Shoulder pain after a car crash: when it is more than a bruise

In a crash, the seat belt holds you right across the shoulder, and many drivers brace against the steering wheel at the last second. So it is not unusual for the shoulder to hurt in the days that follow. Most of the time it is a bruise that heals on its own, but sometimes there is an injury worth finding early.

When it is urgent

MedlinePlus, from the U.S. National Library of Medicine, says to go to the emergency room if you have just had a severe injury and your shoulder is very painful, swollen, bruised or bleeding.

And one warning that has nothing to do with the crash but matters: sudden pain in the left shoulder can be a sign of a heart attack. If you feel pressure or crushing pain that spreads to your chest, jaw, arm or neck, or it comes with shortness of breath, dizziness or sweating, call 911.

The rotator cuff

It is the group of muscles and tendons that keeps the shoulder in place and lets you lift and rotate your arm. The American Academy of Orthopaedic Surgeons explains that an injury can tear it: for example, a fall on an outstretched arm or a hard, jerking pull. Sudden tears often cause intense pain, a snapping feeling and immediate weakness in the arm.

Other symptoms of a tear:

• Pain at rest and at night, especially when lying on that shoulder.
• Pain when lifting or lowering the arm.
• Weakness when lifting or rotating the arm.
• A crackling feeling with certain movements.

When to see your doctor

According to MedlinePlus, make an appointment if:

• The pain comes with fever, swelling or redness.
• Moving the shoulder, or having someone else move it, causes significant pain.
• The pain lasts more than 2 to 4 weeks, even with home care.
• The shoulder is swollen or the skin looks red or blue.

After a crash, it is also worth getting checked early even if the pain is moderate: that way it is documented from the start.

In the meantime, at home

• Ice: 15 minutes on, 15 minutes off, 3 to 4 times a day for 2 or 3 days. Never directly on the skin.
• Rest: for a few days, then slowly return to your activities.
• Over-the-counter pain relievers, such as ibuprofen or acetaminophen, as your doctor advises.

How it is diagnosed and treated

The doctor checks the shoulder’s movement and strength, and also the neck, to rule out a pinched nerve. X-rays are usually the first test, although they do not show the tendons; MRI or ultrasound does that.

The good news: according to the AAOS, in 80 to 85% of patients, nonsurgical treatment, with rest, physical therapy, anti-inflammatories and sometimes an injection, relieves pain and improves movement. Surgery is mainly considered when pain continues despite treatment, when there is significant weakness or after a recent, severe injury.

How we handle it at the clinic

We assess you, document what we find and, if needed, refer you for imaging (X-ray or MRI), physical therapy or a specialist. In Utah, care for the accident is normally covered by the PIP on your own auto policy, and if you have an attorney we share your records with them directly. The visit happens in English or Spanish, whichever you prefer.

Sources

• MedlinePlus, U.S. National Library of Medicine. Shoulder pain.
• American Academy of Orthopaedic Surgeons (OrthoInfo). Rotator Cuff Tears.

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This article is general information about our clinic and about shoulder pain. It is not medical or legal advice and does not replace a consultation with a professional. If you have a medical emergency, call 911.