A rheumatologic perspective on rehabilitation of shoulder problems in the older individual

Shoulder dysfunction is a common but complex clinical problem among the aged. The shoulder is a diarthrodial joint that is designed to complement the elbow and wrist in stabilizing the arm and the hand. This complex joint has the greatest range of motion (ROM) of any joint in the human body. Unfortunately, the aging process increases the shoulder's vulnerability to many pathological conditions that decrease its ROM and interfere with self-care tasks. While initial therapy is typically managed by the primary care physician, the complexity of this problem often requires consultation across disciplines to assure pertinent management. This article provides an overview of rheumatologic considerations specific to geriatric persons with shoulder dysfunction. The differential diagnosis and issues of treatment and rehabilitation are discussed.