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Shoulder Pain Management Guidelines

This document provides management guidelines for common shoulder problems. It lists red flags that warrant urgent referral, such as mass, swelling, trauma, suspected malignancy, or neurological deficit. It then categorizes common shoulder issues by age group and lists recommended treatments or referrals. These include referral for surgical stabilization for instability in patients aged 10-35, possible rotator cuff repair for acute tears in patients over 20, and surgical or nonsurgical options for conditions like impingement, frozen shoulder, and arthritis depending on patient age and symptoms.

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21 views1 page

Shoulder Pain Management Guidelines

This document provides management guidelines for common shoulder problems. It lists red flags that warrant urgent referral, such as mass, swelling, trauma, suspected malignancy, or neurological deficit. It then categorizes common shoulder issues by age group and lists recommended treatments or referrals. These include referral for surgical stabilization for instability in patients aged 10-35, possible rotator cuff repair for acute tears in patients over 20, and surgical or nonsurgical options for conditions like impingement, frozen shoulder, and arthritis depending on patient age and symptoms.

Uploaded by

ula
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Management Guidelines [Link].

uk
for Patients with
Shoulder Problems
RED FLAGS
Mass   /   swelling   •   Trauma   •   Suspected   malignancy   •   Redness/  
fever  •  Acute  Neurological  deficit  
URGENT REFERRAL
Age: 10-35
• Has the shoulder ever
come out of joint?
• Anxiety that the Referral for surgical
Instability stabilisation
shoulder may dislocate
with certain movements
or positions?

Age: 20+
• Hx of acute event Acute  Rotator  Cuff   Refer for possible rotator cuff
Tear   repair
• Pain lateral to acromion
+/- unable to elevate arm

Age: 20+ Refer for


• Pain over AC joint Acromioclavicular surgical
• Worse with movement joint disease opinion:
• Tender over AC joint Rest AC Joint
NSAID’s excision
Age: 35-75 physio
• Pain lateral to acromion injection Refer for
• Pain during shoulder Impingement / surgical opinion
elevation ‘painful arc’ Rotator cuff tear Subacromial
• Impingement tests Decompression
positive Rotator Cuff
Repair

Age: 40-60
• Reduction in active & < 6-12/12 intra-articular
passive range of movement Frozen  shoulder   injection and physiotherapy
Especially external rotation
• Acute painful phase
• Normal X-Ray > 6-12/12
MUA / capsular release
Age: 60+
• Reduction in active &
passive range of movement
Especially external rotation
Arthri0s   Refer for joint replacement
• No Acute painful phase
• Abnormal X-Ray
Mr.  Duncan  Tennent  FRCS(Orth)  2008  

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