Shoulder pain is a common complaint in the family practice setting.
Shoulder pain is a common complaint in the family practice setting. In fact, the incidence of shoulder complaints is approximately 11.2 cases per 1000 patients per year. This article reviews 6 of the more common causes of shoulder pain; rotator cuff tendinitis, adhesive capsulitis, osteoarthritis, bursitis, acromioclavicular joint disorder and clavicular disorders including osteolysis and fractures.
For each condition, a brief review of pathophysiology together with an evidence-based approach to treatment will be provided. Posterior view of the rotator cuff. Anterior view of the rotator cuff.
Rotator Cuff Disease Rotator cuff disease often occurs along a continuum, starting with subacromial bursitis secondary to impingement and progressing to tendinopathy with partial or full thickness rotator cuff tears. Patients with rotator cuff tendinopathy present with pain and weakness particularly over the lateral deltoid. Pain arising from subacromial bursitis usually occurs over the anterolateral aspect of the shoulder, often with radiation to, but not usually beyond, the elbow.
Repetitive overhead activity, whether in sport or work, is a major risk factor for impingement and rotator cuff tendinopathy. Radiography may be normal but can show concomitant pathology such as glenohumeral or AC joint osteoarthritis and calcific tendinitis. Magnetic resonance imaging without contrast media is the current imaging modality of choice [5, 6] although ultrasonography is becoming more popular.
Nonoperative management of impingement and rotator cuff injuries consists of physical therapy, NSAIDS, and glucocorticoid injections. Other modalities such as platelet rich plasma are promising however there is insufficient evidence to its support at present. Surgery is rarely indicated.
If you are experiencing symptoms that may be related to 6 common shoulder conditions every physician should know, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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