Approach to Shoulder Pain in Primary Health Care: Literature Review

Abstract

Shoulder pain is the third most frequent musculoskeletal complaint in primary health care (PHC). This article aims to understand shoulder pain, its diagnostic approach and therapy in PHC. A narrative review was carried out. Seventy-three articles were identified in the research and were included in the review data from 7 bibliographic references. Shoulder pain is more frequent in females, between 45 and 64 years old. There is worst prognosis if advanced age, female gender, intense initial symptoms, and association with neck pain. The most frequent etiologies are rotator cuff pathology, glenohumeral instability and arthrosis, adhesive capsulitis, and acromioclavicular joint pathology. With a complete clinical history and physical examination, most situations can be diagnosed and managed in a first visit without further investigation. If necessary, ultrasound and magnetic resonance imaging are preferable. Hospital referral should occur when complaints are refractory to the initial therapeutic approach (analgesic and anti-inflammatory drugs and physical rehabilitation).