What information should be obtained in the patient history in rotator cuff injuries?

Updated: Oct 25, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Craig C Young, MD  more...
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Answer

First, determine the patient's chief symptom (eg, pain, weakness, instability, limited ROM).

Direct further questions at how and when the problem began.

Determine if the patient's symptoms are related to a specific injury or event or to a repetitive motion or are of a more insidious onset.

Activities and arm positions that increase or decrease symptoms are also helpful in diagnosing and guiding treatment. Previous episodes of similar symptoms may give a useful clue to the patient's present condition.

The presence of associated symptoms (eg, instability, weakness, swelling, numbness, loss of motion, catching or popping of the shoulder) also provides helpful information.

Ask if previous treatments have been tried, including the use of ice, heat, or medications (eg, acetaminophen, aspirin, nonsteroidal anti-inflammatory drugs [NSAIDs]).

Questions regarding previous medical treatment should include physical therapy, previous injections, and any surgical interventions.

A social history should include the patient's occupation and sport (including position) and level of athletic participation.

Pain, weakness, and loss of shoulder motion are common symptoms reported with rotator cuff pathology. Pain is often felt over the anterolateral part of the shoulder and is exacerbated by overhead activities. Night pain is a frequent symptom, especially when the patient lies on the affected shoulder.

Symptoms may be relatively acute, either following an injury or associated with a known repetitive overuse activity.

In elderly patients, symptoms are often insidious and with no specific injury. Repetitive motion can be associated with the symptoms.


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