Pain Mapping for Common Shoulder Disorders

We conducted a study to ascertain specific pat­terns of pain in patients with common shoulder disorders and to describe a comprehensive shoul­der pain map. We prospectively studied 94 cases involving an upper limb pain map and correlated the maps with the final diagnoses made by 2 clini­cians who were blinded to the pain map findings.

Pattern, severity, and type of pain were specific to each common shoulder disorder. In subacromial impinge­ment, pain was predominantly sharp, occurred around the anterior aspect of the shoulder, radiated down the arm, and was associated with dull, aching pain radiating to the hand. A similar pain pattern was found in rota­tor cuff tears. In acromioclavicular joint pathology, pain was sharp, stabbing, and well localized to the antero­superior shoulder area. Glenohumeral joint arthritis was marked by the most severe pain, which occurred in a mixed pattern and affected the entire arm. Whereas the pain of instability was a mixture of sharp and dull pain, the pain of calcific tendonitis was severe and sharp. Both pains were limited to the upper arm and shoulder.

Pain mapping revealed definitive patterns for shoulder pathologies. We advocate using pain maps as useful diagnostic guides and research tools.