Shoulder pain: diagnosis and management in primary care

doi:10.1136/bmj.331.7525.1124

BMJ 2005;331:1124-1128 (12 November), doi:10.1136/bmj.331.7525.1124

Clinical review

Shoulder pain: diagnosis and management in primary care

Caroline Mitchell, senior clinical lecturer¹, Ade Adebajo, honorary senior lecturer², Elaine Hay, professor of community rheumatology³, Andrew Carr, Nuffield professor of orthopaedic surgery⁴

¹ Institute of General Practice and Primary Care, School of Health and Related Research (ScHARR), University of Sheffield, Northern General Hospital, Sheffield S5 7AU, ² Academic Rheumatology Group, Division of Genomic Medicine, University of Sheffield Medical School, Sheffield S10 2RX, ³ Primary Care Sciences Research Centre, Keele University, Keele ST5 5BG, ⁴ Nuffield Department of Orthopaedic Surgery, University of Oxford, Oxford OX3 7LD

Correspondence to: C Mitchell c.mitchell@sheffield.ac.uk

The first 150 words of the full text of this article appear below.

Introduction

Compromised shoulder movement due to pain, stiffness, or weaknesscan cause substantial disability and affect a person's abilityto carry out daily activities (eating, dressing, personal hygiene)and work.^w1 Self reported prevalence of shoulder pain is estimatedto be between 16% and 26%; it is the third most common causeof musculoskeletal consultation in primary care, and approximately1% of adults consult a general practitioner with new shoulderpain annually.¹ Occupations as diverse as construction workand hairdressing are associated with a higher risk of shoulderdisorders. Physical factors such as lifting heavy loads, repetitivemovements in awkward positions, and vibrations influence thelevel of symptoms and disability, and psychosocial factors arealso important.^w1 Recent studies suggest that chronicity andrecurrence are common.^2
3

Common shoulder disorders exhibit similar clinical features,and the lack of consensus on diagnostic criteria and concordancein clinical assessment complicates treatment choices.³ ^w2-w5This review proposes an . . . [Full text of this article]

Sources and selection criteria

Assessment of the painful shoulder

Treatment

Biopsychosocial and complementary interventions

Further investigation

Referral criteria

Future developments and surgical interventions

Conclusions

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

Technorati What's this?

Relevant Articles

Hit parade
BMJ 2005 331: 1481. [Extract] [Full Text]

Nervous laughter: Fiona Godlee
BMJ 2005 331: 0. [Extract] [Full Text] [PDF]

Systematic review of randomised controlled trials of interventions for painful shoulder: selection criteria, outcome assessment, and efficacy: Sally Green, Rachelle Buchbinder, Richard Glazier, and Andrew Forbes
BMJ 1998 316: 354-360. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

Murphy, R., Carr, A. (2009). Management of shoulder pain in general practice. InnovAiT 2: 402-407 [Abstract] [Full text]
Rees, J. L. (2008). The pathogenesis and surgical treatment of tears of the rotator cuff. J Bone Joint Surg Br 90-B: 827-832 [Abstract] [Full text]
Mitchell, C., Adebajo, A. (2006). Primary care guidelines in rheumatology. Rheumatology (Oxford) 45: 1321-1321 [Full text]
(2005). Hit parade. BMJ 331: 1481-1481 [Full text]

Rapid Responses:

Read all Rapid Responses

thoracic oulet syndrome undiagnosed cause of shoulder pain: Carlos A Selmonosky
bmj.com, 11 Nov 2005 [Full text]
Only your thumb...........!!! for the shoulder: harold jitschak bueno de mesquita
bmj.com, 11 Nov 2005 [Full text]
musculo skeletal medicine: Fenella Lemonsky
bmj.com, 13 Nov 2005 [Full text]
�Shoulder pain��A pain in the neck�!: Sidha Sambandan
bmj.com, 14 Nov 2005 [Full text]
Shoulder pain and acupuncture/CAM provision in the NHS: Tanya Trayers
bmj.com, 16 Nov 2005 [Full text]
Re: Shoulder pain and acupuncture/CAM provision in the NHS: John P Heptonstall
bmj.com, 17 Nov 2005 [Full text]
Back to basics: Richard Bartley
bmj.com, 18 Nov 2005 [Full text]
Re: Re: Shoulder pain and acupuncture/CAM provision in the NHS: John P Heptonstall
bmj.com, 18 Nov 2005 [Full text]
What Basics Are We talking About?: Dr. Herbert H. Nehrlich
bmj.com, 19 Nov 2005 [Full text]
Re: Back to basics: John P Heptonstall
bmj.com, 19 Nov 2005 [Full text]
Diagnosis first, treatment second; Patterns of pain: Gavin R Tait
bmj.com, 19 Nov 2005 [Full text]
Re: Diagnosis first, treatment second; Patterns of pain: Richard Bartley
bmj.com, 21 Nov 2005 [Full text]
corticosteroids are effective for rotator cuff disorders: Bruce ARROLL
bmj.com, 27 Nov 2005 [Full text]
Is Steroid Injection The Best Option ?: Dr. Herbert H. Nehrlich
bmj.com, 28 Nov 2005 [Full text]
No treatment without diagnosis: Gabriel Symonds
bmj.com, 21 Dec 2005 [Full text]