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An Open Letter to Anyone Suffering From Shoulder Pain

Are you suffering from shoulder pain?

Your shoulder pain is personal. You have to constantly prove to your doctor that your pain is real. That you are suffering.

It’s not that your healthcare providers are insensitive to your needs.

But you wish they would…

  • listen to your story…
  • hear how your shoulder pain impacts your independence…
  • understand how it causes you to struggle daily…
  • learn of your worries and fears; your goals and aspirations.

Not just a have dispassionate discussion of how many degrees of range of motion you have left…

or how weak your muscles are

or how tight or loose or unstable your shoulder joint is…

or how bad your posture is.

Yes, it is important for us, your healthcare provider, to have access to these clinical information.

But, is that really your story? Or, is that a clinical story of your shoulder?

We are listening to you. But are we hearing what you are saying?

I can’t imagine how distressing it must be for you that we can’t understand your pain, and our treatments haven’t helped.

After all, it is not just your shoulder that is threatened by pain:

  • your sense of security and independence,
  • your identity,
  • your ability to function,
  • your very existence…

…are all threatened by your shoulder pain.

That is the story we rarely hear. That is the story we need to hear. 

Mother with right shoulder pain.

Years ago, my Mom suffered from excruciating pain on her right shoulder, and each time she would confide in me, I would give her my clinical advice.

Until finally, she said, “You just don’t know how bad my shoulder is.

She was right.

I listened to my mother with my clinical ears and gave her my sterile clinical advice. I did not hear what she was saying.

I did not hear her fear of losing her independence

I did not hear her frustration of having to ask for help to do the mundane tasks she used to do easily every day. 

I did not hear her sense of slowly losing her identity because shoulder pain has taken over her life. 

I was focused on the clinical. On the sterile. I was thinking in terms of degrees of motion and muscle grades, not her struggle and distress.

I was wrong and mistaken.

Since then, my mother has taught me to not just listen to my patients but to hear them.

She taught me to hear, acknowledge, validate, and understand… so that my patients can have the freedom to reflect on what it is they are telling me, and we both can find a mutual path to move forward.

It was only by listening to my patients that I learned how to effectively treat shoulder pain.

Now, shoulder pain is personal to me.

I learned that…

“Traditional shoulder pain treatments do not work. After all, you are a whole person, not a body part.”

The traditional approach (biomedical model) of treating only the structural component of pain (your shoulder) and expecting it to result in a reduction of pain and improvement of function simply does not work.

A biomedical model assumes that pain and tissue healing follow linear paths when in fact, they do not.

Sometimes pain can be there even if there is no structural damage to your shoulder. In fact, it is common for pain and disability to last much longer than the healing time that injured tissues require.

In other words, you may be experiencing pain even though the original injury to your shoulder has long since healed.

When we focus only on the structural or physical component of shoulder pain, we end up focusing our treatment options to pain medications, steroid injections, or even surgery. Often, to costly and ineffective results.

To fully and effectively treat shoulder pain, we need to recognize that pain is a multidimensional experience.

Yes, you do have an injured tissue in your shoulder; that is the bio or physical dimension of your shoulder pain. 

We should treat that.

However, your experience of pain is also informed by what you think about the pain, how you feel about the pain, how bad you think the pain is, and how you are reacting to the pain. These are the psychological and emotional dimensions of pain. 

The psychological component of shoulder pain.

We should address that.

What about your environment and lifestyle? 

  • Does your work require a lot of overhead tasks?
  • Are your work files or coffee cups stored on a high shelf?
  • Are your shoulder and arm positioned awkwardly on the desk when you are using your computer?
  • What does your partner or family suggest you do?
  • Do they support your recovery OR add stress to it? 

We often do not think of these things but these social and environmental dimensions also influence your experience of pain.

Wrong ergonomics causing shoulder pain.

We should manage that.

You are not just your shoulder. You are more than a body part. 

If you have been frustrated with the lack of results from the shoulder pain treatments you have received so far, it is not your fault.

Either your healthcare provider does not keep up with the latest research literature or they do not apply evidence-informed practices.

Or, they do not take your shoulder pain personally.

If you address the different components contributing to your pain experience, you will gain the power over your disability and not be constrained by pain. 

If your shoulders feel better, you will live better.

You deserve both.

Dr. Lex Gonzales
Dr. Lex Gonzales, PT, DPT is an award-winning author and speaker. On drlexgonzales.com, he provides practical information to help people over 50 get strong, healthy, and pain-free.
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