Shoulder pain is a prevalent complaint and a frequent reason for seeking medical care. By far the most common cause of shoulder pain is rotator cuff disease; while other causes include adhesive capsulitis, glenohumeral arthritis, calcific tendinitis and acute rotator cuff tear. This presentation will discuss their evidence-based management as well as known evidence-practice gaps.
Studies suggest that primary care physicians lack confidence in making specific diagnoses. In addition there is a high and generally unwarranted overreliance upon imaging (especially X-Ray and ultrasound), image-guided injection and specialist referral. Key messages include: the diagnosis can usually be made by history and physical examination alone; imaging is not required in the majority of cases and exposes patients to potential harm; shoulder pain can frequently be managed with a conservative approach and often improves over time irrespective of the cause; and image-guided glucocorticoid injections are no more efficacious than anatomically guided injections.
Disclosure of Interest None declared