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Shoulder problems in the elderly.

R W Teasell1

  • 1Physical Medicine and Rehabilitation, University Hospital, London, Ontario, Canada.

Journal of Back and Musculoskeletal Rehabilitation
|February 28, 2014
PubMed
Summary
This summary is machine-generated.

Elderly shoulder pain often stems from degenerative changes, frozen shoulder, or arthritis. Diagnostic imaging like MRI rarely alters conservative treatment for older adults.

Keywords:
Shoulderelderlyfrozen shoulderrotator cuff

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Area of Science:

  • Geriatric Medicine
  • Orthopedics
  • Musculoskeletal Disorders

Background:

  • Shoulder disorders are a frequent cause of musculoskeletal pain in the elderly, often presenting with pain and reduced range of motion.
  • Degenerative changes are prevalent in elderly shoulders, with rotator cuff and bicipital tendon issues common, similar to younger populations.
  • Elderly patients experience shoulder pain from unique conditions such as frozen shoulder, polymyalgia rheumatica, degenerative arthritis, referred visceral pain, and hemiplegic shoulder pain.

Purpose of the Study:

  • To review the common causes of shoulder pain in the elderly.
  • To discuss the diagnostic challenges and treatment implications in this demographic.
  • To evaluate the utility of advanced diagnostic imaging in elderly patients with shoulder pain.

Main Methods:

  • Literature review focusing on shoulder disorders in the elderly population.
  • Analysis of common etiologies and clinical presentations.
  • Discussion of diagnostic test utility and management strategies.

Main Results:

  • While rotator cuff and bicipital tendon disorders occur, elderly patients more frequently present with frozen shoulder, polymyalgia rheumatica, degenerative arthritis, referred pain, and hemiplegic shoulder pain.
  • Conservative management is the standard approach for most elderly patients with shoulder pain.
  • High-technology diagnostic tests, such as magnetic resonance imaging (MRI), have questionable utility as they seldom alter the conservative management plan.

Conclusions:

  • The differential diagnosis for shoulder pain in the elderly is broad, including conditions less common in younger individuals.
  • Conservative treatment remains the cornerstone of management for shoulder disorders in older adults.
  • The routine use of advanced imaging like MRI is often not indicated in the elderly shoulder due to limited impact on treatment decisions.