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Shoulder Pain

Rotator Cuff, Frozen Shoulder & Shoulder Pain Treatment in East London

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Start Your Recovery

The shoulder is the most mobile joint in the body — and one of the most commonly injured. At LPAW, we distinguish between the specific shoulder pathologies and treat accordingly. Available at our Bow and Stratford East Village clinics.

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Anatomy & Causes
The shoulder complex includes the glenohumeral joint (the main ball-and-socket joint), the acromioclavicular (AC) joint, the sternoclavicular joint, and the scapulothoracic joint (where the shoulder blade moves against the rib cage). All four must work in coordination for normal shoulder function.

 

The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, subscapularis, teres minor) whose tendons converge to form a cuff around the humeral head. They maintain joint centration — keeping the ball in the socket — during all shoulder movements.
  • Pain at the side, front, or back of the shoulder
  • Pain with overhead activities (reaching a high shelf, swimming, throwing)
  • Pain lying on the affected shoulder at night (particularly rotator cuff and frozen shoulder)
  • Stiffness — progressive loss of range of movement
  • Weakness — difficulty lifting the arm or carrying objects
  • Clicking, catching, or grinding sensations in the joint
  • Pain radiating down the arm (may indicate cervical nerve root involvement)
  •  

Seek urgent medical assessment if:

  • Sudden severe shoulder pain without trauma in a middle-aged or older person (possible acute rotator cuff tear or referred cardiac pain — shoulder pain can be referred from a cardiac event)
  • Shoulder pain in a patient with a history of cancer (possible bony metastasis)
  • Significant trauma with deformity or inability to move the arm (possible fracture or dislocation)
  • Rapidly progressive neurological symptoms in the arm
  • Most shoulder pain is not an emergency but benefits from early assessment. Delays in treating frozen shoulder, in particular, allow the condition to progress to a more severe and prolonged stage.
The shoulder complex includes the glenohumeral joint (the main ball-and-socket joint), the acromioclavicular (AC) joint, the sternoclavicular joint, and the scapulothoracic joint (where the shoulder blade moves against the rib cage). All four must work in coordination for normal shoulder function.

The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, subscapularis, teres minor) whose tendons converge to form a cuff around the humeral head. They maintain joint centration — keeping the ball in the socket — during all shoulder movements.
  • Pain at the side, front, or back of the shoulder
  • Pain with overhead activities (reaching a high shelf, swimming, throwing)
  • Pain lying on the affected shoulder at night (particularly rotator cuff and frozen shoulder)
  • Stiffness — progressive loss of range of movement
  • Weakness — difficulty lifting the arm or carrying objects
  • Clicking, catching, or grinding sensations in the joint
  • Pain radiating down the arm (may indicate cervical nerve root involvement)

Seek urgent medical assessment if:

  • Sudden severe shoulder pain without trauma in a middle-aged or older person (possible acute rotator cuff tear or referred cardiac pain — shoulder pain can be referred from a cardiac event)
  • Shoulder pain in a patient with a history of cancer (possible bony metastasis)
  • Significant trauma with deformity or inability to move the arm (possible fracture or dislocation)
  • Rapidly progressive neurological symptoms in the arm
Most shoulder pain is not an emergency but benefits from early assessment. Delays in treating frozen shoulder, in particular, allow the condition to progress to a more severe and prolonged stage.

Meet our team of experts

LPAW’s clinical team includes 19 practitioners, many holding postgraduate qualifications from UCL, King’s College London, and Guy’s and St Thomas’. Lead clinician Mr Arjun Viswanath MSc, MCSP, MPPA – Co-Founder and Consultant Physiotherapist – brings 25+ years of NHS and private experience including BMI London Independent Hospital and Harley Street.

Every clinician joining LPAW completes a mandatory intensive shadowing placement with our Consultant Physiotherapist before seeing patients independently. This is not a standard practice at most clinics – it’s our way of maintaining clinical consistency across the team.

How LPAW Treats Shoulder Pain

Physiotherapy
  • Manual therapy — joint mobilisation and soft tissue techniques to reduce pain and restore movement
  • Exercise prescription — targeted to address identified muscle imbalances (typically weak deep stabilisers, gluteals, and hip extensors; tight hip flexors and hamstrings)
  • Education — understanding the nature of back pain, its natural history, and activity modification
  • Postural and ergonomic guidance

Frozen shoulder requires different management strategies during each stage of recovery:

  • Freezing phase (0–9 months)
    Characterised by severe pain, often including night pain. Treatment focuses on pain management and gentle manual therapy. Aggressive stretching is usually counterproductive and may worsen symptoms.
  • Frozen phase (4–12 months)
    Pain gradually reduces, but stiffness becomes more pronounced. Graduated mobilisation and stretching exercises become more appropriate during this stage. Physiotherapy is particularly effective here for restoring range of motion.
  • Thawing phase (12–24+ months)
    Gradual spontaneous recovery occurs, with physiotherapy helping to accelerate progress and restore full function.
  • Corticosteroid injection
    Corticosteroid injections can be effective during the freezing phase to reduce pain and improve tolerance to physiotherapy. Referral through a GP or shoulder specialist may be appropriate where indicated.

Shockwave therapy may be used for specific presentations of chronic back pain — particularly those involving myofascial trigger points or thoracolumbar fascial pain — though it is not the primary treatment for most back pain presentations.

How LPAW Treats Shoulder Pain

Most back pain is benign and responds to physiotherapy. However, certain features require urgent medical assessment. Seek immediate medical attention if you experience:

  • Manual therapy — joint mobilisation and soft tissue techniques to reduce pain and restore movement
  • Exercise prescription — targeted to address identified muscle imbalances (typically weak deep stabilisers, gluteals, and hip extensors; tight hip flexors and hamstrings)
  • Education — understanding the nature of back pain, its natural history, and activity modification
  • Postural and ergonomic guidance

Frozen shoulder requires different management strategies during each stage of recovery:

  • Freezing phase (0–9 months)
    Characterised by severe pain, often including night pain. Treatment focuses on pain management and gentle manual therapy. Aggressive stretching is usually counterproductive and may worsen symptoms.
  • Frozen phase (4–12 months)
    Pain gradually reduces, but stiffness becomes more pronounced. Graduated mobilisation and stretching exercises become more appropriate during this stage. Physiotherapy is particularly effective here for restoring range of motion.
  • Thawing phase (12–24+ months)
    Gradual spontaneous recovery occurs, with physiotherapy helping to accelerate progress and restore full function.
  • Corticosteroid injection
    Corticosteroid injections can be effective during the freezing phase to reduce pain and improve tolerance to physiotherapy. Referral through a GP or shoulder specialist may be appropriate where indicated.
 

Shockwave therapy may be used for specific presentations of chronic back pain — particularly those involving myofascial trigger points or thoracolumbar fascial pain — though it is not the primary treatment for most back pain presentations.

What Our Patients Say

Cibelle Andrada S. profile picture
Cibelle Andrada S.
2 weeks ago
From the moment I walked into this clinic, I knew everything was going to be okay. After seeing many physios, Priyanka, the pelvic specialist, was the first one to properly diagnose my back injury and choose exercises that were actually right for my condition.

I HIGHLY recommend hydrotherapy. This clinic has truly been life-changing for me. When you live with constant pain, finding real relief is priceless.

Thank you for the care, professionalism, and for giving me hope again ❤️
Molly W. profile picture
Molly W.
1 month ago
We had 6 of their amazing physiotherapist support London’s Air Ambulance Charity’s post-race reception for the 2026 London Marathon. Their communication before and during the event was excellent and all our runners have commented on how much their post-race massage has helped them with their recovery. We hope to work with them again in the future
Percy C. profile picture
Percy C.
2 months ago
Extremely impressed by the service offered. I injured my knee a while ago and they have been amazing in helping me with me recovery. Uzair Ahmed is very knowledgable and I really trust him with my recovery journey. Would highly recommend!
Ziya H. profile picture
Ziya H.
2 months ago
Been coming here for over a year every six weeks. Very professional and friendly at the same time. Can highly recommend. Big shout out to Mohammed and great reception service.
Kevin P. profile picture
Kevin P.
2 months ago
Fantastic treatment available! Enquired at short notice and they had a superfast response, and the treatment was excellent. Thank you!!
James L. profile picture
James L.
2 months ago
The team were highly professional, pleasant and helpful throughout my process of physiotherapy. I highly recommend this therapy clinic!
Em H. profile picture
Em H.
2 months ago
Had a couple of excellent sessions with Priyanka Shah, with really useful exercises and advice. Highly recommend!
Nicola W. profile picture
Nicola W.
3 months ago
Helpful and knowledgeable. Thank you!
Richard T. profile picture
Richard T.
3 months ago
I suffer with lower back disc bulges pinching my muscles and severely limiting my mobility, stability, and indeed causing agonising pain at the worst of times. I received a kind, patient and conscientious home visit at first before being invited to hydrotherapy at the clinic. 2 sessions in and I'm loving it so much, I'm determined to get one of these pools for myself later on in life. Couldn't recommend them highly enough.
Chris C. profile picture
Chris C.
3 months ago
Miracle workers!! Great gym rehab facilities patience to really understand the problem. Would highly recommend for anyone with chronic neck or back pain who are prepared to do some work on themselves.
Arif H. profile picture
Arif H.
3 months ago
Have been attending sessions for Physiotherapy here twice a week for many weeks now. Everyone is very patient and understanding. My treatment is going exceptionally well so far and Im already seeing massive progress from before my first ever session.

Would definitely recommend this clinic for anyone who needs rehabilitation or treatment!
D.Iyalla 1 profile picture
D.Iyalla 1
4 months ago
I’ve been attending London Physiotherapy And Wellness Stratford for 3 weeks now and already there are improvements in the areas I had problems with.
The physiotherapist is very knowledgeable and passionate about how he can help to improve & build your strength.
To help you recover is his main focus.
Not only is the physiotherapists customer service is great the admin team is also.
I personally recommend.
Ollie S. profile picture
Ollie S.
4 months ago
I had to visit the clinic for a hip injury I received from running. I started physio with Anup back in November and started with hydrotherapy, moving into physio in the new year. I've had a great experience with Anup and now I'm well on the road to recovery, I've started running again and I know what strength workouts I should be doing to keep up my recovery. So glad I found Anup and the clinic and would recommend them to anyone who has an injury!
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无颜Music
4 months ago
The location is really convenient for me. The physiotherapist was very knowledgeable. He helped me identified the root cause of my heel pain and provided me with a clear pathway to my recovery.
Will recommend them ????????
Ervis L. profile picture
Ervis L.
6 months ago
I was assisted by Priyanka while recovering from a torn quad, and I couldn’t have asked for a better physiotherapist. She was incredibly supportive during a moment of real vulnerability, and I always felt truly taken care of. Her focus during every session was exceptional she even kept counting my reps to make sure I stayed on track!

Priyanka is a wonderful asset to the team, and I feel very lucky to have had her during my recovery. Highly recommended.
andrea B. profile picture
andrea B.
8 months ago
Best Physio ever. I visited the clinic after I damaged the ACL ligament practicing judo. I was unable to walk, using crutches and couldn't bend the leg. I was initially told by the doctor to wait at least 6/7 months to be fully recovered and the physiotherapy was the only way to get better. Thanks to the skilled clinic and very professional physiotherapist, they managed to get me back on trainings after 3/4 months only having now a stronger knee than before. I was assisted my Mohammed N R and his job was beyond the expectations. They have specific equipment to practice a high variety of exercises and furthermore they are super friendly and easy reachable by email or phone for last minute doubts. I cannot thank more for the assistance received for a faster recovery they granted me. I fully recommend them.

Common Causes

Shoulder Pain

  • Rotator cuff tendinopathy
    Degeneration of the rotator cuff tendons — most commonly the supraspinatus tendon — causing pain with overhead movement and loading. Often linked to repetitive overhead activity, training load, or age-related changes.
  • Subacromial impingement syndrome
    Compression of the supraspinatus tendon and subacromial bursa beneath the acromion (the bony roof of the shoulder). Typically causes pain with lifting the arm or overhead activities.
  • Rotator cuff tear
    A partial or full-thickness tear of the rotator cuff. Severity can range from minor injuries manageable with conservative treatment to complete tears requiring surgical assessment.
  • Frozen shoulder (adhesive capsulitis)
    An inflammatory tightening of the glenohumeral joint capsule, leading to progressive stiffness and significant pain. Commonly progresses through three stages: freezing, frozen, and thawing.
  • Acromioclavicular (AC) joint injury
    Often caused by a fall directly onto the shoulder or impact during contact sports.
  • Shoulder instability
    The shoulder may partially or fully dislocate or feel unstable, commonly following trauma or in hypermobile individuals. Associated injuries may include labral tears, such as SLAP tears or Bankart lesions.
  • Biceps tendinopathy or tear
    Causes pain at the front of the shoulder, often aggravated by resisted elbow flexion or forearm rotation.
  • Calcific tendinopathy
    Calcium deposits form within the rotator cuff tendons, sometimes causing sudden and severe pain.
  • Referred pain from the cervical spine
    Neck dysfunction or cervical nerve irritation can commonly refer pain into the shoulder and upper arm, making cervical spine assessment important in shoulder presentation
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Frequently Asked Questions

Rotator cuff tears range from small partial tears (which may be asymptomatic or cause mild pain) to complete full-thickness tears (causing significant weakness and pain). Symptoms suggesting a significant tear include inability to lift the arm, profound weakness, and pain that has not improved with several weeks of physiotherapy. MRI is the gold standard for imaging rotator cuff tears. Your physiotherapist will advise whether imaging is appropriate based on your clinical presentation.
Nocturnal shoulder pain is a hallmark of rotator cuff pathology and frozen shoulder. The mechanism involves compression of the rotator cuff and subacromial bursa with the arm in certain positions, and an increase in inflammatory cytokines at night. It is a significant indicator that the condition needs active management.
No. The majority of shoulder conditions — including most rotator cuff tendinopathy, impingement, and partial rotator cuff tears — are managed successfully with physiotherapy. Surgery is indicated for full-thickness rotator cuff tears in active individuals where conservative treatment has failed, labral instability not responding to rehabilitation, and certain AC joint injuries. Our physiotherapists will advise honestly about when surgical opinion is warranted.
Subacromial impingement refers to compression of the supraspinatus tendon in the subacromial space during elevation — causing pain without structural disruption of the tendon. A rotator cuff tear involves actual disruption of tendon fibre continuity. Both can cause similar symptoms (shoulder arc pain, overhead pain, night pain) but require somewhat different management approaches. Imaging distinguishes the two definitively.
Shockwave therapy is particularly effective for calcific tendinopathy of the rotator cuff and for chronic tendinopathy not responding to physiotherapy. For standard impingement without calcification, physiotherapy is the primary intervention. Your assessment at LPAW will clarify whether shockwave is appropriate for your specific diagnosis.
Without treatment, frozen shoulder typically runs its natural course over 1–3 years. With physiotherapy, most patients achieve good functional recovery within 12–18 months, and many significantly faster. The condition does eventually resolve in the majority of cases — but waiting untreated costs months of unnecessary pain and disability.

Recovery

Recovery Timeline
  • Rotator cuff tendinopathy / impingement
    Most cases improve with approximately 8–16 weeks of physiotherapy.
  • Frozen shoulder
    Without treatment, symptoms may last 1–3 years. Physiotherapy can significantly shorten recovery time, with many patients achieving meaningful improvement within 3–6 months of starting treatment.
  • AC joint injury (Grade I–II)
    Typical recovery time is around 4–8 weeks.
  • Calcific tendinopathy
    Often responds well to 3–6 sessions of shockwave therapy, with continued improvement over the following 8–12 weeks.
  • Post-surgical rehabilitation (rotator cuff repair or labral repair)
    Functional recovery usually takes 4–6 months, while return to sport or heavy overhead activity may take 9–12 months.
  • Don’t avoid all movement
    Complete immobilisation can worsen shoulder conditions. Keep the shoulder moving within a comfortable range where possible.
  • Postural awareness
    Rounded shoulders and forward head posture reduce the subacromial space and may increase impingement risk. Improving thoracic mobility and posterior shoulder flexibility can help.
  • Sleep position
    If symptoms worsen when lying on the affected side, try sleeping on your back or the opposite side. Supporting the affected arm with a pillow may reduce discomfort.
  • Avoid overhead loading until advised
    In tendinopathy and impingement, reducing overhead activity during the acute stage is important while maintaining pain-free strengthening below shoulder height.
  • Scapular retraction exercise
    Regularly drawing the shoulder blades back and down can improve scapular positioning and reduce impingement. Correct technique should be guided by a physiotherapist.

Recovery

  • Rotator cuff tendinopathy / impingement
    Most cases improve with approximately 8–16 weeks of physiotherapy.
  • Frozen shoulder
    Without treatment, symptoms may last 1–3 years. Physiotherapy can significantly shorten recovery time, with many patients achieving meaningful improvement within 3–6 months of starting treatment.
  • AC joint injury (Grade I–II)
    Typical recovery time is around 4–8 weeks.
  • Calcific tendinopathy
    Often responds well to 3–6 sessions of shockwave therapy, with continued improvement over the following 8–12 weeks.
  • Post-surgical rehabilitation (rotator cuff repair or labral repair)
    Functional recovery usually takes 4–6 months, while return to sport or heavy overhead activity may take 9–12 months.
  • Don’t avoid all movement
    Complete immobilisation can worsen shoulder conditions. Keep the shoulder moving within a comfortable range where possible.
  • Postural awareness
    Rounded shoulders and forward head posture reduce the subacromial space and may increase impingement risk. Improving thoracic mobility and posterior shoulder flexibility can help.
  • Sleep position
    If symptoms worsen when lying on the affected side, try sleeping on your back or the opposite side. Supporting the affected arm with a pillow may reduce discomfort.
  • Avoid overhead loading until advised
    In tendinopathy and impingement, reducing overhead activity during the acute stage is important while maintaining pain-free strengthening below shoulder height.
  • Scapular retraction exercise
    Regularly drawing the shoulder blades back and down can improve scapular positioning and reduce impingement. Correct technique should be guided by a physiotherapist.

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