Shoulder complaints are a very prevalent condition and a significant cause of morbidity and disability. Most patients with shoulder complaints are primarily seen by general physicians. The guideline, as developed by the Dutch College of General Physicians (NHG) in 2019, formulates a basic algorithm to start early conservative management of shoulder complaints. This article describes several causes of shoulder complaints more extensively and offers possible tools to obtain a more precise diagnosis. With a better knowledge of the multiple causes of shoulder complaints, most shoulder complaints can be adequately managed by general physicians, thus preventing unnecessary referrals.