Shoulder Pain Diagnosis Chart

Understanding shoulder pain

The shoulder is a complex and multifunctional joint essential for various upper-body movements. Its anatomy allows for a wide range of motion, making it vulnerable to different types of injuries and conditions that can cause pain.

The shoulder joint, also known as the glenohumeral joint, is a ball-and-socket joint formed by the upper arm bone (humerus) and the shoulder blade (scapula). This remarkably mobile joint allows for a wide range of shoulder movements but can also make it susceptible to injuries and conditions affecting the surrounding muscles, tendons, and bones (Chang & Varacallo, 2019).

Shoulder pain can arise from various causes, and a proper diagnosis is crucial for effective treatment. Effective diagnosis of shoulder pain and dislocations is vital for healthcare providers to relieve shoulder pain and determine the appropriate treatment plan for their patient's pain relief.

What is a Shoulder Pain Diagnosis Chart?

A Shoulder Pain Diagnosis Chart is a comprehensive tool that healthcare practitioners use to systematically evaluate and identify the underlying condition causing discomfort in the shoulder region. It serves as a guide, providing an organized approach to diagnosing various shoulder conditions based on the patient's symptoms, physical examination findings, and relevant diagnostic tests.

For instance, a patient's shoulder may be in pain due to shoulder dislocations or a frozen shoulder. Limited shoulder movements or a frozen shoulder means stiffness in the shoulder area, which can cause reduced mobility. On the other hand, a shoulder dislocation means the upper arm bone comes out of the shoulder socket, which can cause immediate and immense pain. Intense pain on the shoulder blade can indicate muscle strain, posture problems, or arthritis. Meanwhile, pain in the rotator cuff muscles may mean inflammation in these areas.

Our Shoulder Pain Diagnosis Chart is a pre-formatted tool designed to help you and your patients map out areas causing pain. This tool is flexible enough for left, right, or bilateral shoulder pain and differentiates between four types of significant pain. This helps identify areas of concern to plan to relieve pain and address their shoulder condition.

How does this Shoulder Pain Diagnosis Chart work?

We have aimed to keep this chart simple and widely applicable for patients experiencing shoulder pain. To make the most out of this tool, you can follow these steps:

Step 1: Add patient details

Click "Use template" to open the Shoulder Pain Diagnosis Chart and fill the several pre-formatted fields for your patient's details, including their name, identifier, and date of birth. 

Step 2: Annotate diagram(s) and/or write the location of pain

Start mapping your patient's pain on the diagram by annotating it with your digital pen or markers if you're using a printed copy of the chart. Your patient can also complete this part of the chart if they feel confident, which may provide a more accurate representation of their pain. Alternatively, you or your patient can write the location of the pain on the box provided.

Step 3: Note down symptoms and other relevant information

Note down the pain type your patient is experiencing as well as their medical history, your observations during your physical examination, and the results of the tests you've requested. These are crucial to identifying the cause, communicating with your patient, and diagnosing their shoulder pain.

Step 4: Fill in practitioner details

At the bottom of the Shoulder Pain Diagnosis Chart is space to add your details, designation, and signature. 

Step 5: Store securely

The last step is securely storing the resource as part of your patient's clinical record. To improve accessibility and utilize digital encryption, we recommend doing this digitally rather than as a paper copy. You can do this seamlessly from within the Carepatron app.

Common causes of shoulder pain

Understanding the common causes of shoulder problems is essential for better planning interventions to treat shoulder pain.

Rotator cuff tear and tendinitis

The rotator cuff is a group of four tendons that attach the shoulder muscles to the upper arm bone (humerus). Rotator cuff injuries can result from overuse, aging, or acute trauma, causing severe pain, weakness, and limited range of motion (Bigoni et al., 2019). Practitioners can use Shoulder Pain Diagnosis Charts like the Rotator Cuff Pain Location Diagram to diagnose shoulder pain in this area.

Shoulder impingement syndrome

Shoulder impingement syndrome occurs when the rotator cuff tendons become trapped and compressed against the shoulder blade, leading to inflammation and shoulder blade pain.

Frozen shoulder (adhesive capsulitis)

Frozen shoulder, or adhesive capsulitis, is a condition characterized by stiffness, pain, and limited shoulder joint mobility due to the joint capsule's thickening and tightening.

Shoulder bursitis

Bursitis is an inflammation of the fluid-filled sac (bursa) that cushions the shoulder joint, often caused by repetitive motions or injury.

Shoulder instability and dislocation

Shoulder instability or dislocation occurs when the upper arm bone (humerus) becomes wholly or partially displaced from the shoulder socket, often due to trauma or repetitive overhead activities.

Rotator cuff tendonitis

Rotator cuff tendinitis is a tendon inflammation that connects the rotator cuff muscles to the upper arm bone, typically caused by overuse or injury (Bigoni et al., 2009).

Shoulder separation or acromioclavicular (AC) joint injury

A shoulder separation or acromioclavicular (AC) joint injury involves the separation of the collarbone (clavicle) from the shoulder blade (scapula), commonly resulting from a fall or direct impact on the shoulder.

Clavicle fracture

The clavicle, or collarbone, is the most frequently broken bone. A clavicle injury can cause pain, swelling, and limited shoulder movement, often due to a motor vehicle accident or sports-related trauma.

Soft tissue injuries

Shoulder pain can also arise from injuries to the soft tissues surrounding the shoulder joint, such as the muscles, tendons, and ligaments. These injuries can result from trauma, overuse, or underlying conditions like rotator cuff tears or shoulder impingement syndrome.

Shoulder blade fractures

Fractures of the shoulder blade (scapula) are relatively uncommon but can occur due to high-energy trauma, such as motor vehicle accidents or falls from significant heights. These fractures in the shoulder blades can cause severe pain, swelling, and limited shoulder motion.

Muscle spasms and strains

Overuse, sudden movements, or underlying conditions like muscle weakness or imbalances can cause muscle spasms and muscle strains in the shoulder region. These issues can lead to pain, stiffness, and reduced shoulder mobility.

Shoulder arthritis

Arthritis in the shoulder joint can be a source of chronic pain and stiffness. Different types of arthritis, such as osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis, can affect the shoulder joints and surrounding structures.

Referred pain

In some cases, shoulder pain may be referred from other areas of the human body, such as the neck (cervical spine), which causes nerve pain, chest (heart or lungs), or upper back (thoracic spine). This phenomenon, called referred pain, can make it challenging to identify the underlying cause of shoulder discomfort.

The most vulnerable parts of the shoulder to pain and injury are the four rotator cuff tendons, which are prone to conditions like rotator cuff injuries, tears, bursitis, and tendinitis. These structures play a crucial role in shoulder stability and movement, making them susceptible to overuse, trauma, and degeneration, leading to various painful conditions that can impact the function of the shoulder joint. It is then essential for patients to protect these shoulder bones and joints to prevent shoulder pain and shoulder injury.

References

Bigoni, M., Gorla, M., Guerrasio, S., Brignoli, A., Cossio, A., Grillo, P., & Marinoni, E.C. (2009). Shoulder evaluation with isokinetic strength testing after arthroscopic rotator cuff repairs. Journal of Shoulder and Elbow Surgery, 18 2, 178-83. https://doi.org./10.1016/j.jse.2008.09.002

Chang, L. R., & Varacallo, M. (2019, February 15). Anatomy, shoulder and upper limb, glenohumeral joint. In Statpearls [Internet]. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537018/