Shoulder Pain: Causes, Treatments, and When to Seek Help - Orthopedics

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Shoulder pain can be a complex issue, especially following an injury such as a car accident. Based on your description, it seems that you have been experiencing persistent pain and limited mobility in your right shoulder and elbow for several months. This is not uncommon after trauma, and it can be attributed to various factors, including soft tissue injuries, nerve involvement, or even joint issues.


Understanding the Causes of Shoulder Pain
1. Rotator Cuff Injury: One of the most common causes of shoulder pain is a rotator cuff injury. This can range from tendinitis to complete tears of the rotator cuff muscles, which are crucial for shoulder movement. Symptoms often include pain, weakness, and limited range of motion, especially when lifting the arm.

2. Adhesive Capsulitis (Frozen Shoulder): This condition can develop after an injury or surgery, leading to stiffness and pain in the shoulder joint. It can make it difficult to move the shoulder and can be quite painful, especially at night.

3. Bursitis: Inflammation of the bursa (a fluid-filled sac that reduces friction between tissues) can also cause shoulder pain. This is often associated with rotator cuff injuries and can lead to swelling and discomfort.

4. Nerve Impingement: If there is compression of the nerves in the neck or shoulder area, it can lead to pain radiating down the arm, numbness, or weakness.

5. Referred Pain: Sometimes, pain in the shoulder can be referred from other areas, such as the neck or even the heart, so it’s essential to rule out other causes.


When to Seek Medical Help
Given that your symptoms have persisted for several months and have not improved with conservative treatment, it is advisable to seek further medical evaluation. Here are some signs that indicate you should see a doctor:
- Persistent Pain: If the pain is severe and does not improve with rest or over-the-counter medications.

- Limited Range of Motion: If you cannot move your shoulder or elbow without significant pain.

- Numbness or Weakness: If you experience numbness, tingling, or weakness in your arm or hand.

- Difficulty Performing Daily Activities: If the pain interferes with your ability to perform everyday tasks, such as dressing or lifting objects.


Recommended Actions
1. Consult a Specialist: If you haven't already, consider seeing an orthopedic specialist or a sports medicine physician. They can provide a more comprehensive evaluation and may recommend imaging studies such as an MRI or ultrasound to assess soft tissue injuries.

2. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can design a rehabilitation program tailored to your needs, focusing on strengthening the shoulder and improving flexibility.

3. Injections: Corticosteroid injections may be considered to reduce inflammation and pain, especially if bursitis or tendinitis is suspected.

4. Alternative Imaging: If you are waiting for an ultrasound appointment, you might want to inquire about the possibility of getting an MRI, which can provide more detailed information about soft tissue injuries.

5. Pain Management: Since you have a history of liver issues, discuss pain management options with your doctor that do not involve NSAIDs, such as physical therapy, acupuncture, or topical treatments.


Conclusion
Shoulder pain can significantly impact your quality of life, and it’s essential to address it proactively. Given your ongoing symptoms and the fact that conservative treatments have not yielded satisfactory results, it would be prudent to pursue further evaluation and possibly change healthcare providers if you feel your current treatment plan is not effective. Remember, early intervention can often lead to better outcomes, so don’t hesitate to seek the care you need.