[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-565450-105":53,"doc-detail-565450-en":120},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":113,"head_meta":115,"extra_data":117,"updated_unix":119},105,"en","diagnosis-of-shoulder-problems-in-primary-care-clinical-guidelines","Diagnosis of Shoulder Problems in Primary Care - Clinical Guidelines","","This document serves as a clinical guide for healthcare providers in primary care settings to differentiate between neck and shoulder pathologies. It provides structured diagnostic pathways, including physical movement assessments to pinpoint pain sources and identify instabilities. The text outlines critical red flags that necessitate urgent referral, such as acute cuff tears, tumors, infections, or unreduced dislocations. Furthermore, it offers specific criteria for assessing acromioclavicular (AC) joint issues and impingement, providing a clear triage framework for managing patients through physiotherapy or specialized shoulder clinic referrals, supported by the Oxford Shoulder Clinic resources.",{"@graph":63,"@context":112},[64,80,95],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":26,"@type":70,"position":76},"https://docshare.wps.com/template/posters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/diagnosis-of-shoulder-problems-in-primary-care-clinical-guidelines/565450/",4,{"url":78,"name":59,"@type":81,"author":82,"headline":59,"publisher":85,"fileFormat":88,"inLanguage":57,"description":61,"dateModified":89,"datePublished":89,"encodingFormat":88,"isAccessibleForFree":90,"interactionStatistic":91},"DigitalDocument",{"name":83,"@type":84},"awa","Person",{"url":68,"name":86,"@type":87},"DocShare","Organization","application/pdf","2026-10-13",true,{"@type":92,"interactionType":93,"userInteractionCount":4},"InteractionCounter",{"@type":94},"ViewAction",{"@type":96,"mainEntity":97},"FAQPage",[98,104,108],{"name":99,"@type":100,"acceptedAnswer":101},"How can a provider distinguish between neck and shoulder pain?","Question",{"text":102,"@type":103},"Ask the patient to move the neck first and then the shoulder, observing which specific movement reproduces the pain.","Answer",{"name":105,"@type":100,"acceptedAnswer":106},"What are the red flags requiring urgent referral?",{"text":107,"@type":103},"Red flags include trauma with weakness (acute cuff tear), masses or swelling (tumor), systemic illness or fever (infection), and loss of rotation or abnormal shape following trauma or electrical shock (unreduced dislocation).",{"name":109,"@type":100,"acceptedAnswer":110},"When should a patient with shoulder instability be referred to a shoulder clinic?",{"text":111,"@type":103},"Refer to the clinic if there is a history of traumatic dislocation, persistent ongoing symptoms, or if the patient has atraumatic instability that has failed physiotherapy treatment.","https://schema.org",{"og:url":78,"og:type":114,"og:title":59,"og:site_name":86,"og:description":61},"article",{"robots":116,"canonical":78},"index,follow",{"doc_id":118,"site_id":56},565450,1791854127,{"code":4,"msg":5,"data":121},{"doc_id":118,"user_id":122,"nickname":83,"user_avatar":123,"doc_module":9,"category_id":25,"category_name":26,"doc_title":59,"doc_description":61,"doc_content":124,"file_id":125,"file_url":126,"file_type":127,"file_size":128,"view_count":4,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":129,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":130,"faqs":131,"seo_title":132,"seo_description":61,"update_tm":119,"read_time":4},3985747858093,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Diagnosis of Shoulder problems in Primary Care:  \nIs it Neck~~ or Shoulder ? ~~  \n• Ask the patient to first move the neck and then move the shoulder.  \n• Which reproduces the pain?  \nGuidelines on treatment and referral  \nInstability  \n• Traumatic dislocation  \n• Ongoing symptoms  \n• Atraumatic with failed physio  \nRefer to Shoulder Clinic  \nInstability  \nCommon age 10-35 yrs  \n• Physio ifAtraumatic  \n\n| Neck |\n| --- |\n| • Follow local\u003Cbr>spinal service guidelines |\n\n\n|  |\n| --- |\n| Shoulder |\n| History of Instability?\u003Cbr>• Does the shoulder ever partly or completely come out of joint?\u003Cbr>• Is your patient worried that their shoulder may dislocate during sport or on certain activities? |\n\nPrimary Care  \nRed Flags = Urgent Referral  \n1. Trauma, pain and weakness- ? Acute cuff tear 2. Any mass or swelling- ? Tumour  \n3. Red skin, fever or systemically unwell  \n- ? Infection  \n4. Trauma / epileptic fit /electric shock leading to loss of rotation and abnormal shape  \n-? Unreduced dislocation  \n| • Is the pain localised to the AC joint and associated with tenderness?\u003Cbr>• Is there high arc pain.\u003Cbr>• Is there a positive cross arm test.\u003Cbr>|  |  |\n| --- | --- | --- |\n|  | No |  |\n| |  |  |\n|  | No |  |\n| • Is there a painful arc of abduction?\u003Cbr>• Is there pain on abduction with the thumb down, worse against resistance?\u003Cbr>N. B. A history of trauma with loss of abduction in a younger patient =  Red Flag 1\u003Cbr>No\u003Cbr>|  |  |\n|  |  |  |\n| Other cause of Neck or Arm pain\u003Cbr>|  |  |\n\n|  |\n| --- |\n|  |\n| The Oxford Shoulder Clinic at the Nuffield Orthopaedic Centre (see – [www.noc.nhs.uk/shoulderandelbow](www.noc.nhs.uk/shoulderandelbow-for)[-for](www.noc.nhs.uk/shoulderandelbow-for) patient information booklets) |","cbCaia7Xa7vCPz9I","https://ap.wps.com/l/cbCaia7Xa7vCPz9I","pdf",620459,"English","# Assessment of Neck versus Shoulder Pain\n## Initial Diagnostic Movements\n# Shoulder Instability Management\n## Treatment Pathways\n## Assessment Criteria\n# Primary Care Red Flags\n## Referral Indicators\n# Specific Diagnostic Tests\n## AC Joint Assessment\n## Impingement Signs\n# Patient Resources","[{\"question\":\"How can a provider distinguish between neck and shoulder pain?\",\"answer\":\"Ask the patient to move the neck first and then the shoulder, observing which specific movement reproduces the pain.\"},{\"question\":\"What are the red flags requiring urgent referral?\",\"answer\":\"Red flags include trauma with weakness (acute cuff tear), masses or swelling (tumor), systemic illness or fever (infection), and loss of rotation or abnormal shape following trauma or electrical shock (unreduced dislocation).\"},{\"question\":\"When should a patient with shoulder instability be referred to a shoulder clinic?\",\"answer\":\"Refer to the clinic if there is a history of traumatic dislocation, persistent ongoing symptoms, or if the patient has atraumatic instability that has failed physiotherapy treatment.\"}]","Diagnosis of Shoulder Problems in Primary Care - Clinical Guidelines | PDF"]