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Waddell, et al. (1980) described five categories of signs: Tenderness tests: superficial and diffuse tenderness and/or nonanatomic tenderness; Simulation tests: these are based on movements which produce pain, without actually causing that movement, such as axial loading and pain on simulated rotation
A positive test is indicated by pain in the anterior or lateral shoulder when in full flexion. It is indicative of problems involving the supraspinatus and the long head of the biceps brachii tendons. The examiner needs to be aware of a false positive test which is due to the patient having limited forward flexion. [1]
Evaluation of passive and active range of motion: Neck range of motion should be assessed that may reveal a neck source of shoulder pain. The Apley scratch test specifically tests range of motion and in a normal exam, an individual should be able to reach C7 on external rotation, and T7 on internal rotation.
The McGill Pain Questionnaire, also known as McGill Pain Index, is a scale of rating pain developed at McGill University by Melzack and Torgerson in 1971. [1] It is a self-report questionnaire that allows individuals to give their doctor a good description of the quality and intensity of pain that they are experiencing.
Tony was on the verge of a catastrophic heart attack, and the shoulder pain was “referred pain” as the heart was screaming for help. Thankfully, despite 100% blockage in a key artery, Tony ...
A patient's self-reported pain is so critical in the pain assessment method that it has been described as the "most valid measure" of pain. [ 2 ] [ 3 ] The focus on patient report of pain is an essential aspect of any pain scale, but there are additional features that should be included in a pain scale.
If pain disappears and shoulder function remains good, no further testing is pursued. The test helps to confirm that the pain arises primarily from the shoulder, rather than being referred from the neck, heart, or gut. If pain is relieved, the test is considered positive for rotator-cuff impingement, of which tendinitis and bursitis are major ...
However, imaging studies are unable to show cause of shoulder pain in diagnosing. For example, MRI imaging would show rotator cuff pathology and bursitis but is unable to specify the cause. [15] On physical exam, the physician may twist or elevate the patient's arm to test for reproducible pain (the Neer sign and Hawkins-Kennedy test).
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