Painful shoulders are commonly caused by disorders of periarticular soft tissues, especially rotator cuff tendinopathies. In contrast to arthritic conditions of the shoulder, soft-tissue disorders can present a diagnostic dilemma that often results in the use of such nonspecific or unproved terminologies as periarthritis or bursitis. To promote an efficient use of investigative studies necessary to arrive at a proper diagnosis, an algorithm can serve as a guide for clinicians in the diagnosis and management of common, nonarthritic conditions of painful shoulders.