Should We Provide a Clinical Diagnosis for People with Shoulder Pain? Absolutely, Maybe, Never! The Ongoing Clinical Debate Between Leavers and Retainers

Abstract

When trauma results in a fracture of one of the shoulder bones, or a dislocation of one of the shoulder joints, providing a diagnosis is acceptable practice. Similarly, providing a diagnosis for the person seeking an explanation for their shoulder symptoms when an osteosarcoma is discovered in the humeral head is also viewed as acceptable. In these situations, the diagnosis is sensitively communicated, explained and, following shared decision-making, a management plan started, and modified as required. However, the awkward reality is that most people seek care with a history of idiopathic and non-traumatic shoulder pain, and here lies one of the most hotly contested debates pertaining to clinical diagnosis in current clinical practice. On one side there are clinicians who wish to jettison all diagnostic labels (leavers), and on the other side are those who will fight to the end to retain them (retainers)