Most people will experience shoulder pain at some point in their lives. Usually this pain is self-limiting and resolves on its own with a little TLC within a few a days. Unfortunately, pain that doesn’t disappear can be alarming. Not to fear, even in these cases, the cause can be benign and just needs some non-surgical conservative management to improve. When should you be concerned though and what should you do when the pain just won’t go away?

1.     Most types of strains and sprains of the shoulder will usually get better with some activity modification, ice and the use of anti-inflammatories. A shoulder strain can take 4-6 weeks to improve with these measures as that is how long our biology requires to heal itself. What we are looking for is a progressive improvement in pain, indicating that the strain is healing. 

2.     In those cases where the pain just hasn’t gotten better, and especially if it’s getting worse, you may want to consider getting help from a shoulder specialist. Oftentimes the pain persists due to deconditioning of the shoulder, aggravating the underlying shoulder strain. A short course of physical therapy and a home exercise program is the best option to getting you on your way to a pain-free shoulder. Sometimes your physician may also recommend an injection of steroid or PRP (platelet-rich plasma) to help decrease the inflammation to allow you to better participate in your therapy and get the maximum benefit from these exercises. 

3.     For those patients that suffer a traumatic injury or sudden onset of pain from a known cause, seeking the advice of a professional sooner rather than later may be the better option. The concern would be that you have suffered a rotator cuff tear (click on link to read about this). Some patients may not even be able to raise the arm due to this tear and this is called pseudoparalysis. In this instance, surgery may be a more appropriate option depending on your age, level of activity, concurrent medical problems, etc. Just like every person is different, every patient with a tendon tear is different and that’s why a comprehensive treatment plan should be patient-centered and not based solely on the diagnosis.

4.     Take home message: most shoulder pains are common and will get better on their own and without surgery. However, if the pain doesn’t improve or if you have a lot of weakness, surgery may be the best option.