Last reviewed
2026-02-07
Workflow pack
Shoulder pain function-first workflow
Workflow for shoulder pain visits balancing imaging appropriateness, functional recovery, and escalation cues.
Trust and governance
Use only within this workflow's defined scope and exclusions.
Clinical owner
Family Medicine Editorial Team
Risk tier
Low
Review cadence
Every 12 months
Next due 2027-02-07
Review status
Current
Scope limits
Initial outpatient shoulder pain management in stable patients without limb-threatening findings.
Exclusions (escalate/redirect)
- Major trauma/dislocation with neurovascular compromise.
- Inpatient orthopedic emergency pathways.
References
At a glance
Rapid decision framing for in-visit use. Educational only; always apply clinical judgment.
Immediate actions
- Assess trauma history, weakness, and range-of-motion limitations.
- Screen for fracture/dislocation and neurovascular compromise.
- Determine immediate imaging/escalation need before conservative pathway.
Red flags / escalate now
- Deformity or severe trauma with suspected fracture/dislocation.
- Progressive weakness with severe functional loss.
- Severe persistent pain with systemic concern.
First-line plan
- Start conservative management and function-preserving exercise strategy.
- Use imaging selectively based on validated rule criteria.
- Set clear expectations for pain/function recovery timeline.
Follow-up and monitoring
- Reassess functional gains and pain trend at planned interval.
- Escalate for deterioration, persistent severe limitation, or instability.
- Refer for suspected structural tears or non-response.
Condition guidance
Referral checklists
Tools and calculators
Patient handouts
Return precautions (patient script)
Suggested plain-language wording for safety-net counseling:
If symptoms get worse, new warning signs appear, or you cannot follow the plan from this visit, seek urgent care now.
- Use with the specific red flags listed on this page.
- Confirm follow-up timing and where to go after-hours.
- Document that return precautions were reviewed and understood.
Visit-close checklist
- Document disposition, rationale, and unresolved diagnostic uncertainty.
- Give explicit return precautions and follow-up timeline before ending visit.
- Attach a relevant handout when available to reinforce adherence and safety-netting.