With SMH Orthopedic Surgeon Brian Schofield, MD
Written by SMH Copywriter Philip Lederer
Aches and pains in shoulder muscles and joints are unavoidable facts of life. Oftentimes, they come with aging, but some are caused by stress, lifestyle or from trying that popular new workout that involves pushing tractor tires across the park.
So, between the workouts, awkward office posture and rising years, how do you differentiate healthy soreness and pain that signifies a bigger problem? How do you know when to hit the medicine cabinet and when to hit the doctor’s office?
Here, Orthopedic surgeon Brian Schofield, MD, lifts the curtain.
Know Your Pain
“The number one driver for any type of shoulder surgery is pain,” says Dr. Schofield, who specializes in shoulder and elbow surgery. The leading exception would be in the case of a torn labrum — the cartilage rim reinforcing the socket joint of the shoulder — which causes the shoulder to dislocate frequently. “Even if you don’t have pain, it becomes debilitating because you can’t trust your shoulder,” he says, and that is absolutely a cause to see a shoulder specialist.
Here are a few key factors to keep in mind when assessing your shoulder pain and gauging whether or not you should see a specialist.
Duration: Most pain from stress or minor strain can be treated effectively at home with a combination of rest, ice packs, heat therapy and over-the-counter medication, but if pain is persistent and lasts for longer than a few days, talking with a medical professional is advised. If pain continues for weeks, that’s an indication that something probably more serious is going on,” says Dr. Schofield.
Timing: Shoulder pain while actively using a sore muscle is expected to some degree, but pain while at rest is a different matter. The number one time that most people with shoulder problems have pain is at night.
“They can’t sleep,” Dr. Schofield explains. “So, if your pain is significant enough that you’re having trouble sleeping, that’s usually a good indicator that something more serious is going on. And that’s notorious for any kind of shoulder problem.”
Your shoulder might even feel good during the day, but if it’s painful at night, no matter what side you’re sleeping on, bring it to the attention of a specialist. “Nighttime shoulder pain is a major driver to seek treatment,” he says.
Effect: Soreness in the shoulder is one thing; debilitating pain is another.
"If the pain affects your ability to use your arm, either for work or recreation, then it’s time to see somebody,” Dr. Schofield advises.
An Exception for Trauma
A notable exception to these guidelines is in cases of trauma. If you’ve experienced a fall or other traumatic injury that leads to shoulder pain, do not wait weeks to see whether the pain goes away. Persistent pain lasting even a week can be cause for concern — especially for older patients.
“If there’s a trauma and they’re having shoulder pain, the threshold for seeing someone should be a lot lower, because a lot of things can hide,” Dr. Schofield says. “There are a lot of patients who fall down and don’t know that they have actually broken their shoulder.”
Consequence of Delaying Care
Delaying treatment for shoulder pain is not recommended, as a general rule. And while permanent shoulder damage due to a delay in care is unlikely, “you can certainly make your situation worse,” says Dr. Schofield. This is particularly true when someone decides to play doctor and fashion a homemade sling for a persistently painful shoulder. “That’s a common problem,” he says.
Why? Stiffness. Homemade slings without proper calibration or use often leads to debilitating stiffness that only ends up increasing the pain and prolonging recovery. Leaving an untreated shoulder in a sling for long periods with regular physical therapy leads to such stiffness that sometimes all mobility is lost without extensive rehabilitation.
“It’s worth it to go see somebody, so that you don’t make a mistake like that,” Dr. Schofield says.
As a Sarasota Memorial copywriter, local journalist Philip Lederer crafts a variety of external communications for the healthcare system. He earned his master’s degree in public administration and political philosophy from Morehead State University, Ky.