Shoulder pain referral checklist

Referral checklist for persistent shoulder dysfunction, suspected structural tears, or refractory pain.

Last reviewed February 7, 2026

Urgency tier

Same-day escalation for dislocation, fracture concern, or neurovascular compromise.
Expedited referral for severe functional loss or suspected full-thickness tear.
Routine referral for persistent non-urgent symptoms despite first-line care.

Minimum pre-referral workup

Mechanism history, weakness pattern, and motion limitation profile.
Neurovascular assessment and cervical differential screen.
Response to initial conservative management and exercise plan.

Referral packet checklist

Symptom chronology and exam findings.
Imaging/tests completed and treatment trial outcomes.
Current medication plan and functional goals.

Pre-referral optimization tasks

Continue conservative pain/function strategy while awaiting review.
Reinforce return precautions for sudden deterioration.
Arrange interval follow-up for function monitoring.

References

Choosing Wisely Canada recommendations (opens in a new tab)

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