II. History: Injury
- Mechanism of Injury
- Direct blow to Shoulder (e.g. Fall on Shoulder)
- Fall on Outstretched Hand
- Prior Shoulder injuries or dislocations
- Shoulder Pain without Trauma is often due to Shoulder Impingement or calcific Tendinopathy
III. History: Age at onset
- Under age 40 years old
- Glenohumeral Instability (especially if history of Trauma)
- Shoulder Impingement
- Over age 40 years old
- Rotator Cuff Tear (especially if history of Trauma)
- Shoulder Adhesive Capsulitis
- Glenohumeral Osteoarthritis
IV. History: Timing
- Night pain
V. History: Provocative factors
- Pain with overhead activity
- Collision Sports or overhead activities (Throwing sports and Raquet sports)
VI. History: Associated Symptoms
- Arm weakness
- Rotator Cuff Tear (esp. complete tear)
- Shoulder Impingement
- Glenohumeral Osteoarthritis
- Peripheral Neuropathy (e.g. Cervical Radiculopathy)
- Decreased Shoulder Range of Motion
- Distal arm Paresthesias beyond elbow (esp. if Neck Pain)
- Cervical disc disorder
- Thoracic Outlet Syndrome
- Instability sensation (especially if history of prior Shoulder Dislocation)
- Catching or locking sensation
- Glenohumeral labrum tear
- Glenohumeral Arthritis
- Comorbid conditions or referred pain
- See Shoulder Pain for differential diagnosis
- Diabetes Mellitus predisposes to Adhesive Capsulitis
VII. References
- Kiel and Koneru (2019) Crit Dec Emerg Med 33(9): 17-27
- Yedlinsky (2021) Am Fam Physician 103(3):147-54 [PubMed]
