Lasting shoulder soreness is worth a clear exam

A visit makes sense when daily use keeps getting harder

Call when soreness returns after lighter use and gentle care. Reaching, dressing, or driving may also keep getting harder.

Bring old scan reports and the names of your medicines. Include dates and results from earlier shoulder care.

The person examining you checks your neck, shoulder motion, and arm strength. You’ll point to the sore spot and show the painful movement.

The exam is like checking a loose door before buying parts. It helps match care to the part causing trouble.

Some warning signs need care without delay

Get urgent help for fever and a hot, swollen shoulder. Don’t wait when a fall leaves the arm bent or very weak.

A cool pale hand, new numbness, or fast bruising also needs prompt care. These signs can mean nerve or blood-flow trouble.

Chest pressure, sweating, nausea, jaw soreness, or breathlessness may not come from your shoulder. Call emergency services when those symptoms occur.

Call promptly if a procedure brings severe new soreness. Contact the care team or an urgent medical service.

Leave knowing what may be wrong

Ask what the person examining you thinks is wrong. Then ask whether a scan would change the answer.

You need to hear why home care, therapy, a procedure, or surgery fits now. Ask when you’ll check the result together.

The same talk should cover cost, recovery time, and activity limits. Don’t book until those points make sense to you.

You can leave without choosing a procedure that day. A useful visit still gives you a clear next step.

Sources

1. A four-arm, multicentre, single-blind phase 2/3 randomized trial of 480 knee OA patients (KL II-IV) compared autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction and allogeneic umbilical-cord-tissue mesenchymal stromal cells against a corticosteroid injection control. At 12 months NONE of the three orthobiologic injections was superior to another, or to the corticosteroid control, and none of the four groups showed a significant change in MRI osteoarthritis score from baseline. No procedure-related serious adverse events occurred.

   Mautner K, et al. — Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial.. Nature medicine, 2023. DOI: 10.1038/s41591-023-02632-w.

2. A Mayo Clinic single-blind placebo-controlled trial used each patient as their own control: 25 patients with BILATERAL knee OA received bone marrow aspirate concentrate in one knee and saline in the other. Pain fell significantly in BOTH knees at 1 week, 3 months and 6 months - and the relief, described by the authors as dramatic, did NOT differ significantly between the BMAC knee and the saline knee. No serious adverse events occurred.

   Shapiro SA, et al. — A Prospective, Single-Blind, Placebo-Controlled Trial of Bone Marrow Aspirate Concentrate for Knee Osteoarthritis.. The American journal of sports medicine, 2017. DOI: 10.1177/0363546516662455.

3. The August 2025 AAOS Evidence-Based Clinical Practice Guideline on Management of Rotator Cuff Injuries issued 25 recommendations and 4 consensus statements. Among its updates it clearly RESTRICTS the use of platelet-rich plasma and marrow stimulation in rotator cuff repair, limits prolotherapy in full-thickness tears, establishes CT as an adjunctive imaging modality, and endorses early mobilization after repair of small-to-medium tears.

   Ye Y, et al. — [Interpretation of the 2025 American Academy of Orthopaedic Surgeons (AAOS) on Management of Rotator Cuff Injuries Evidence-Based Clinical Practice Guideline].. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi, 2026. DOI: 10.7507/1002-1892.202511084.

4. In the MOON Shoulder prospective cohort of 452 patients with symptomatic, ATRAUMATIC full-thickness rotator cuff tears, physical therapy succeeded in more than 70% of patients at 10 years: only 115 (27.0%) had surgery at any point over the decade. Patient-reported outcomes improved with physical therapy and did NOT decline over 10 years in those who never had surgery. The strongest predictor of early surgery was low patient expectation of physical therapy, not tear anatomy.

   Kuhn JE, et al. — The Predictors of Surgery for Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears Change Over Time: Ten-Year Outcomes of the MOON Shoulder Prospective Cohort.. J Bone Joint Surg Am, 2024. DOI: 10.2106/JBJS.23.00978.

5. A meta-analysis of nine randomized trials (n=629) in partial-thickness rotator cuff tears and tendinopathy found statistically significant SHORT-term (6 +/- 1 months) PRP effects on pain (MD -1.56), Constant-Murley (+16.48) and SPADI (-18.78), but NO long-term effect on pain or function except Constant-Murley - i.e. the benefit may not last.

   Xiang XN, et al. — Conservative treatment of partial-thickness rotator cuff tears and tendinopathy with platelet-rich plasma: A systematic review and meta-analysis.. Clin Rehabil, 2021. DOI: 10.1177/02692155211011944.