
- Working with restricted or overloaded fascia and soft tissue
- Supporting the shoulder to move with greater ease and confidence
Rather than forcing range or strength, the aim is to help the shoulder feel safer to move again — allowing function to return gradually.
What this approach involves
Work with persistent shoulder pain usually combines hands-on treatment, guided movement, and clear explanation, adapted to how your shoulder — and your body more generally — is responding.
Sessions often focus on:
- Reducing protective muscle tension
- Working with restricted or overloaded soft tissue and fascia
- Supporting the shoulder’s stabilising muscles to work more comfortably
- Helping movement feel safer and less effortful
Hands-on work is not limited to the shoulder itself. Depending on what’s contributing, treatment may also involve areas such as the chest, upper back, abdomen, or hips, where tension or restriction can influence shoulder function.
Where appropriate, heat may be used as part of treatment. Heat is a well-recognised pain-relieving tool and can help soften protective tissue responses, making movement easier and more comfortable.
The role of self-care
Self-care is an important part of this approach.
Rather than long or complicated programmes, this usually involves:
- Simple movement or awareness exercises
- Practical ways to reduce unnecessary shoulder tension
- Guidance on habits or positions that may be contributing to symptoms
The aim is to help you support progress between sessions, without adding pressure or turning recovery into another task to manage.
What people often notice over time
Everyone’s shoulder pain is different, and change doesn’t follow a fixed timeline. That said, many people begin to notice gradual, meaningful shifts.
These often include:
- Less guarding or tension around the shoulder
- Easier, smoother movement
- Fewer flare-ups, or flare-ups that settle more quickly
- Improved comfort during sleep or daily activities
- A growing sense of confidence using the arm again
For some, the first change is reduced restriction rather than reduced pain. For others, it’s a clearer understanding of what helps and what aggravates symptoms.
Progress is usually gradual and occurs in stages rather than all at once.
Experiences of shoulder treatment
“After a lot of research I came across Steven as I have shoulder/rotator cuff pain which was steadily getting worse and my range of movement was limiting.
He did an assessment prior to my first treatment and explained everything to me and his recommended treatment and how it would help.
I have had 4 sessions with Steven and it is quite amazing how much relief I now have. My range of movement equals my right shoulder and it has relieved the pain and tension that has been steadily progressing over a few years.”
Bernadette
“I had an ongoing shoulder problem for several months which limited my mobility considerably.
Having a comprehensive plan with end goals, and how to achieve these, was a feature of every consultation, and I found this very useful.
With each session there was improvement in my mobility, and after a course of treatment the difference in the range, and comfort, of the movement was really noticeable.”
Miss Waltham
“I went to Steven suffering from the intense pain and immobility of a Frozen Shoulder.
Steven thoroughly assessed my condition and we initially put in place a six session period of treatment. Together, we decided on several realistic goals in terms of pain level and range of movement associated with some everyday activities that I was having particular problems with.
I’m happy to say that, although my treatment is ongoing, we met those goals very quickly. This was extremely encouraging and I continue to make measurable progress.”
Jo
A research-informed approach
My work with persistent shoulder pain has been shaped not only by clinical experience, but also by formal research.
In 2023, as part of a Level 6 diploma, I completed a research project exploring the effects of advanced clinical massage within a multi-modal approach to chronic shoulder pain.
This work deepened my understanding of how soft-tissue restriction, movement patterns, and protective responses interact over time.
While the research itself isn’t written for patients, it continues to inform how I assess and work with shoulder pain in practice — supporting a thoughtful, individualised approach to treatment.
Is this approach right for you?
This type of shoulder pain therapy is often a good fit when shoulder pain or restriction has been present for some time, keeps returning, or hasn’t responded as expected.
It’s designed for people who want hands-on treatment alongside clear explanation and guidance, and who are open to looking beyond a single structure to understand what’s contributing.
If your shoulder problem is very recent and already settling, you may find that time, reassurance, and gentle movement are enough for now.
This approach tends to be most helpful when symptoms have become persistent, restrictive, or difficult to manage on your own.
Next steps
If you’re dealing with persistent shoulder pain or restriction — such as a frozen shoulder or long-standing limitation — and this approach feels appropriate, you can book a treatment session.
An initial session focuses on:
- Understanding how your shoulder is currently moving and responding
- Identifying key areas of restriction or overload
- Beginning hands-on treatment in a way your shoulder can tolerate
You don’t need a firm diagnosis or referral. Treatment can be adapted as your shoulder responds over time.
Frequently asked questions
These are questions that often come up for people with persistent shoulder pain or restriction who are considering hands-on treatment. If something isn’t covered here, you’re always welcome to ask.
No. You don’t need a formal diagnosis or referral to book a session.
Many people come with terms like rotator cuff pain or frozen shoulder, while others simply know that their shoulder is painful or restricted.
Assessment is based on how your shoulder is currently moving, responding, and adapting — not on labels alone.
That’s very common.
Some people find physiotherapy or exercise helpful early on, while others notice that progress stalls or symptoms return.
This approach can be useful where pain or restriction has become persistent, particularly if protective tension, stiffness, or sensitivity seem to be limiting movement rather than strength alone.
There isn’t a fixed number, but most people notice clear, meaningful improvement within the first few sessions.
As a general guide, many people find that around 5–6 sessions is enough to make significant progress, particularly when shoulder pain or restriction has been present for some time. Often, changes in comfort or movement are noticeable within the first 3–4 sessions, which helps guide next steps.
Treatment is reviewed as you go, based on how your shoulder responds, rather than following an open-ended or indefinite plan.
Yes, it can be.
Frozen shoulder and long-standing restriction often involve protective muscle tension, soft-tissue stiffness, and guarded movement patterns.
Treatment is adapted to what your shoulder can tolerate at each stage, with the aim of gradually improving comfort, confidence, and range of movement over time.
If this doesn’t quite fit
If your symptoms overlap, change over time, or don’t fit neatly into one category, this page explains the main pain issues I work with and may help you decide where to begin.
