Pain that is localized in the shoulder joint may be acute or chronic. The joint may be injured by either direct or indirect trauma. Some relief is afforded by ice bags, salicylates, and codeine during the acute stage, but an arthrogram may be necessary for precise diagnosis, and surgical repair depends on exact understanding of the anatomy. Musculotendinous lesions, while frequently induced by acute trauma, tend to attain chronicity in patients over 40 years of age. Frequent findings in the chronically painful shoulder are calcification of the joint capsule and pericapsular structures, bicipital tendinitis, and immobilization of the joint by pericapsulitis and periarthritis. Pain not localized in the shoulder but referred to it has a number of possible causes, including structural abnormalities and trauma to the cervical part of the vertebral column. These may often be treated with success by means of traction, supportive collar, posture, and carefully prescribed exercise.
Nicholson ET, Wieder HS. SHOULDER PAIN. JAMA. 1959;169(8):809–814. doi:10.1001/jama.1959.03000250027008
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