Central sensitization syndrome in patients with rotator cuff tear: prevalence and associated factors

Abstract

ABSTRACT Introduction A significant number of rotator cuff tear (RCT) patients developed chronic shoulder pain that did not correspond to physiological changes. Central sensitization syndrome (CSS) is a neurophysiological adaptation process that can result in hypersensitivity to peripheral stimuli. Although there is evidence of an association between CSS and musculoskeletal problems, no studies have focused on the association between CSS and RCT. The primary purpose of this study was to examine the prevalence of CSS in patients with RCT. The secondary purpose was to document the associated conditions and comorbidity that were associated with the CSS. Methods This was a cross-sectional study of patients with RCT who completed the Central Sensitization Inventory (CSI). Patients with score of ≥ 40/100 were considered positive for CSS. Demographic and clinical data and CSI results were collected to analyze the prevalence and associated factors of CSS in RCT patients. Results A total of 404 RCT patients were included, and the CSS prevalence was 39.4%. Compared to the non-CSS group, the CSS group had an odds ratio of 4.13 (95% CI, 2.70–6.32; p＜0.001) for ages 51–60, 3.07 (95% CI, 2.00–4.69; p＜0.001) for symptoms lasting more than 6 months, 6.08 (95% CI, 3.90–9.47; p＜0.001) for nonphysical laborers, 3.69 (95%CI, 2.42–5.61; p＜0.001) for long head of biceps (LHB) abnormality, 2.93 (95% CI, 1.93–4.45; p＜0.001) for concurrent shoulder stiffness, 4.82 (95% CI, 2.55–9.10; p＜0.001) for anxiety or panic episodes, and 2.11 (95% CI, 1.12, 4.00; p＜0.001) for depression. Conclusions The prevalence of CSS in patients with RCT was relatively high at 39.4%. The CSS was associated with higher age, female gender, and clinical findings of symptoms lasting over six months, nonphysical laborers, abnormal LHB, concurrent shoulder stiffness, anxiety, and depression.