rheumatology ortho-trauma

SPADI — Shoulder Pain and Disability Index

Self-administered shoulder outcome measure (Roach 1991). 5 pain + 8 disability items, each scored 0–10 (NRS). Raw total /130; normalised to 0–100% by dividing by 130 and ×100. Higher = worse. Minimum clinically important difference ≈8 points.

Pain — worst pain (0 = no pain, 10 = worst)*

Pain — lying on affected side (0 = no pain, 10 = worst)*

Pain — reaching for high shelf (0 = no pain, 10 = worst)*

Pain — touching back of neck (0 = no pain, 10 = worst)*

Pain — pushing with affected arm (0 = no pain, 10 = worst)*

Disability — washing hair (0 = no difficulty, 10 = unable)*

Disability — washing back (0 = no difficulty, 10 = unable)*

Disability — putting on undershirt (0 = no difficulty, 10 = unable)*

Disability — putting on shirt that buttons (0 = no difficulty, 10 = unable)*

Disability — putting on trousers (0 = no difficulty, 10 = unable)*

Disability — placing object on high shelf (0 = no difficulty, 10 = unable)*

Disability — carrying heavy 10 lb / 4.5 kg object (0 = no difficulty, 10 = unable)*

Disability — removing item from back pocket (0 = no difficulty, 10 = unable)*

Score interpretation

Mild shoulder dysfunction (<30%) 0–39

→ Conservative care: NSAIDs, physiotherapy (eccentric rotator-cuff strengthening), activity modification.

Moderate shoulder dysfunction (30–69%) 40–90

→ Structured physiotherapy programme; consider US-guided subacromial corticosteroid injection if impingement; imaging (US/MRI) if symptoms >6 weeks.

Severe shoulder dysfunction (≥70%) 91–130

→ Refer to upper-limb orthopaedic clinic. MRI to characterise rotator cuff / labrum / OA. Consider arthroscopic decompression, cuff repair, or arthroplasty as indicated.

Interpretation bands for the SPADI. Apply clinical judgement and local guidance.

References

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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