Identifying Shoulder Pain in Older Patients: The History, Physical Examination, and Testing

Shoulder pain, the third most common musculoskeletal complaint in primary care physicians' offices, often occurs in older patients—it has its peak incidence in the fourth to the sixth decades of life.1 Common shoulder conditions in this age-group include rotator cuff tendinopathy, impingement, rotator cuff tear, adhesive capsulitis ("frozen shoulder"), and glenohumeral (GH) arthritis. Diagnosis can present a unique challenge because the shoulder joint is complex and shoulder pain has a broad differential.2 In addition, older patients who present with shoulder pain have issues and concerns different from those of younger patients.