Shoulder pain creeps into everything, from reaching for a seatbelt to serving at padel or lifting a bag into the overhead locker on the flight into Nice. Most shoulder pain comes from the rotator cuff tendons, a stiff joint capsule or the neck, and manual therapy plus a sensible plan gets most people using their arm again. As an osteopath, I work out where your pain comes from and treat the shoulder, neck and upper back together.
I am Aloïs Ruetsch, an English-speaking osteopath and manual therapist in central Nice, with 15 years of practice and more than 10,000 consultations. If you see a chiropractor or a manual therapist back home, a French osteopath is the closest equivalent.
This article covers rotator cuff problems, frozen shoulder, the evidence, and when to see a doctor.
The essentials
- Most shoulder pain comes from the rotator cuff tendons or a stiff joint capsule (frozen shoulder), or is referred from the neck.
- Manual therapy helps pain and movement in the short term, best combined with a gradual loading plan; for frozen shoulder, osteopathy eases the stiff phase but cannot shorten the condition with certainty.
- Rotator cuff pain usually needs two to four sessions; frozen shoulder is a months-long story with spaced sessions.
- Keep using the arm within comfort, sleep with the arm supported, and avoid both total rest and repeated overhead strain.
- Shoulder pain with chest pressure, breathlessness or pain spreading to the jaw or arm can be a heart attack. In France, dial 15 or 112.
What causes shoulder pain?
The most common cause of shoulder pain is irritation of the rotator cuff, the group of tendons that hold the ball of the shoulder in its shallow socket and lift and turn the arm. Overhead sport such as padel, tennis, swimming and sailing, heavy luggage or years of hunching at a desk all overload these tendons. Pain is typically felt on the outside of the upper arm, worse when reaching up or behind the back and when lying on that side.
Frozen shoulder (adhesive capsulitis) is different. The capsule around the joint thickens and tightens, usually between 40 and 60 and more often in people with diabetes or thyroid problems. It starts with pain, progresses to stiffness in every direction, and slowly thaws over many months. Other causes include bursitis, the small AC joint at the top of the shoulder, osteoarthritis, instability after a dislocation, and pain referred from the neck, which is why I always examine both.
What does an osteopath actually do for shoulder pain?
I start by working out which structure is responsible, because a tendon, a frozen shoulder and a neck problem need different approaches. That means watching how you lift and rotate the arm, testing the rotator cuff muscles one by one, checking the shoulder blade, neck and upper back, and screening for anything that needs a doctor.
Osteopathy for the shoulder combines soft-tissue work on the rotator cuff, chest and shoulder blade muscles, gentle articulation and mobilisation of the shoulder joint, the AC joint and the upper back, and muscle energy techniques where you push lightly against my hand to restore rotation. Where the neck or upper back is part of the picture, I treat it too, sometimes with a short-lever manipulation of the thoracic spine, with your consent. For frozen shoulder I work within what the joint allows, because forcing it only increases pain. Every session ends with advice on using the arm, sleeping and building back to sport.
Does osteopathy work for shoulder pain and frozen shoulder?
For rotator cuff-related pain, manual therapy gives useful short-term relief and improves movement, and the evidence is best when it is combined with a programme that loads the tendon progressively. A tendon that has been irritated for months needs that gradual loading as well as osteopathy, and I say so at the first visit.
For frozen shoulder, the evidence that any treatment shortens the condition is limited. Osteopathy can ease pain, keep the neck and shoulder blade moving and improve range of motion during the stiff phase, and many patients find that helpful, but I cannot promise to speed up the thaw. Steroid injections, hydrodilatation and, rarely, surgery are medical options your doctor can discuss. Osteopaths in France do not make medical diagnoses, so an ultrasound scan or an injection goes through your médecin généraliste.
How many sessions will I need?
Rotator cuff pain and neck-related shoulder pain usually need two to four sessions of manual therapy over four to six weeks, with the gaps lengthening as you improve. A shoulder that seized after a flight or a single heavy lift may settle in one or two visits.
Frozen shoulder is a longer story. The condition itself lasts many months, so I see patients every few weeks during the painful and stiff phases, with a clear aim for each session rather than an open-ended course. If a shoulder is not improving after three or four sessions, I will say so and suggest a medical review.
What can I do myself in the meantime?
Keep using the arm for everyday tasks within comfort, because a shoulder that stops moving stiffens quickly. Avoid both extremes, total rest and pushing through sharp pain. For a few weeks, cut back on the overhead activities that provoke it, such as serving at padel, front crawl and hauling luggage, then reintroduce them gradually.
At night, lie on the other side with a pillow in front to rest the painful arm on, or on your back with a small pillow under the elbow. Heat relaxes the surrounding muscles, and ice after an aggravating activity can calm an angry tendon. Pharmacists in Nice can advise on over-the-counter pain relief. Keep your neck and upper back moving with gentle rotations, and check your desk set-up if you work remotely.
When should you see a doctor instead?
Call for emergency help if shoulder pain comes with chest pressure or tightness, breathlessness, sweating, nausea or pain spreading to the jaw, neck or arm, because this can be a heart attack. In France, dial 15 (SAMU) or 112.
See a doctor promptly if the shoulder is deformed or you cannot lift the arm at all after a fall or injury, which may mean a dislocation, a fracture or a complete rotator cuff tear; if the joint is hot, red and swollen with fever; if there is a lump, unexplained weight loss or a history of cancer; if the pain is constant and unrelieved by any position or by rest; or if you have numbness, weakness or wasting in the arm or hand. A médecin généraliste can see you without a referral and arrange an X-ray or ultrasound, and I refer on whenever the picture does not fit.
Osteopath, chiropractor or physio: who should I see in Nice?
For shoulder pain without warning signs, an osteopath is a sensible first stop in Nice, with no referral needed. Osteopaths and chiropractors are very similar hands-on professions; in France the osteopath is the everyday equivalent, with a five-year state-recognised degree, and chiropractors are far fewer.
A physiotherapist (kinésithérapeute) is the right person for a supervised strengthening programme on prescription, and for a long frozen shoulder I often suggest combining the two. Your médecin généraliste handles diagnosis, scans, injections and referral to an orthopaedic surgeon if needed. Pharmacies advise on pain relief, SOS Médecins visits at home, and 15 or 112 are for emergencies. Osteopathy complements medical care; it does not replace it.
How do I see an English-speaking osteopath in Nice?
You can reach me on WhatsApp at +33 7 71 27 24 25 or book online via Doctolib. My clinic, Pôle Ostéo, is at 22 rue Gounod in the Musicians’ quarter of central Nice. A session lasts about 45 minutes and costs €90 at the clinic. I am open seven days a week, often with same-day availability.
I also visit hotels, villas, apartments and yachts at berth in Nice and along the nearby Côte d’Azur coast for €120, with no surcharge for evenings, weekends or same-day calls. I take card or cash and give you a receipt for your insurance, in English on request. No referral is needed in France to see an osteopath or manual therapist.
In practice
Illustrative example, details changed. A deckhand on a yacht berthed in Nice came in with three weeks of pain on the outside of his right shoulder, worse when hoisting fenders and when lying on it at night. The rotator cuff tests pointed to an irritated tendon, his neck was clear, and there were no warning signs. Two sessions of soft-tissue work, mobilisation of the shoulder and upper back and muscle energy techniques eased the pain and restored his reach, and we agreed a gradual return to heavy overhead work so the tendon could adapt.
Frequently asked questions
Is an osteopath the same as a chiropractor?
How do I know if I have a frozen shoulder?
Can shoulder pain come from the neck?
Do I need a scan before treatment?
Can I keep playing padel or sailing?
Book an English-speaking osteopath in Nice
Clinic at 22 rue Gounod (€90) or a visit to your hotel, villa, yacht or home in Nice (€120, no surcharge). Seven days a week, often same day. Write in English, Spanish or French.