Shoulder Pain and Disability Index

If you are handling a patient dealing with shoulder pain, issue the Shoulder Pain and Disability Index and have them rate themselves based on the pain they are feeling and how it’s affecting their functional activities.

By Matt Olivares on May 15, 2024.

Fact Checked by Nate Lacson.

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What is the Shoulder Pain and Disability Index?

If you have a new patient who sets up an appointment with you to discuss pains in their shoulder, or if you are already handling a patient who is dealing with a specific shoulder condition (e.g. shoulder inflammation, rotator cuff tears, arthritis in the shoulder area, frozen shoulder), then the is a nifty clinical assessment tool that allows you to assess shoulder pain and/or shoulder condition.

The Shoulder Pain and Disability Index (or SPADI, for short), is a self-administered clinical assessment that’s usually handed out to patients for them to answer on their own. It comes in the form of a two-part questionnaire with a total of thirteen items!

The first part of the questionnaire revolves around the pain in their shoulder(s). It has a total of five questions that are about how frequently they feel shoulder pain and how intense their pain usually is.

The second part of the questionnaire has a total of eight questions, and it focuses on the impact that their shoulder pain has had on their functional abilities, specifically their capability to perform certain activities of daily living.

Printable Shoulder Pain and Disability Index

Download this Shoulder Pain and Disability Index to assess your patient’s shoulder pain.

How to use the Shoulder Pain and Disability Index

If you’re a healthcare professional, there are two ways for you to administer this clinical assessment. You can either:

  1. Conduct this clinical assessment in an interview format. You will read each question to the patient, and they have to rate themselves based on how they perceive their pain severity of their pain and how bad their pain has impacted functional status. This is a time-consuming way of administering this assessment. However, the upside is that you can have patients expound on their self-ratings, which should be beneficial to you in terms of determining the next steps for the patient’s treatment.
  2. Or, you can do it as intended, which is to hand out a sheet for them to answer on their own.

Whichever method you choose, the patient will still do the same thing. They will be rating themselves on a scale of zero to ten for the following items:

  1. How severe is your pain?
  • At its worst?
  • When lying on the involved side?
  • Reaching for something on a high shelf?
  • Touching the back of your neck?
  • Pushing with the involved arm?
  1. How much difficulty do you have?
  • Washing your hair?
  • Washing your back?
  • Putting on an undershirt or jumper?
  • Putting on a shirt that buttons down the front?
  • Putting on your pants?
  • Placing an object on a high shelf?
  • Carrying a heavy object of 10 pounds (4.5 kilograms)?
  • Removing something from your back pocket?

How to score the Shoulder Pain and Disability Index

The patient simply needs to rate themselves between zero to ten. Here’s what they mean for both parts of the questionnaire:

  1. For the first part, 0 means “there is no pain,” while 10 means “the worst pain imaginable.”
  2. For the second part, 0 means “no difficulty,” while 10 means that “it’s so difficult that it requires help.”

Once the patient answers all questions, you need to calculate the scores. You will compute three scores: one for the first part, one for the second part, and one for the entire index. Just follow these equations:

  1. Total Pain Score:

(Total Score ÷ 50) x 100 = ____ %

If the patient does not answer all questions under this section, divide by the total possible score. So, if the patient didn’t answer one question, the total score will be divided by 40 instead of 50.

  1. Total Disability Score

(Total Score ÷ 80) x 100 = ____ %

If the patient does not answer all questions under this section, you’ll do the same thing as the previous section, which is divide by the total possible score. So, if the patient didn’t answer one question, the total score will be divided by 70 instead of 80.

  1. Total SPADI Score

(Total Score ÷ 130) x 100 = ____ %

Same thing as the previous two: divide by the total possible score based on how many questions they didn’t answer. So, if the patient didn’t answer one question, the total score will be divided by 120 instead of 130.

There are no score range designations for this. Just for your reference, a total SPADI score of 0 means “best” and 100 means “worst.” Higher scores mean that the patient’s shoulder pain is terrible, and this pain is impacting certain activities of daily living to a severe degree.

As for your next steps, you can run some tests and determine what the specific problem is if the patient hasn’t undergone examinations yet. If they already have specific shoulder problems, you can construct or tweak a treatment plan that takes into account their self-ratings.

Shoulder Pain and Disability Index Example

Now you know what the Shoulder Pain and Disability Index is, and how it can be administered, answered, and scored, it’s time for you to see what a filled-out copy looks like:

Download this Shoulder Pain and Disability Index Example (Sample) here:

Shoulder Pain and Disability Index Example

If you like what you see and you think this is a good clinical assessment to have when it comes to gauging patients with shoulder pain, feel free to download a copy from our platform! You can print it and have your patient fill it out immediately! Or, if you want to go paperless, you can send the PDF to your patient instead! The SPADI PDF template has radio buttons for patients to designate their self-ratings, and there are editable fields for them to input their scores. It’s perfect if you want to have them answer it before their appointment with you. That way, you can better prepare for it.

When is it best to issue the Shoulder Pain and Disability Index?

There are two appropriate times to use the Shoulder Pain and Disability Index.

The first one is when a patient attends an appointment they scheduled with you and they talk about shoulder pain. To properly gauge their pain, hand them the Shoulder Pain and Disability Index, then have them expound on their answers so you can get a better picture of how they are feeling beyond the numbers. That way, you can determine what particular tests and physical examination techniques you should conduct to determine the possible problem their shoulders are going through.

The SPADI can also be used during the treatment plan-making phase. Let’s say that the patient already has a specific shoulder condition diagnosis. You can use the index to determine how bad the condition has been affecting them, and then, based on their self-ratings, you can determine what might be best to add to their treatment plan. Will you prescribe medication? Will you have them undergo a shoulder rehabilitation program? Do they need to undergo surgery? Do you think they need someone to assist them with certain activities of daily living? These are just some of the questions that you will be able to answer using the results of the Shoulder Pain and Disability Index, and the results of other tests that were conducted on the patient.

What are the benefits of using the Shoulder Pain and Disability Index?

It helps healthcare professionals understand their patients better.

The Shoulder Pain and Disability Index is a self-assessment, so it relies on a patient’s perspective regarding their pain and how it affects their daily life. It gives the patient the opportunity to communicate how they feel, and you can have them explain themselves better by expounding on their self-ratings. This can establish rapport between the healthcare professional and the patient, in the sense that there can be shared decision-making regarding treatment and how it can be tailor-fitted to the patient.

It is a comprehensive and standardized assessment of shoulder pain.

If there are two words that you can use to describe the Shoulder Pain and Disability Index, that would be comprehensive and consistent.

The SPADI is comprehensive because it doesn’t just ask about how often patients feel their shoulder pain and how bad it feels. It also asks about how the pain has impacted them. Their self-ratings will help healthcare professionals determine what to do next in order to cover all bases related to their shoulder pain.

It also has a standardized scoring system. Since the answers are based on the patient’s perspectives and experiences, you can definitely say that the answers are subjective. But with the SPADI’s scoring system, the index gains a semblance of objectivity because it assigns a score to the totality of their self-ratings. This can be used down the line to track changes and compare results.

It can be used to monitor patients and evaluate treatment plans.

Speaking of tracking changes over time and comparing results, the Shoulder Pain and Disability Index can be used to monitor patients who are undergoing a rehabilitation plan or a treatment plan. It’s a way for healthcare professionals to check if they are getting better (the scores based on their self-ratings should reflect this) and if the implemented plans are working or not. If the patient’s shoulder is feeling better (less pain or no pain) and if their quality of life has improved (their functional independence is getting better and they require less or no support/supervision). If they are getting better, then you can also say that your treatment or rehabilitation plan is working. If not, then perhaps you should tweak or overhaul it, and see if the changes will do the trick.

Why use Carepatron for orthopedic and physical therapy work?

If you are a healthcare professional that specializes in assessing and treating patients who have musculoskeletal issues, then we’d like to ask you to take the time to browse the Carepatron platform and consider taking advantage of our features.

One such feature that you will surely find to be beneficial is our resource repository, which houses a wide variety of worksheets, assessments (including the Shoulder Pain and Disability Index), survey templates, general treatment plans, progress note templates, ICD code guides, and a whole lot more. It covers multiple healthcare fields, including orthopedics and physical therapy.

Normally, musculoskeletal issues require comprehensive examinations in order to fully identify and understand the specific problems. While the Shoulder Pain and Disability Index can determine how a patient feels regarding their pain and how it is impacting them, it doesn’t pinpoint the specific shoulder problem.

If you are dealing with a new patient with shoulder issues, we recommend performing physical examination techniques like the Shoulder Abduction Test and the Clunk Test to assess your patient. We have templates for these that you can download for free! We also have other assessments for gauging the upper extremities so take the time to browse our resource repository.

Another feature of ours that you can take advantage of is our storage system, which allows you to store your clinical documents in a HIPAA-compliant manner. If you want, you can store copies of the Shoulder Pain and Disability Index with us! Doing so essentially creates backups of your files, and you can secure them with access permission! If you are working with a wider team, you can give them access to your files via the storage. It’s an easy way to relay results to them, especially if you’re not done examining the patient.

We at Carepatron are committed to helping healthcare professionals with their work, so take advantage of our platform so we can find ways to streamline your workflows and help you preserve your work!

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How long does it normally take to accomplish the Shoulder Pain and Disability Index?
How long does it normally take to accomplish the Shoulder Pain and Disability Index?

Commonly asked questions

How long does it normally take to accomplish the Shoulder Pain and Disability Index?

It should take around 5 to 10 minutes. This includes the calculation of the scores. There are only 13 questions that need to be answered, and the patient only needs to tick the rating that applies to them per item.

Are there any specific shoulder conditions that this index can gauge?

It doesn’t matter what particular shoulder condition the patient has. So long as there is pain and their quality of life has been impacted, the SPADI can be used to assess the patient.

Since the SPADI is a self-assessment, can the results be trusted?

Yes, because you will act according to what your patient is feeling and how their shoulder pain has impacted them. It is subjective, but the scoring system should give the index a semblance of objectivity. The results should help professionals determine the necessary tests that should be conducted, or what goes into a tailor-fitted treatment plan for the patient.

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