Steps to Diagnose Shoulder Pain Accurately: A Guide to Shoulder Pain Examination

Shoulder pain can be a frustrating and limiting experience. When it affects your daily activities, finding the right cause and treatment becomes essential. Over the years, I have seen many patients struggle with shoulder discomfort, and I understand how important it is to approach diagnosis carefully and methodically. In this post, I will walk you through the key steps involved in a thorough shoulder pain examination, helping you understand what to expect and how to prepare for your consultation.

Understanding the Importance of a Shoulder Pain Examination

A detailed history and examination is the foundation of effective treatment. It allows the clinician to identify the exact source of pain, whether it stems from muscles, tendons, joints, or nerves. Without a proper examination, treatment may be misguided, leading to prolonged discomfort or even worsening symptoms.

During the examination, I focus on several aspects:

• Patient history: Understanding when the pain started, its nature, and any activities that worsen or relieve it.

• Physical assessment: Observing the shoulder’s range of motion, strength, and any visible abnormalities.

• Special tests: Performing specific manoeuvres to isolate the affected structures.

  
  

This process helps narrow down potential causes such as rotator cuff injuries, frozen shoulder, arthritis, or nerve impingement.

Key Steps in a Shoulder Pain Examination

When you come in for a shoulder pain examination, here is what typically happens:

1. Detailed History Taking

   I begin by asking about your pain’s onset, duration, and characteristics. For example, is the pain sharp or dull? Does it occur during certain movements or at rest? Have you had any recent injuries or repetitive strain? This information guides the rest of the examination.

   
   

2. Observation and Inspection

   I look for swelling, bruising, muscle wasting, or deformities. Sometimes, subtle changes in posture or muscle bulk can provide clues about the underlying problem.

   
   

3. Palpation

   Gently pressing around the shoulder helps identify tender areas or abnormal lumps. This can indicate inflammation or structural damage.

   
   

4. Range of Motion Testing

   You will be asked to move your arm in different directions. I assess both active (your own movement) and passive (movement assisted by me) ranges. Limited or painful movement can point to specific conditions like frozen shoulder or tendonitis.

   
   

5. Strength Testing

   Testing the strength of shoulder muscles helps detect weakness or nerve involvement. For example, difficulty lifting the arm may suggest rotator cuff tears.

   
   

6. Special Orthopaedic Tests

   These are targeted manoeuvres designed to stress particular structures. For instance, the Hawkins-Kennedy test can indicate impingement, while the Apprehension test assesses shoulder instability.

   
   

7. Imaging and Further Investigations

   If needed, I may recommend X-rays, ultrasound, or MRI scans to get a clearer picture of the shoulder’s internal structures.

   
   

This systematic approach ensures that no detail is overlooked and that the diagnosis is as accurate as possible.

How do I know if my shoulder pain is serious?

It is natural to wonder when shoulder pain requires urgent attention. While many shoulder issues improve with conservative care, some signs suggest a more serious problem:

• Severe pain that does not improve with rest or medication

• Sudden inability to move the shoulder or arm

• Visible deformity or swelling

• Numbness, tingling, or weakness in the arm or hand

• Pain following a significant injury or fall

• Fever or signs of infection around the shoulder

  
  

If you experience any of these symptoms, it is important to seek medical advice promptly. Early diagnosis and treatment can prevent complications and improve outcomes.

Practical Tips to Prepare for Your Shoulder Pain Consultation

To make the most of your appointment, consider the following:

• Keep a pain diary: Note when the pain occurs, its intensity, and any activities that affect it.

• List previous treatments: Include medications, physiotherapy, or surgeries.

• Bring relevant medical records: Imaging reports or notes from other healthcare providers can be helpful.

• Wear comfortable clothing: This allows easy access to the shoulder during examination.

• Prepare questions: Think about what you want to know regarding diagnosis, treatment options, and recovery.

  
  

Being organised helps me provide a more personalised and effective assessment.

Moving Forward with Confidence

Accurate shoulder pain diagnosis is the first step towards regaining your quality of life. With a careful examination and a clear understanding of your symptoms, we can develop a treatment plan tailored to your needs. Whether it involves physiotherapy, medication, or in some cases, surgery, the goal is always to restore function and reduce pain.

Remember, shoulder pain is common but manageable. Taking the time to undergo a thorough shoulder pain examination ensures that you receive the right care at the right time. If you have concerns or persistent discomfort, do not hesitate to seek professional advice. Your shoulder health is vital for everyday activities, and with the right approach, you can look forward to a more comfortable and active future.