Shoulder pain that is not shoulder pathology – a shoulder surgeon's guide to concomitant cervical spine and rotator cuff disease

Background: Rotator cuff and cervical spine disease are complex and nuanced conditions that commonly coexist, creating a challenging treatment paradigm. Methods: An algorithmic approach to diagnosis and management is developed in this study and illustrated through clinical vignettes. Results: The diagnostic and therapeutic challenges of concomitant shoulder and neck conditions may be simplified by this approach. Conclusion: Shoulder surgeons should seek cervical disease with a high index of suspicion and understand cervical conditions that may take surgical precedence to rotator cuff repair.