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Shoulder pain

Primarily rotator cuff pain-follows behind back and neck pain as the most frequent cause of dysfunction in the working population.

Usually related to overhead movement.

Associated with night pain.

May not necessarily be associated with weakness.

Related to bursitis, rotator cuff tear, acromion spurs, secondary impingement syndrome, post-traumatic scar formation, shoulder dislocation and os acromiale.

Painful shoulder impingement may occur up to 24% of patients with cervical radiculopathy.

One in 10 patients with cervical radiculopathy have comorbid shoulder pathology.

Injections into the cervical facet joints may manifest as shoulder pain

Common causes of shoulder pain can be broadly categorized into acute and chronic etiologies.
Acute shoulder pain often results from trauma or injury, include:
Rotator cuff injuries: ranging from tendinopathy to partial or complete tears, often presenting with pain during overhead activities and weakness on specific tests such as the empty can and external rotation tests.
Acromioclavicular joint injuries resulting from direct trauma and can present with pain localized to the superior shoulder and tenderness over the AC joint.
Dislocations/fractures: dislocations of the glenohumeral joint and fractures of the clavicle, humerus, or scapula, often resulting from falls or direct blows.
Chronic shoulder pain usually due to degenerative or overuse conditions:
Rotator cuff disorders:
tendinopathy, partial tears, and complete tears, often associated with subacromial impingement.
Adhesive  capsulitis characterized by diffuse shoulder pain and restricted passive range of motion, often associated with diabetes and thyroid disorders.
Shoulder osteoarthritis:
includes glenohumeral and AC joint osteoarthritis, presenting with gradual pain and loss of motion, particularly in older adults.
Shoulder instability: seen in younger individuals, often with a history of dislocation or subluxation events, presenting with positive apprehension and relocation tests.
Other causes include subacromial bursitis, biceps tendinitis, and labral tears, which can also contribute to shoulder pain.

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