Rotator cuff related shoulder pain/ rotator cuff tendinopathy- Considerations relating to diagnosis
NICE CKS 2017 definitions; includes “rotator cuff tendinopathy” “also known as shoulder impingement”. As the diagnosis of other causes of subacromial pain, such as supraspinatus tendinopathy, tendinitis and subacromial bursisits is essentially the same as rotator cuff tendinopathy these are referred to as rotator cuff tendinopathy in the NICE CKS 2017 document
BESS/ BOA definitions- Subacromial shoulder pain- Pain from this area is mainly caused by rotator cuff tendinopathy, also referred to as shoulder impingement. A number of other terms such as supraspinatus tendinopathy, tendinits, and bursitis are also used across different disciplines but the diagnosis is essentially the same and referred to within the BESS/BOA guidelines as rotator cuff tendinopathy/ impingement
Link to NICE CKS 2017 definitions and diagnostic considerations here;
https://cks.nice.org.uk/shoulder-pain#!backgroundsub
Link to BESS/ BOA definitions and diagnostic considerations here;
http://www.bess.org.uk/media/Research Committee/National Guidelines/Subacromial Shoulder Pain.pdf
Key points from the above documents (not exhaustive)
- Most common cause of shoulder pain presenting in primary care, reportedly up to 70% of all shoulder pain problems
- Typically age 35- 75
- Typically history of change in loading activities at onset i.e. repetitive movements, heavy lifting etc
- Key to distinguish traumatic rotator cuff tear in the younger patient (typically <65)- red flag
- Typically pain top and lateral side of shoulder, worse with lifting the arm, overhead activities. May be night pain.
- Active movements are painful and may be restricted, passive movements tend to be full but painful. May be a painful arc. May be pain on abduction with the thumb down which is worse against resistance.
- No reduced passive external rotation
