What conservative treatment options are supported by guidelines for managing shoulder pain in adults?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Rest in the acute phase, followed by a gradual increase in activity, is recommended for shoulder pain management .

Advice includes self-help guidance and discussion of physical contributory factors and analgesia, with paracetamol as first-line treatment, and NSAIDs or codeine if paracetamol is ineffective .

Physiotherapy is supported for subacromial shoulder pain, including exercises such as postural correction, motor control retraining, stretching, and strengthening of rotator cuff and scapular muscles, performed within the patient's pain threshold .

Activity modifications to avoid aggravating movements, especially overhead activities, are advised to help reduce pain during the recovery process .

Intra-articular corticosteroid injections may be considered as part of conservative management, particularly when physiotherapy alone is insufficient, with the procedure performed by trained personnel .

Educational content only. Always verify information and use clinical judgement.