Medical history (history of illness) represents an important component in the diagnosis of omalgia (shoulder pain). Family history Are there any diseases of bones/joints in your family that are common? Social history What is your profession? Do you work physically hard in your profession? (regarding specific overload syndromes). Are you left-handed or right-handed? Current medical … Shoulder Pain (Omalgia): Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Sprengel deformity – congenital scapulothoracic deformity that is usually unilateral. Blood, blood-forming organs – immune system (D50-D90). Splenic rupture (rupture of the spleen) [Kehr sign: left shoulder pain with accompanying hyperesthesia (hypersensitivity to touch stimuli) of the skin]. Cardiovascular system (I00-I99). Aortic aneurysm (outpouching (aneurysm) of the aorta). … Shoulder Pain (Omalgia): Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by omalgia (shoulder pain) as well: Musculoskeletal system and connective tissue (M00-M99). Movement restriction / restraint
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait (fluid, limping). Body or joint posture (upright, bent, gentle posture; posture, shoulder and pelvic position). Axis deviations … Shoulder Pain (Omalgia): Examination
2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Uric acid If necessary, rheumatism diagnostics (see at the corresponding clinical picture).
Therapy goals Reduction of pain and thus increase of mobility. Diagnosis finding Therapy recommendations Analgesia (pain relief) during diagnosis until definitive therapy according to WHO staging scheme: Non-opioid analgesic (paracetamol, first-line agent) – see also “Further notes”. Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. If necessary, … Shoulder Pain (Omalgia): Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Sonography (ultrasound examination) of the shoulder – to detect biceps tendon rupture, rotator cuff rupture, disease of the subacromial space (space between the bony acromion and the shoulder joint … Shoulder Pain (Omalgia): Diagnostic Tests
The following symptoms and complaints may indicate omalgia (shoulder pain): Radiating pain into the arm, back. Restriction of movement Gentle posture Tension / hardening of the muscles Warning signs (red flags) Shoulder pain + sensorimotor deficits (interplay of sensory and motor performance concerning) → immediate action inevitable! Shoulder- arm pain + neurological deficits → think … Shoulder Pain (Omalgia): Symptoms, Complaints, Signs
The type of therapy depends on the cause and must be carried out according to the stage. Conventional nonsurgical therapy methods Analgesics (painkillers) If necessary, puncture of the shoulder joint (for relief) or installation of local anesthetics (painkillers for local anesthesia) and / or steroidal anti-inflammatory drugs (cortisone). Surgical therapy If conservative therapeutic influence is … Shoulder Pain (Omalgia): Therapy
