Chronic shoulder pain

Chronic shoulder pain is a common presenting compliant in general practice. The differential diagnosis is broad and varies with patient age.This article reviews the management of patients presenting with chronic shoulder pain. A structured approach to history and physical examination is presented, and appropriate investigations are discussed. Non-surgical and surgical treatment options are reviewed.Many patients presenting with chronic shoulder pain can be successfully treated non-surgically. A multidisciplinary approach including physiotherapy, occupational therapy and psychology as needed will optimise care. Patients presenting with acute injuries or 'red flag' diagnoses should be urgently referred for specialist care. Referral to an orthopaedic surgeon is also recommended for patients who have failed an appropriate course of non-surgical treatment.