**5. Conclusions**

The purpose of the present review was to summarize findings on the psychosomatics of shoulder pain, regarding psychopathologic syndromes and factors of the personality, and to connect them with specific psychosomatic, as well as psychotraumatologic, concept formation. As others did before, we underscore the frequent coincidence of psychopathology in relation to shoulder pain. Not unlike the knee, which—when painful—is robustly associated with a variety of mood and cognitive changes, and with higher-order factors such as neuroticism, shoulder pain is also entangled with psychopathology. A similar observation can be made regarding the physical comorbidities of shoulder pain, i.e., arterial hypertension and diabetes mellitus, which display a similar pattern of association with psychiatric syndromes. The present review demonstrates the complexity of psychosocial epiphenomena of chronic pain and of their interaction with shoulder pain, in particular, as well as the necessity of an integrated neuropsychosocial understanding and of a holistic treatment of pain.

## **6. Limitations**

The present review summarizes the findings on the psychological and psychosomatic implications of shoulder pain. In doing so, it focusses on the interface between lateralized pain and the respective anatomy including the lateralization of pain afferents as well as the peculiarities of psychological trauma and its role in the chronification of pain. We discuss the included studies in accordance with these foci.

**Funding:** This research received no external funding.

**Institutional Review Board Statement:** Not applicable.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** Not applicable.

**Acknowledgments:** The authors would like to thank Jörg Frommer for leading the group to a fruitful and interdisciplinary cooperation. We also thank Christopher Coutts for language editing.

**Conflicts of Interest:** The authors declare no conflict of interest.
