(English) Episode 244-Distinguishing Pinched Nerves From Rotator Cuffs

Differentiating the cause of pain and dysfunction due to cervical spine and shoulder pathology presents a significant clinical challenge in many patients. Furthermore, the anatomic location of the pain reported by the patient may mislead the practitioner. Successful management of these patients requires a careful and complete history and physical examination, including appropriate provocative maneuvers.An evidence-based selection of clinical testing is also essential and should be tailored to the most likely underlying cause. When advanced imaging does not reveal a conclusive source of pathology, electromyography and selective injections have proven to be useful adjuncts, although the sensitivity, specificity, and risk-benefit ratio of each test must be considered. This review provides an evidence-based synthesis of common causes of shoulder and neck pain, as well as guidelines to help identify the pain generator in ambiguous cases.(Bokshan SL, DePasse JM, Eltorai AEM, Paxton ES, Green A, Daniels AH. An evidence-based approach to differentiating the cause of shoulder and cervical spine pain. Am J Med [Internet]. 2016;129(9):913–8. Available from: http://dx.doi.org/10.1016/j.amjmed.2016.04.023)