Yes. The nerves that supply your shoulder and arm start in your neck, so neck joint or disc irritation can produce pain felt in the shoulder or upper arm. Clues include pain that changes when you turn or tilt your head, pins and needles below the elbow, and a shoulder that tests strong and moves fully despite hurting. Your physiotherapist assesses your neck and shoulder together at the first visit.

It can. The diaphragm, heart, lungs and gallbladder all refer pain to the shoulder or the tip of the shoulder blade. Warning signs are pain unrelated to shoulder movement, or pain arriving with chest tightness, breathlessness, sweating, nausea or fever. Pain like that is a medical matter first: call 000 for chest symptoms, or see your GP promptly rather than booking physiotherapy.

No. Most shoulder pain is diagnosed from your history and physical testing. Scans are used selectively because they often show tendon changes and bursal thickening in shoulders that do not hurt, which can mislead treatment. Imaging earns its place after significant trauma, when weakness suggests a full tendon tear, or when the plan is not progressing; your physiotherapist arranges it with your GP at that point.

Lying down removes the gentle traction gravity provides during the day, and lying on the shoulder compresses the tendons and bursa directly. There are also fewer distractions at night, so pain registers more. A pillow supporting the arm in front of you, or lying on the other side, reduces the compression. Night pain that regularly wakes you or makes it difficult to sleep is worth having assessed.

Usually, with changes rather than stopping. The common aggravators are overhead pressing, deep bench press, upright rows and dips. Lower body work, most pulling exercises and chest-height pressing through a comfortable range typically continue fine. Your physiotherapist maps which movements to modify, which to keep, and when to reintroduce the rest, so you hold your training habit while the shoulder settles.

Some does. Mild, recent-onset pain with an obvious trigger often settles once the load that caused it drops. Pain that has lasted more than a few weeks, wakes you at night, or comes with weakness or restricted movement tends to persist, and a shoulder guarded for months can stiffen into a bigger problem. The longer it has been there, the more an assessment earns its keep.