Cervical spine and the shoulder.

Cervical spine pathosis and pain can be referred to the shoulder and can actually result in a frozen shoulder or a tendinitis pattern. Concomitant cervical spine pathosis can coexist with primary shoulder pathosis and can present a diagnostic and therapeutic dilemma. Conservative programs usually require an aggressive attack on the cervical spine, often with therapy to the shoulder. Surgical considerations rely on diagnostic acumen to sort out accurately where the predominant problem exists. The usual scenario of shoulder pain referred from the cervical spine involves an appropriate history, physical examination, selective subacromial injection, appropriate roentgenograms of the cervical spine and shoulder and finally a cervical discogram to document the level of the disorder followed occasionally by an anterior cervical fusion.