Red flags & when to go in person for Shoulder Pain (Strain/Tendinitis) in Children

Audience: pediatric

Shoulder pain in children from strain or tendinitis often happens after activity or injury and usually improves with rest and simple care. Many cases can be managed through telemedicine by discussing symptoms, activity history, and pain level. However, some signs mean your child needs to see a healthcare provider in person promptly. These include severe pain, swelling, inability to move the shoulder, fever, or signs of infection. Early in-person evaluation helps prevent complications and ensures proper treatment. This guide helps families understand when telemedicine is appropriate and when urgent in-person care is needed for shoulder pain in children.

Red flags — go in person / ER

• Severe shoulder pain not relieved by rest or medication — seek urgent in-person evaluation.
• Swelling, redness, or warmth around the shoulder with fever — possible infection needing immediate care.
• Inability to move the shoulder or arm, or numbness/weakness — urgent assessment required.

What telemedicine can do

• Assessment of mild to moderate shoulder pain from strain or tendinitis.
• Guidance on home care, pain management, and activity modification.
• Monitoring recovery progress and advising on exercises.

What telemedicine cannot do

• Evaluation of severe pain, swelling, or signs of infection.
• Diagnosis and treatment of fractures or dislocations.
• Assessment of neurological symptoms like numbness or weakness.

What is Shoulder Strain and Tendinitis in Children?

Shoulder strain happens when muscles or tendons around the shoulder stretch or tear. Tendinitis means the tendons are inflamed, often from overuse. Both can cause pain, stiffness, and trouble moving the shoulder. These conditions are common in active children and usually improve with rest and gentle care.

When Can Telemedicine Help?

Telemedicine can help by letting you talk to a healthcare provider about your child's symptoms. The provider can guide you on home care, pain relief, and when to watch for warning signs. You can also learn exercises to help recovery and understand how to avoid further injury.

Red Flags That Need In-Person Care

Certain signs mean your child should see a healthcare provider in person right away:

These may indicate a more serious problem like a fracture, infection, or nerve injury.

How to Prepare for a Telemedicine Visit

Before your tele-visit, gather information such as:

Have a quiet space with good lighting and a device with a camera to show the shoulder if needed.

After the Telemedicine Visit

Follow the care instructions provided by the healthcare provider. This may include rest, ice, over-the-counter pain medicine, and gentle exercises. Watch for any red flag signs and seek in-person care if they appear. Schedule follow-up visits if recommended to monitor progress.

How to prepare for your tele-visit

• Note when the shoulder pain began and any injury or activity that caused it.
• Observe and record the pain severity and any changes with movement.
• Check for swelling, redness, or warmth around the shoulder.
• Test your child's ability to move the shoulder and arm.
• Have a device ready with a camera for showing the shoulder area.
• Prepare to describe any other symptoms like fever or numbness.

After your tele-visit

• Follow the healthcare provider's advice on rest and pain relief.
• Apply ice to reduce pain and swelling as recommended.
• Encourage gentle shoulder movements or exercises if advised.
• Monitor for any worsening symptoms or red flags.
• Schedule follow-up appointments if suggested.

FAQs

Can shoulder strain or tendinitis in children heal without seeing a doctor?

Many mild cases improve with rest and simple home care. However, if pain is severe, lasts more than a few days, or is accompanied by other symptoms, it's important to see a healthcare provider.

What activities can cause shoulder strain or tendinitis in kids?

Repetitive overhead activities like throwing, swimming, or carrying heavy backpacks can strain shoulder muscles and tendons. Sudden injuries from falls or sports may also cause strain.

Is it safe to give my child pain medicine for shoulder pain?

Over-the-counter pain relievers like acetaminophen or ibuprofen are often safe for children when used as directed. Always follow dosing instructions and check with a healthcare provider if unsure.

When should I take my child to the emergency room for shoulder pain?

Go to the emergency room if your child has severe pain, cannot move the shoulder or arm, has numbness or weakness, or shows signs of infection like fever with redness and swelling.

Sources

1. Shoulder Pain in Children — MedlinePlus, U.S. National Library of Medicine.
2. Tendinitis and Bursitis — Mayo Clinic.
3. Muscle Strain — Centers for Disease Control and Prevention (CDC).
4. Pediatric Musculoskeletal Injuries — American Academy of Pediatrics.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child shows any red flag symptoms or if you are concerned about their health, seek prompt evaluation by a healthcare professional in person.