The most movable joint in the human body is the shoulder. However, it is an unstable joint due to the range of motion permitted. The shoulder socket that holds the shoulder is smaller than the ball of the upper arm, which makes it easily susceptible to injury. The shoulder must be anchored to its ligaments, muscles and tendons to stay stable. Some shoulder problems are caused from the disturbance of these delicate tissues as a result of injury or from underuse or overuse of the shoulder. There are many causes of shoulder pain, and it is a very common complaint. This article will show you effectively evaluate shoulder pain.
Instructions
1. Perform the physical examination. Examine the shoulder and identify the specific location of the shoulder pain. Determine the chief complaint of your patient. Familiar complaints include stiffness, pain, irritation and clicking sounds.
2. Find out the mechanism of injury and duration of symptoms. If trauma has taken place, you can determine the mechanism by ordering an x-ray of the shoulder. Review the alleviating and aggravating factors. Include work, sports, recreation and hobbies. If your patient is older than 65 years and complains of pain when lying on the affected side with a history of trauma, then she has a rotator cuff tear.
3. Observe and identify any gross abnormalities. Look for degenerative arthritis, muscle atrophy and acromiodavicular joint disparity. If lumps are present, be prepared to perform a biopsy to submit to the pathology laboratory for analysis. This will help you in your final diagnosis.
4. Assess your patient's range of motion (ROM). Assess for flexion (how far it can be bent) and extension (how far it can be stretched out). This will help you find out the limitations of shoulder movement and if physical therapy is required.
5. Order an x-ray of the shoulder area. The x-ray will reveal any fractures, bony lesions, dislocations and degenerative arthritic changes. You should order the x-ray when your patient's range of motion (ROM) is gone, especially when there is abduction that is less than 90 degrees, acute pain and after-trauma.
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