Shoulder pain: Difference between revisions
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imported>Howard C. Berkowitz No edit summary |
imported>Robert Badgett |
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==Diagnosis== | ==Diagnosis== | ||
===History and physical examination=== | ===History and physical examination=== | ||
The history and physical examination has limited ability | The history and physical examination has limited ability to diagnose the causes of shoulder pain according to a [[systematic review]]<ref name="pmid17720798">{{cite journal |author=Hegedus EJ, Goode A, Campbell S, ''et al'' |title=Physical Examination Tests of the Shoulder: A Systematic Review with Meta-analysis of Individual Tests |journal=Br J Sports Med |volume= |issue= |pages= |year=2007 |pmid=17720798 |doi=10.1136/bjsm.2007.038406|url=http://bjsm.bmj.com/cgi/content/full/42/2/80}}</ref> and more recent research studies<ref name="pmid18006674">{{cite journal |author=Oh JH, Kim JY, Kim WS, Gong HS, Lee JH |title=The evaluation of various physical examinations for the diagnosis of type II superior labrum anterior and posterior lesion |journal=Am J Sports Med |volume=36 |issue=2 |pages=353–9 |year=2008 |pmid=18006674 |doi=10.1177/0363546507308363 |issn=}}</ref><ref name="pmid18375403">{{cite journal |author=Silva L, Andréu JL, Muñoz P, ''et al'' |title=Accuracy of physical examination in subacromial impingement syndrome |journal=Rheumatology (Oxford) |volume=47 |issue=5 |pages=679–83 |year=2008 |month=May |pmid=18375403 |doi=10.1093/rheumatology/ken101 |url=http://rheumatology.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18375403 |issn=}}</ref><ref name="pmid19887215">{{cite journal| author=Michener LA, Walsworth MK, Doukas WC, Murphy KP| title=Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement. | journal=Arch Phys Med Rehabil | year= 2009 | volume= 90 | issue= 11 | pages= 1898-903 | pmid=19887215 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=19887215 | doi=10.1016/j.apmr.2009.05.015 }} <!--Formatted by http://sumsearch.uthscsa.edu/cite/--></ref> of the topic. | |||
A more recent study suggests the Gerber test can diagnose subacromial-subdeltoid bursitis with greater than 90% sensitivity.<ref name="pmid18375403">{{cite journal |author=Silva L, Andréu JL, Muñoz P, ''et al'' |title=Accuracy of physical examination in subacromial impingement syndrome |journal=Rheumatology (Oxford) |volume=47 |issue=5 |pages=679–83 |year=2008 |month=May |pmid=18375403 |doi=10.1093/rheumatology/ken101 |url=http://rheumatology.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18375403 |issn=}}</ref> | A more recent study suggests the Gerber test can diagnose subacromial-subdeltoid bursitis with greater than 90% sensitivity.<ref name="pmid18375403">{{cite journal |author=Silva L, Andréu JL, Muñoz P, ''et al'' |title=Accuracy of physical examination in subacromial impingement syndrome |journal=Rheumatology (Oxford) |volume=47 |issue=5 |pages=679–83 |year=2008 |month=May |pmid=18375403 |doi=10.1093/rheumatology/ken101 |url=http://rheumatology.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18375403 |issn=}}</ref> | ||
Revision as of 09:18, 28 January 2010
Shoulder pain is "unilateral or bilateral pain of the shoulder. It is often caused by physical activities such as work or sports participation, but may also be pathologic in origin."[1]
Cause/etiology
Two-thirds of shoulder pain is due to rotator cuff lesions.[2] Rotator cuff strengthening and stretching should be part of athletic training programs, but the specific but simple exercises are not often done, predisposing to injury.
Shoulder impingement syndrome
Shoulder impingement syndrome is "compression of the rotator cuff tendons and subacromial bursa between the humeral head and structures that make up the coracoacromial arch and the humeral tuberosities. This condition is associated with subacromial bursitis and rotator cuff (largely supraspinatus) and bicipital tendon inflammation, with or without degenerative changes in the tendon. Pain that is most severe when the arm is abducted in an arc between 40 and 120 degrees, sometimes associated with tears in the rotator cuff, is the chief symptom."[3]
Diagnosis
History and physical examination
The history and physical examination has limited ability to diagnose the causes of shoulder pain according to a systematic review[4] and more recent research studies[5][6][7] of the topic.
A more recent study suggests the Gerber test can diagnose subacromial-subdeltoid bursitis with greater than 90% sensitivity.[6]
Treatment
Acupuncture
Acupuncture may help.[8]
Extracorporeal shock wave therapy
Extracorporeal shock wave therapy (ESWT) may help calcific tendonitis of the shoulder.[9]
References
- ↑ Anonymous (2024), Shoulder pain (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Vecchio P, Kavanagh R, Hazleman BL, King RH (May 1995). "Shoulder pain in a community-based rheumatology clinic". Br. J. Rheumatol. 34 (5): 440–2. PMID 7788173. [e]
- ↑ Anonymous (2024), Shoulder impingement syndrome (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Hegedus EJ, Goode A, Campbell S, et al (2007). "Physical Examination Tests of the Shoulder: A Systematic Review with Meta-analysis of Individual Tests". Br J Sports Med. DOI:10.1136/bjsm.2007.038406. PMID 17720798. Research Blogging.
- ↑ Oh JH, Kim JY, Kim WS, Gong HS, Lee JH (2008). "The evaluation of various physical examinations for the diagnosis of type II superior labrum anterior and posterior lesion". Am J Sports Med 36 (2): 353–9. DOI:10.1177/0363546507308363. PMID 18006674. Research Blogging.
- ↑ 6.0 6.1 Silva L, Andréu JL, Muñoz P, et al (May 2008). "Accuracy of physical examination in subacromial impingement syndrome". Rheumatology (Oxford) 47 (5): 679–83. DOI:10.1093/rheumatology/ken101. PMID 18375403. Research Blogging.
- ↑ Michener LA, Walsworth MK, Doukas WC, Murphy KP (2009). "Reliability and diagnostic accuracy of 5 physical examination tests and combination of tests for subacromial impingement.". Arch Phys Med Rehabil 90 (11): 1898-903. DOI:10.1016/j.apmr.2009.05.015. PMID 19887215. Research Blogging.
- ↑ Vas J, Ortega C, Olmo V, et al (June 2008). "Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial". Rheumatology (Oxford) 47 (6): 887–93. DOI:10.1093/rheumatology/ken040. PMID 18403402. Research Blogging.
- ↑ Gerdesmeyer L, Wagenpfeil S, Haake M, et al (November 2003). "Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial". JAMA 290 (19): 2573–80. DOI:10.1001/jama.290.19.2573. PMID 14625334. Research Blogging.