Shoulder pain is the third common areas of musculoskeletal pain. Shoulder pain was originated from pathology which neck and upper thoracic spines and destabilize movement of shoulder girdle. Treatment of chronic shoulder pain was used by acupuncture in recent time. Therefore research studies increased and we made search Medline and found articles on biomechanics of shoulder complaint, when we consolidated articles on biomechanics of shoulder complaint. Then we coordinated results of consolidated articles to theory of the Chinese acupuncture meridians and collaterals. Findings of coordination biomechanics of shoulder complaints to theory of the Chinese acupuncture meridians and collaterals studies to improve diagnostics and acupuncture treatment of shoulder pain.

Shoulder pain is a common complaint in modern societies which affects on functional abilities and quality of life. Long timefor shoulder pain the diagnosis " shoulder joint periarthritis" was explaining all disorders of shoulder. Modern studies of functional anatomy of shoulder area requires new vision of the problem and new attitude of the diagnosis and treatment. In International classification of diseases - 10 there is classification of shoulder disorders in terms of functional anatomy. Later studies of shoulder disorders described it as three groups of disorders as synovial disorders, shoulder girdle disorders and combination diagnosis. There are examination test for identification of shoulder disorder topography. In Mongolia the shoulder pain is not studied enough, there is no guidelines on diagnostics and treatment. Therefore we did this literature review to find out modern tendencies of shoulder disorder diagnostic approaches which could become a basis for shoulder examination guideline.

Introduction: Shoulder pain is quite common complaint worldwide, studied and described in many trials evaluating the effects of different treatment methods. Generally, shoulder complains managed by general practitioners and as a result of these studies many countries developed guidelines for management of shoulder complaints for general practitioners. In Oriental Traditional Medicine shoulder pain syndromes is a part of "Bi" syndromes and explained as quite common syndrome and one of the oldest afflictions. It is classified, as well as other joint complaints, as Complicated diseases, and many textbooks give the explanations on diagnostics and treatments of joint pain. In our days, when Traditional Oriental treatment methods becoming popular for the treatment of the shoulder complains, there is need to compare diagnostic approaches of two Medicines and try to develop integrated methods, which could be used by oriental medical doctors (OMD) as well as medical doctors. Taking into account the popularity of acupuncture for pain management in Mongolia we made a literature review and wanted to develop integrative understanding of the patho-mechanism of shoulder complaints and diagnostic guidelines for OMD. Diagnosis of the shoulder complaints should be done in combination of modern medicine view and theory of Channels and collaterals. Objectives: To develop the chronic shoulder pain diagnostic principles for OMD, basing on 10th international disease classification, diagnostic methods used in GP practice, and theory of Pathogens, Channels and Collaterals, TCM. Methods: We did a literature review on diagnostic methods of chronic shoulder pain in modern medicine and Oriental medicine. By the shoulder pain we mean pain located in the region of deltoid muscle, the acromioclavicular joint, the superior part of the trapezoid muscle and the scapula. We excluded rheumatic disorders, severe traumas, tumors, shoulder complains due to internal and neurological diseases because it needs different treatment principles. In TCM, the joint problems are caused by invasion of Wind, Cold and Dampness into the body, which leads to obstruction or "Bi" syndrome. No doubt, that there are many other factors, such as weakness of defensive energy or insufficient energy of certain organs, but patho-mechanism describes that, pathogenic factors invade the body and obstructs Channels and Collaterals and lead to insufficient flow of Qi and Blood. There are five painful joint "Bi" syndromes such as Wind, Cold, Damp, Heat, and Bony Painful Obstruction Syndrome. Three of them (Cold, Damp, Bony syndromes) could be classified as chronic conditions, so we emphasized out attention on them. From the modern medicine view we take diagnostic groups according to the 10th International disease classification: adhesive capsulitis of shoulder (frosen shoulder)M75, Rotator cuff syndrome M75.1, Bicipital tendinitis M75.2, Calcific tendinitis of shoulder M75.3, Impingement syndrome of shoulder M75.4, Bursitis of shoulder M75.5, Other shoulder lesions M75.8. Shoulder lesion, unspecified M75.9. These diagnosis could include into three general groups of complains, which has different therapeutic principles: 1) Synovial group - consisting of patients with pain and /or limitation of motion in one or more directions of the range of active or passive motion of the glenohumeral joint. This complains originate from disorders of the subacromial structures, the acromioclavicular joint, the glenohumeral joint or combinations. 2) A shoulder girdle group - the pain and limitation of the range of active motion of the glenohumeral joint are not related to synovial structures. Instead, pain or limitation of one or several directions of the range of motion of the cervical spine, upper thoracic spine or the upper ribs is found. 3) Patients with combinations of synovial and shoulder girdle disorders - patients with pain and sometimes with slight limitations in the active or passive range of motion of the glenohumeral joint together with pain or limitation of the range of motion of the cervical, upper thoracic spine and/or the upper ribs. Both the synovial structures and the structures of the cervical spine, the upper thoracic spine and the upper ribs may cause the complains. For the diagnosis of the diseases which cause the shoulder pain, it is recommended to use examination tests developed by Cyriax, and then modernized by Sobel and Winters. It is useful to examine Dowborn test, Howkins' test, drop-arm test, empty-can test, the cross-body adduction test, and the external rotation tests used for diagnosis of shoulder complains. Conclusion: The mechanism of shoulder pain in TCM could be adopted in Modern medicine diagnosis, as well as guidelines' examination items could be adopted in Traditional medicine. Pathological changes in shoulder joint and shoulder girdle could be integrated into the diagnostic items used in Traditional medicine. It will improve the quality of acupuncture treatment for shoulder pain.