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Rheumatology clinic

The painful shoulder

E Michael Shanahan, Rachelle Buchbinder

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Abstract

Shoulder pain is usually manageable in primary care with a conservative approach. It often improves over time, irrespective of the cause. Red flag diagnoses, should, however, be considered first.

Article Extract

Shoulder pain is a common and often disabling complaint. It is the third most common musculoskeletal reason for attending a GP after back and neck problems and makes up 1.1% of all chronic problems and 2.5% of all work-related problems encountered by Australian GPs. In the community, the estimated prevalence of shoulder pain is between 16 and 26%. Shoulder pain is more common in middle-aged and elderly people and in certain working populations, such as those involved in frequent activities above shoulder height or in heavy lifting. Psychological aspects of the work environment also appear to play a role in shoulder pain presentations. In addition, patients with inflammatory arthritis have high rates of shoulder pain, with over 90% of patients with rheumatoid arthritis reporting shoulder involvement.

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