Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, dull, aching shoulder pain, localized to the lateral deltoid region, exacerbated by overhead activities and reaching behind the back. Reports nocturnal pain when lying on the affected side. Denies history of acute trauma, numbness, tingling, or radiation of pain distal to the elbow. Symptoms have been progressive over [Duration].
Clinical Examination Findings
Inspection reveals no visible atrophy or deformity. Palpation demonstrates tenderness over the greater tuberosity and subacromial space. Range of motion (ROM) is full but painful at the terminal arc of abduction (painful arc sign). Strength testing shows weakness in abduction and external rotation due to pain. Positive Neer and Hawkins-Kennedy impingement signs. Rotator cuff integrity intact with negative drop-arm test.
Treatment Protocol
Initiate conservative management including activity modification, avoidance of overhead lifting, and application of cryotherapy for 15-20 minutes, 3 times daily. Prescribe NSAIDs for inflammation control. Referral to physical therapy for rotator cuff strengthening, scapular stabilization, and subacromial decompression exercises. Consider subacromial corticosteroid injection if symptoms persist despite conservative measures.