Shoulder pain: differential diagnosis with mechanical diagnosis and therapy extremity assessment - a case report

Man Ther. 2013 Aug;18(4):354-7. doi: 10.1016/j.math.2012.06.011. Epub 2012 Jul 13.


Mechanical Diagnosis and Therapy (MDT) is now probably the only non-specific classification system that can be used with both spinal and non-spinal patients. Derangement syndrome, which presents with rapid changes in symptoms or mechanical response with the use of repeated movements, appears to be common in both spinal and extremity cases. Shoulder problems can be attributed to specific shoulder problems, but may also be referred from the neck. The case report describes a patient presenting with shoulder pain and limitations to shoulder function, and who tested positive to functional shoulder tests. However, repeated neck movements demonstrated the ability to worsen and improve the shoulder pain and limitations. MDT was an effective tool at making the differential diagnosis between 'genuine' and referred shoulder pain.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Diagnosis, Differential
  • Exercise / physiology*
  • Humans
  • Male
  • Middle Aged
  • Neck Pain / diagnosis*
  • Neck Pain / therapy
  • Pain Measurement / methods*
  • Physical Examination / methods
  • Range of Motion, Articular / physiology*
  • Risk Assessment
  • Severity of Illness Index
  • Shoulder Pain / diagnosis*
  • Shoulder Pain / therapy
  • Treatment Outcome