Painful Shoulder Syndrome

Aim: a painful shoulder is one of the ten most frequent causes of physiatric consultation and it affects a high percentage of the economically active population. In 2008, 5.47% of the new cases seen at the physiatrics service of one of our metropolitan clinics were associated with a painful shoulder. This study looked at the way the painful shoulder syndrome occurs in this populationby assessing the demographic variables of these patients and the treatment strategies applied to them. 

Methods: a retrospective analysis of the medical records of 171 patients consulting for painful shoulder syndrome during 2008 at a second-level peripheral metropolitan clinic which serves a population of 400 000 inhabitants of rural, marginal urban, and urban areas was carried out.Demographic variables, diagnoses and clinical assessment, medical images, and applied treatments were recorded. 

Results: mean age in patients was 55.5 years, with a higher frequency of female individuals (74.3%) and right side pain (45%). The coexistence of diabetes (20.9%) and depressive disorders (15%) was confirmed. This work is the first one to identify fibromyalgia (4.3%) as a simultaneous factor to shoulder pathology. Regarding treatment, high quality interventions including exercise, infiltrations and use of nonsteroidal anti-inflammatory drugs were detected. 

Conclusion: many clinical and demographic variables previously described as being associated with painful shoulder syndrome are applicable to this population (gender, age, side of pain, comorbidities). Also, we report a possible relationship between fibromyalgia and shoulder pain. The recording of a quality minimal clinical evaluation of the patients could be improved. The general quality of care given to these patients complies with proposed international minimal standards, although it is advisable to implement protocols for this aspect.