Shoulder Pain Flashcards
What are the three most common causes of musculoskeletal complaints?
- Low back pain
- Neck pain
- Shoulder pain
What are the common classifications of pain?
- Nociceptive pain (local)
- Neuropathic pain
- Referred pain
What is nociceptive pain?
Local pain due to activation of peripheral nociceptor terminal endings
What is neuropathic pain?
Pain stemming from intrinsic disease or injury to the nervous system (ie. radiculopathy, diabetic neuropathy, multiple sclerosis)
What is referred pain?
Musculoskeletal and visceral referred pain (feeling pain elsewhere)
If sensory nerves from two different sources synapse on the same second order neurons, then nociception originating the territory of one nerve can be felt as pain in the territory of the other nerve
What theory is this?
Convergent theory of referred pain
What is the convergent theory of referred pain?
If sensory nerves from two different sources synapse on the same second order neurons, then nociception in one territory can be felt as pain in another territory
Where might the liver and gallbladder refer pain?
Right shoulder
Where might the lungs and diaphragm refer pain?
Neck
Where might the heart refer pain?
Left pectoral, inside of left arm, and around T1
Diagnosis is ___% history, ___% examination, and ___% imaging and other tests
70% history
20% examination
10% imaging and other tests
What is a red flag?
Signs and symptoms from the history, physical exam, and response to care that are uncommon in the usual patient with mechanical shoulder pain, which can alert the doctor to the possibility of a more serious condition
Red flags help the doctor to rule in/rule out:
- Life threatening conditions
- Serious conditions or illnesses
- Visceral disorders
What is differential diagnosis?
List of possible disorders that could be causing the patient’s signs or symptoms
When does the differential diagnosis process begin?
Beginning of patient history
