9. Painful shoulder complaints.
Painful shoulder complaints have a high incidence and prevalence. The etiology is not always clear. Clinical history and the active and passive motion examination of the shoulder are the cornerstones of the diagnostic process. Three shoulder tests are important for the examination of shoulder complaints: shoulder abduction, shoulder external rotation, and horizontal shoulder adduction. These tests can guide the examiner to the correct diagnosis. Based on this diagnosis, in most cases, primarily a conservative treatment with nonsteroidal anti-inflammatory drugs possibly in combination with manual and/or exercise therapy can be started. When conservative treatment fails, injection with local anesthetics and corticosteroids can be considered. In the case of frozen shoulder, a continuous cervical epidural infusion of local anesthetic and small doses of opioids or a pulsed radiofrequency treatment of the nervus suprascapularis can be considered.
Huygen
Frank
F
Department of Anesthesiology and Pain Management, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Patijn
Jacob
J
Rohof
Olav
O
Lataster
Arno
A
Mekhail
Nagy
N
van Kleef
Maarten
M
Van Zundert
Jan
J
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005081:Exercise Therapy / Q000379:methods; D017408:Guidelines as Topic; D006801:Humans; D009038:Motion; D010147:Pain Measurement / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D012782:Shoulder / Q000503:physiopathology; D020069:Shoulder Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy
D000305:Adrenal Cortex Hormones; D000779:Anesthetics, Local