Part 3 of 7 in the "shoulder pain and frozen shoulder" series. The other six are listed at the foot.
The capsule is not the only source of shoulder pain. The NHS shoulder-pain page is direct: do not self-diagnose; see a doctor if you are worried.
The table below is not a self-test. It shows what a doctor may be distinguishing and what public patient pages record as common presentations, so you can describe your shoulder more precisely at the visit.
The short version
- Five directions, each with a public patient page behind it: frozen shoulder, rotator cuff tear, subacromial impingement, referred pain from the neck, calcific tendinitis.
- Three things per row: what the doctor may be distinguishing, what the sources record, and when to see a doctor first.
- These five are not a complete list, and the same presentation can appear in more than one situation.
- The three that get mixed up most have different sources: frozen shoulder is in the capsule, a tear is at the tendon's attachment to bone, impingement is about space.
- What the table changes is not your conclusion but what you say at the visit.
First, the things that cannot wait
Persistent numbness, loss of feeling or marked weakness in the arm or fingers; sudden severe pain, being unable to move the arm, or a change in shape after a fall, blow or clear injury; redness, swelling or heat in the shoulder, or persistent fever — get urgent help, do not wait.
Left shoulder pain with chest tightness, chest pain, breathlessness or a cold sweat — this is an emergency, not a consultation booking. Call 999 now, or go to the nearest hospital emergency department.
The full list, and the reason for each, are in part 6. TCM and Western medicine complement each other; it is not a choice between them.
A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.
I. Five directions, one table
Every cell comes from that condition's own public patient page: frozen shoulder, rotator cuff tears, impingement, cervical radiculopathy and calcific tendinitis are all AAOS condition pages; the "two weeks" and "sudden very bad pain" cells, and the "often worse with use" clause in the impingement row, come from the NHS shoulder-pain page; the limited movements in the frozen-shoulder row come from Singapore's HealthHub, and the "does not go away" standard from the NHS frozen-shoulder page.
| Situation | What the doctor may be distinguishing | Common presentation recorded in public sources | When to see a doctor first |
|---|---|---|---|
| Frozen shoulder (adhesive capsulitis) | The capsule itself has thickened and tightened, adhesions have formed, and there is often less synovial fluid | Pain plus stiffness; pain usually dull or aching, mostly over the outer shoulder; lifting the arm, reaching behind the back or behind the head especially limited; limited whether you move it or someone else does | Pain and stiffness that does not go away, or pain so bad it is hard to move the arm |
| Rotator cuff tear | Whether a tendon has become partially or completely detached from the head of the humerus; most tears are slow wear of the tendon with age, and a fall or lifting something too heavy with a jerk can also tear it | Pain at rest and at night, especially lying on the affected shoulder; pain when lifting, lowering or rotating the arm, with weakness | Sudden intense pain after a fall, with immediate weakness — get urgent help (see part 6) |
| Subacromial impingement / rotator cuff tendinitis | The space between tendon and acromion narrowing when the arm is raised, so they rub | Pain and tenderness at the front or side of the shoulder, pain reaching for things overhead, typically worst at night; often worse with use | If it has not improved after two weeks, see a doctor |
| Referred pain from the neck (cervical radiculopathy) | A nerve in the neck compressed or irritated where it branches away from the spinal cord, with pain radiating into the shoulder and arm in the area served by that nerve | Pain starting at the neck and travelling down the arm, usually described as burning or sharp; turning or extending the neck may increase it; tingling in the fingers, weakness | Persistent numbness or weakness in the arm or fingers (see part 6 — get urgent help) |
| Calcific tendinitis | Calcium deposits within the rotator cuff tendons | Pain and tenderness at the front or side of the shoulder, which may be severe and may occur without trauma or movement; adults between 30 and 60 at increased risk | Sudden very bad pain, cannot move the arm — get urgent help |
These five directions have a public patient-information page behind them; the list is not complete. The table records presentations, not "this presentation means this condition".
The same presentation can appear in more than one situation. Telling them apart is done by a doctor's hands, with imaging where needed — part 2 sets out those three examination questions.
💡 Remember: the table exists so that you can describe your shoulder precisely at the visit, not so that you can match yourself to a row.
II. Three that get mixed up, and where they differ
Frozen shoulder, a rotator cuff tear and impingement all hurt when you lift the arm, but the three AAOS pages locate the problem in different places:
- Frozen shoulder is in the capsule: it thickens and tightens, so both kinds of range of motion are limited.
- A tear is at the tendon's attachment to bone: the tendon becomes partially or completely detached from the head of the humerus; among the symptoms that page lists is "weakness when lifting or rotating your arm".
- Impingement is about space: when the arm is raised, the space between the acromion and the tendon becomes smaller and they rub, which is why that page writes of pain when reaching for things overhead, typically worst at night.
This is not for you to decide which one it is. What it changes is what you say at the visit: stuck or weak, does it go up when someone else lifts it, at which height it hurts most, and whether it hurts at night.
A few terms from this part
All four come from the pages cited above, and you may meet them at a clinic or on a referral letter.
- Rotator cuff tear (旋转肌袖撕裂) — the AAOS's description: a tendon partially or completely detached from the head of the humerus. The page states most tears are slow wear of the tendon with age.
- Subacromial impingement (肩峰下撞击) — the same set of pages: the space between the acromion at the top of the shoulder and the rotator cuff tendons becomes smaller when the arm is raised, and they rub.
- Referred pain (牵涉痛) — where it hurts is not where the problem is. The cervical radiculopathy page states that a compressed nerve in the neck may send pain radiating into the shoulder and arm.
- Calcific tendinitis (钙化性肌腱炎) — the same set of pages: calcium deposits within the rotator cuff tendons. The page states adults between 30 and 60 are at increased risk.
Frequently asked
One row looks a lot like me — does that make it the one? No. The table records what public sources report, not a rule for deciding; the same presentation can appear in more than one situation. Confirming it belongs to a doctor, by hands-on examination and imaging where needed.
Is it worth taking this table to the visit? What helps is not the table but the sentences it prepares: stuck or weak, which direction is limited, does it go up when someone else lifts it, at which height it hurts most, whether it wakes you at night, and whether numbness travels into the arm or fingers.
Better not to: use the table to reach a conclusion about yourself and then plan around that conclusion.
The other six parts
- Part 1: What frozen shoulder is, and who tends to get it
- Part 2: How it happens, and what the exam tests
- Part 4: How TCM sees it: wind-cold-damp and bi-impediment
- Part 5: What the theory advises, and heat
- Part 6: When to see a doctor first
- Part 7: What an online consultation can do, and what else to tell it
👉 If you are not sure "where my shoulder should go next", you are welcome to bring it to an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it; if you do not yet have a firm diagnosis, or if anything in this part's "the things that cannot wait" or in part 6 applies, see a doctor first. In-person consultations are coming soon.
Sit with a licensed TCM practitioner from wherever you are.
HansMed Modern TCM
For general wellness education only — not medical advice. Consult a registered TCM practitioner for personal guidance.
Sources
- AAOS OrthoInfo, Frozen Shoulder — https://www.orthoinfo.org/en/diseases--conditions/frozen-shoulder/
- AAOS OrthoInfo, Rotator Cuff Tears — https://www.orthoinfo.org/en/diseases--conditions/rotator-cuff-tears/
- AAOS OrthoInfo, Shoulder Impingement/Rotator Cuff Tendinitis — https://www.orthoinfo.org/en/diseases--conditions/shoulder-impingementrotator-cuff-tendinitis/
- AAOS OrthoInfo, Cervical Radiculopathy (Pinched Nerve) — https://www.orthoinfo.org/en/diseases--conditions/cervical-radiculopathy-pinched-nerve/
- AAOS OrthoInfo, Calcific Tendinitis of the Shoulder — https://www.orthoinfo.org/en/diseases--conditions/calcific-tendinitis-of-the-shoulder/
- NHS, Frozen shoulder, page last reviewed 24 June 2024 — https://www.nhs.uk/conditions/frozen-shoulder/
- NHS, Shoulder pain, page last reviewed 22 May 2023 — https://www.nhs.uk/conditions/shoulder-pain/
- Singapore HealthHub (MOH), Frozen Shoulder, article last reviewed 21 December 2021 — https://www.healthhub.sg/health-conditions/frozen-shoulder
