Why is it important to see a specialist for my shoulder pain?

By ShareMD Connect

Orthopedic specialists have specialized training in the care of bones, joints, and muscles. No one knows the complexities of the shoulder better than an orthopedist. These specialists also perform orthopedic surgery, such as joint repairs or replacements. Most orthopedists concentrate on one specific part of the body, such as the knee, hip, shoulder, hand, or spine and therefore seeking out an orthopedist that specializes in shoulders is a great start to finding the right treatment for your shoulder pain. 

Should I see my PCP first?

For short-term shoulder pain, your primary care provider should be able to perform initial assessments and develop a treatment plan. If your pain persists or your daily basic functions are becoming increasingly difficult, an orthopedic specialist evaluation is certainly appropriate. 

Signs you Need to See an Orthopedic Specialist:

If you see your primary care doctor and they suspect you may have a serious injury or tear, they may refer you to an orthopedic specialist right away. There are other signs that it’s time to see an orthopedic specialist:

  • You have chronic pain: If you experience continuous pain that does not start feeling better within two to four weeks or gets progressively worse day to day or week to week, that’s a sign you should see an orthopedic specialist.
  • Your range of motion is limited: If pain, stiffness, or weakness is keeping you from moving freely, then orthopedic doctors can help with that. Limited motion is often a symptom of an injury, arthritis, or other joint diseases. Significant weakness (sometimes without pain) is a sign you may have a rotator cuff tear. You should seek treatment when you notice that you are losing range of motion so that the condition does not get worse or require more aggressive treatment. Untreated, long-standing rotator cuff tendinopathy (tendon damage) can cause a significant loss of shoulder motion. Ultimately, adhesive capsulitis (frozen shoulder) which can be difficult to treat can result from untreated shoulder injuries and should therefore be evaluated as soon as possible.
  • You have difficulty performing everyday tasks: If you are having problems with day to day activities due to pain or limited range of motion, then you should probably see an orthopedist. These activities may include combing your hair, reaching behind your back or above your head. An orthopedic specialist can evaluate you and recommend treatments to help improve your quality of life and restore your ability to perform necessary activities on a daily basis.
  • You experience orthopedic trauma: If you are in an accident, have a fall or sustain a sports injury, you may have traumatic injury. You should be examined and monitored by an orthopedic specialist promptly to ensure that there is no irreversible damage to your bones, joints, or muscles.
What Will The Orthopedist Do?

The orthopedist will perform an exam on your shoulder and might have you undergo some of these imaging tests to help visualize what’s wrong with your shoulder:

  • X-rays are a way to diagnose bone fractures and degenerative bone disease. X-rays are not commonly used to evaluate the shoulder joint, but it depends on what the provider suspects could be the cause of your pain.
  • MRI uses radio waves and a magnet, producing 3D images of the inside of your shoulder. This technique diagnoses soft tissue injuries, including those affecting the muscles, cartilage, and tendons. MRI is used to rule out rotator cuff tear when conservative therapy fails, to assess for a suspected tear, or to aid in diagnosis. 
  • Ultrasound waves detect your shoulder’s soft tissue structure, similar to the MRI scanner but more localized. Musculoskeletal ultrasound enables your orthopedist to evaluate tendons while they are in motion and to compare them with your other shoulder. This requires specific training and regular practice, which is another reason seeing an orthopedic shoulder specialist is important. 
What Treatments Can an Orthopedist Provide?

Because an orthopedist sees and treats many of the same type of issues, they are also in the best position to be most up to date with the latest medications and treatments that are available for your shoulder pain. 

An orthopedic specialist may suggest a combination of treatments that may include physical therapy, injections (like steroid injections or viscosupplementation), or topical medications. They may also prescribe more potent NSAIDs than those you can buy over the counter. However, surgery may be recommended in specific cases.

No one knows the complexities of the human bone structures and joints better than an orthopedist.