My mother is having chronic shoulder pain that just doesn't seem to respond to pain relievers. I'm thinking about having her see someone but I don't know who to go to. We have a sports clinic in our town but do they know much about older adults? What do you advise?

You may want to start with her primary care physician -- the doctor who sees her most regularly for all health concerns. He or she will have a good idea of your mother's history and general health that might contribute to a shoulder problem. Although most shoulder pain is really caused by an underlying soft tissue or musculoskeletal problem, there can be other systemic causes of shoulder pain (e.g., bleeding ulcer, tumor, infection). If she doesn't have a regular doctor, this might be a good time to establish one -- perhaps someone who has experience and training in working with older adults. Evaluating pain and problems in the shoulder is different when the patient is older. The underlying causes aren't the same as in active, younger adults. Older adults have more degenerative disease or injuries from falls. Younger adults experience more injuries from sports or athletic participation. If you are still interested in seeing someone at a specialty clinic like the sports clinic in your local area, give them a call. They may have someone on staff who specializes in all ages. With the increased interest on the part of older adults in staying physically active, some sports physicians follow their patients from the cradle to the grave.

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