Shoulder Pain & Approach to Diagnosis Flashcards
What are the three most common causes of musculoskeletal complaints?
- Low back pain
- Neck pain
- Shoulder pain
What are common classifications of pain?
- Nociceptive
- Neuropathic
- Referred
What is nociceptive pain?
Local pain
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 reffered pain?
Musculoskeletal and visceral 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 that originates in the territory of one nerve can be felt as pain in the territory of the other nerve
If there is a cervical zygapophyseal joint issue, where might the pain refer?
Neck, head, shoulders
If there is an infraspinatus trigger point, where might the pain refer?
Lateral shoulder and down the arm
Where might liver and gallbladder issues refer pain?
The shoulder
Where might the lungs and diaphragm issues refer pain?
Around the neck
Where might heart issues refer pain?
Left pectoralis region and medial upper thoracic region
Diagnosis is:
70% ___
20% ___
10% ___
70% history
20% examination
10% imaging and other tests
Red flags help the doctor to rule in/out:
- Life threatening conditions
- Serious conditions or illnesses
- Visceral disorders
What are five ways a doctor may find a red flag?
- History of present illness
- Past medical history
- Review of systems
- Physical examination
- Treatment
What is differential diagnosis?
A list of possible disorders that could be causing the patient’s signs or symptoms
