• Steven L Bokshan, J Mason DePasse, Adam E M Eltorai, E Scott Paxton, Andrew Green, and Alan H Daniels.
• Department of Orthopedics, Warren Alpert Medical School of Brown University, Providence, RI.
• Am. J. Med. 2016 Sep 1; 129 (9): 913-8.

AbstractDifferentiating the cause of pain and dysfunction due to cervical spine and shoulder pathology presents a difficult clinical challenge in many patients. Furthermore, the anatomic region reported to be painful may mislead the practitioner. Successfully treating these patients requires a careful and complete history and physical examination with appropriate provocative maneuvers. An evidence-based selection of clinical testing also is essential and should be tailored to the most likely underlying cause. When advanced imaging does not reveal a conclusive source of pathology, electromyography and selective injections have been shown to be useful adjuncts, although the sensitivity, specificity, and risk-reward ratio of each test must be considered. This review provides an evidence-based review of common causes of shoulder and neck pain and guidelines for assistance in determining the pain generator in ambiguous cases.Copyright © 2016 Elsevier Inc. All rights reserved.

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