Shoulder pain: Difference between revisions
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==Cause/etiology== | ==Cause/etiology== | ||
Two-thirds of shoulder pain is due [[rotator cuff]] lesions.<ref name="pmid7788173">{{cite journal |author=Vecchio P, Kavanagh R, Hazleman BL, King RH |title=Shoulder pain in a community-based rheumatology clinic |journal=Br. J. Rheumatol. |volume=34 |issue=5 |pages=440–2 |year=1995 |month=May |pmid=7788173 |doi= |url=http://rheumatology.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=7788173 |issn=}}</ref> | |||
===Shoulder impingement syndrome=== | ===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."<ref>{{MeSH|Shoulder impingement syndrome}}</ref> | 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."<ref>{{MeSH|Shoulder impingement syndrome}}</ref> | ||
==Diagnosis== | ==Diagnosis== | ||
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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> | ||
==Treatment== | |||
===Acupuncture=== | |||
[[Acupuncture]] may help.<ref name="pmid18403402">{{cite journal |author=Vas J, Ortega C, Olmo V, ''et al'' |title=Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial |journal=Rheumatology (Oxford) |volume=47 |issue=6 |pages=887–93 |year=2008 |month=June |pmid=18403402 |doi=10.1093/rheumatology/ken040 |url=http://rheumatology.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18403402 |issn=}}</ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 19:36, 14 April 2009
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 rotator cuff lesions.[2]
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 with no finding having more than 80% sensitivity to diagnose the causes of shoulder pain according to a systematic review[4] and more recent research studies[5][6] 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.[7]
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.
- ↑ 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.