ISSN : 2092-8475(Print)
ISSN : 2714-0148(Online)
ISSN : 2714-0148(Online)
Journal of International Academy of Physical Therapy Research Vol.17 No.1 pp.3802-3811
DOI : https://doi.org/10.20540/JIAPTR.2026.17.1.3802
DOI : https://doi.org/10.20540/JIAPTR.2026.17.1.3802
The Use of Symptom Localization in the Differential Diagnosis of Shoulder Pain: A Case Report
Abstract
Background: Shoulder pain, a common reason for seeking physical therapy (PT), may arise from the cervical spine or shoulder. Symptom localization (SL), is a systematic process to determine the source of symptoms through provocation/ alleviation testing.
Objectives: To illustrate the clinical application of the SL sequence in a patient with shoulder pain.
Design: A retrospective case report.
Methods: A 29-year-old, female presented to PT with a 6-month history of right anterolateral shoulder pain that began after leaning on her arm while driving. Symptoms were aggravated with overhead movement and alleviated by external support. A thorough history/medical screening was performed. The SL examination sequence included: regional localization, structural localization, and confirmation testing.
Results: The shoulder was identified as the source of symptoms (supraspinatus muscle-tendon unit). Prognosis was good secondary to the absence of underlying comorbidities and the ability to manually and positionally alleviate symptoms. Intervention included a combination of manual therapy (functional massage and joint mobilization) and neuromuscular re-education (gravity reduced training progressed to resisted exercises).
Conclusion: This case provides an in-context example of SL to determine the source of symptoms, allowing for the implementation of a phased treatment approach, and return to prior level of function.
Objectives: To illustrate the clinical application of the SL sequence in a patient with shoulder pain.
Design: A retrospective case report.
Methods: A 29-year-old, female presented to PT with a 6-month history of right anterolateral shoulder pain that began after leaning on her arm while driving. Symptoms were aggravated with overhead movement and alleviated by external support. A thorough history/medical screening was performed. The SL examination sequence included: regional localization, structural localization, and confirmation testing.
Results: The shoulder was identified as the source of symptoms (supraspinatus muscle-tendon unit). Prognosis was good secondary to the absence of underlying comorbidities and the ability to manually and positionally alleviate symptoms. Intervention included a combination of manual therapy (functional massage and joint mobilization) and neuromuscular re-education (gravity reduced training progressed to resisted exercises).
Conclusion: This case provides an in-context example of SL to determine the source of symptoms, allowing for the implementation of a phased treatment approach, and return to prior level of function.
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