Muscle spasm in shoulder: causes and treatments

If your shoulder feels unusually tight, or it feels like your shoulder muscles are twitching, you may have a muscle spasm in your shoulder. 

Everyday activities — from spending long hours at a desk to trying a new workout or even feeling more stressed than usual — can all affect how your shoulder feels. “While shoulder muscle spasms can range from a mild annoyance to something more uncomfortable, they usually improve on their own with time and conservative, at-home treatments,” says Melia Lewis, PT, DPT, a Hinge Health physical therapist.

Here, learn what causes a muscle spasm in the shoulder, as well as ways to treat and prevent them, especially with exercises recommended by Hinge Health physical therapists.

What is a shoulder muscle spasm? 

 A muscle spasm in the shoulder is when the muscles in and around your shoulder — like those in your upper back or the front of your chest — tighten up. This sensation is known as an ‌involuntary muscle contraction. Sometimes a muscle spasm can feel like a brief twitch. But if muscles stay in that contracted, tight position, it can lead to a muscle knot and make movement uncomfortable.  

“Shoulder twitching is usually more of an annoyance, while intense muscle tightness can sometimes feel uncomfortable or even painful,” says Dr. Lewis. 

What causes muscle spasms in the shoulder blade?

Shoulder muscle spasms and twitching can have a variety of causes, many of which are linked to your everyday habits and routines, says Dr. Lewis. Some common reasons you might notice muscle spasms in your shoulder include:

• Overuse or strain. After a challenging workout or activities that require a lot of reaching overhead, your shoulders can feel overworked, which can lead to a muscle knot, or a hard, lumpy spot in your muscle. Similarly, if muscle fibers become overstretched during an activity, it can lead to ‌‌a shoulder muscle strain, leading to involuntary muscle contractions and spasms. 

• Muscle fatigue from repetitive motions. Doing the same movements over and over again, like lifting objects above your head, can overload or fatigue your muscles. This can make muscle fibers feel sensitive, leading to shoulder muscle twitching. 

• Office ergonomics. Sitting at a desk for long periods with rounded shoulders can strain your shoulder muscles. “You might notice twitching or spasming, especially on the same side you use your computer mouse, because those muscles are holding the same position for a while,” says Dr. Lewis. Taking breaks to do stretches at your desk and change positions can keep your shoulders feeling comfortable throughout the day.

• Dehydration. Your muscles need enough water and electrolytes to function well. If you’re not staying hydrated or you’ve been sweating a lot (which can lower electrolytes like sodium), you might notice muscle twitching in your shoulder as a result.

• Anxiety or stress. When you’re under a lot of stress or feeling anxious, you might notice your shoulders feeling tense, almost as if they’re creeping up toward your ears. “This muscle tension can sometimes lead to twitching or spasms in your shoulders,” says Dr. Lewis. Taking a moment to relax or reset your posture can help ease that tension.

• Muscle weakness. When your shoulder muscles aren’t regularly challenged, they may not feel as strong or supportive during daily activities. “This can make you more likely to experience shoulder pain and muscle spasms,” says Dr. Lewis. Regular movement, especially shoulder strengthening exercises (like bent over row and superman) can help your shoulders feel stronger and more resilient.

• Frozen shoulder. If you develop frozen shoulder, it’s common for your shoulder to feel tense or even go through periods of sudden discomfort that can feel a lot like muscle spasms. 

What are symptoms of shoulder muscle spasms?

There are several telltale signs of a shoulder muscle spasm. Some of the most common signs of a shoulder muscle spasm include: 

• A twitching sensation in your shoulder 

• Shoulder pain that may be accompanied by upper back, neck, or upper arm pain 

• Muscle stiffness or tension in your upper back and shoulder 

• Difficulty lifting your arm overhead on the affected side

Doing a combination of gentle stretching and strengthening exercises for your shoulder is a great way to prevent and relieve muscle spasms. “Stretching helps your muscles stay relaxed, while strengthening makes it easier for your shoulders to move comfortably and maintain different positions throughout your day,” says Dr. Lewis.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

What are the treatment options for muscle spasms in the shoulder?

Simple at-home strategies are often enough to help ease shoulder muscle spasms, says Dr. Lewis. These include:

• Try physical therapy and targeted exercises. Targeted exercises can help strengthen weak muscles and stretch tense ones that contribute to spasms. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Engage in gentle movement. It might feel counterintuitive to exercise when you’re uncomfortable, but movement is a simple way to release tension in your shoulder muscles — and your entire body. Even a short walk or quick yoga practice during your work break can help boost blood flow to tense areas, says Dr. Lewis. 

• Apply heat therapy. Applying a hot pad directly on your shoulder can help promote blood flow in muscle tissue, which can in turn ease tension and may even prevent muscle twitching or spasms. You can also take a hot shower or sit in a sauna.

• Adjust your sleep position. If you often have shoulder spasms at night, changing how you sleep may help. Sometimes stomach sleeping can put more strain on your neck and shoulder muscles. Consider sleeping on your back or sleeping on the unaffected shoulder side instead. 

• Try over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can perform your targeted exercises and stay active when you have a shoulder muscle spasm. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• Get a massage. Doing a self-massage or getting one done by a professional can help break up muscle tension and improve circulation to the area. A trigger point massage can be especially helpful if a muscle knot is the reason your shoulder muscle is spasming. You can also use a massage gun to ease neck and shoulder pain. 

• Consider acupuncture or dry needling. Talk to your provider if you’re interested in trying alternative treatments for alleviating a muscle spasm in the shoulder, such as acupuncture and dry needling. An acupuncturist or a physical therapist with dry needling training can release muscle knots or trigger points that may be contributing to your muscle spasm.

• Try TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle electrical impulses to interact with your nervous system and help reduce pain associated with muscle spasms in the shoulder. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

How can I prevent shoulder muscle spasms?

Sometimes a shoulder muscle spasm comes on without warning. But there are a few things you can do to lower your chances of getting one. Tips include: 

• Prioritize hydration. Make sure you drink plenty of fluids throughout the day. Keeping water at your desk can help you stay hydrated all day long. “Both water and electrolyte-infused beverages can play an important role in muscle health and function,” says Dr. Lewis. 

• Practice stress reduction. It’s common to hold stress in your shoulders. In addition to physical movement, Dr. Lewis encourages doing activities that help you relax emotionally and mentally, such as meditation or deep breathing exercises.

• Do more stretching. Gentle stretches like the ones above can help your shoulders feel looser and more comfortable. Try weaving these moves into your day — maybe during work breaks or while you’re preparing dinner — to help release shoulder tension.

• Change positions frequently. There’s no right or wrong posture. The most important thing is to switch positions as much as possible throughout the day, because your muscles like variety. If you sit at a desk, it may help to set an alarm every hour or so to remind yourself to switch up how you’re sitting or get up to move your body. 

Should I see a doctor for shoulder spasms?

Muscle spasms often improve on their own with conservative treatments. But if your spasms are severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. 

PT tip: Change your desk setup

If your shoulders feel tight after working at a desk, try making small adjustments to your chair or desk. “If your chair arm rests are too high or too low while you work, it can leave your shoulder feeling tense or uncomfortable,” says Dr. Lewis. Finding a setup that feels natural for you can help your shoulders stay more relaxed.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Painful Shoulder: Exercise Can Reduce Pain and Improve Mobility and Function. (2020). Journal of Orthopaedic & Sports Physical Therapy, 50(3), 142–142. doi:10.2519/jospt.2020.0501

2. Pieters et al. (2020). An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain. Journal of  Orthopedic & Sports Physical Therapy, 50(3):131-141. doi:10.2519/jospt.2020.8498

3. Barley, O. R., Chapman, D. W., Blazevich, A. J., & Abbiss, C. R. (2018). Acute Dehydration Impairs Endurance Without Modulating Neuromuscular Function. Frontiers in Physiology, 9:1562. doi:10.3389/fphys.2018.01562