Glenohumeral Pain Research Articles

Can Subscapularis Deficiency Explain Glenoid Wear (Thus Possibly Glenohumeral Pain)

Can Subscapularis Deficiency Explain Glenoid Wear (Thus Possibly Glenohumeral Pain)

POST-INFLATED GLENOHUMERAL PAIN

The aim of the study was to assess the prevalence of post-storoke glenohumeral pain and the effectiveness of its diagnosis and treatment in a university clinic. It was shown that pain in the shoulder joint of the parectic limb is recorded in 28.3% of inpatients and 20.3% during the first weeks after discharge. At controlled visits 3 and 6 months later, in 61.5% of cases, satisfactory clinical effects were achieved by reducing the intensity of pain to 1.8 ± 0.1 scores, and in the rest of the patients to achieve complete control of the pain. It was established that the use of preventive measures can reduce the number of patients with post-venous glomerular syndrome, moral pain.

POST-INFLATED GLENOHUMERAL PAIN

The aim of the study was to assess the prevalence of post-storoke glenohumeral pain and the effectiveness of its diagnosis and treatment in a university clinic. It was shown that pain in the shoulder joint of the parectic limb is recorded in 28.3% of inpatients and 20.3% during the first weeks after discharge. At controlled visits 3 and 6 months later, in 61.5% of cases, satisfactory clinical effects were achieved by reducing the intensity of pain to 1.8 ± 0.1 scores, and in the rest of the patients to achieve complete control of the pain. It was established that the use of preventive measures can reduce the number of patients with post-venous glomerular syndrome, moral pain.

Is sleep position associated with glenohumeral shoulder pain and rotator cuff tendinopathy: a cross-sectional study

BackgroundGlenohumeral pain and rotator cuff tendinopathy (RCT) are common musculoskeletal complaints with high prevalence among working populations. The primary proposed pathophysiologic mechanisms are sub-acromial RC tendon impingement and reduced tendon blood flow. Some sleep postures may increase subacromial pressure, potentially contributing to these postulated mechanisms. This study uses a large population of workers to investigate whether there is an association between preferred sleeping position and prevalence of: (1) shoulder pain, and (2) rotator cuff tendinopathy.MethodsA cross-sectional analysis was performed on baseline data from a multicenter prospective cohort study. Participants were 761 workers who were evaluated by questionnaire using a body diagram to determine the presence of glenohumeral pain within 30 days prior to enrollment. The questionnaire also assessed primary and secondary preferred sleep position(s) using 6 labeled diagrams. All workers underwent a structured physical examination to determine whether RCT was present. For this study, the case definition of RCT was glenohumeral pain plus at least one of a positive supraspinatus test, painful arc and/or Neer’s test. Prevalence of glenohumeral pain and RCT were individually calculated for the primary and secondary sleep postures and odds ratios were calculated.ResultsAge, sex, Framingham cardiovascular risk score and BMI had significant associations with glenohumeral pain. For rotator cuff tendinopathy, increasing age, Framingham risk score and Hand Activity Level (HAL) showed significant associations. The sleep position anticipated to have the highest risk of glenohumeral pain and RCT was paradoxically associated with a decreased prevalence of glenohumeral pain and also trended toward being protective for RCT. Multivariable logistic regression showed no further significant associations.ConclusionThis cross-sectional study unexpectedly found a reduced association between one sleep posture and glenohumeral pain. This cross-sectional study may be potentially confounded, by participants who are prone to glenohumeral pain and RCT may have learned to avoid sleeping in the predisposing position. Longitudinal studies are needed to further evaluate a possible association between glenohumeral pain or RCT and sleep posture as a potential risk factor.

Conservative Management Of Biceps Brachii Spasticity And Pain With Vibration At The Proper Frequency Range Produced By Oscillating Percussion: Case Report

Objective: Case reports of a patient suffering from biceps brachii spasticity and pain accompanied by limited range of motion in flexion and extension. Clinical features: Patient presented with right arm pain at the glenohumeral area and the elbow. Patient was assessed and treated accordingly. There was glenohumeral pain and muscle fatigue from overuse. Intervention and outcome: A treatment with an instrument generating vibration within specific frequencies to facilitate or inhibit voluntary muscles. The treatment resulted in pain relief and normal range of motion. Conclusion: This case report describes the use of a new technology specific to facilitation and inhibition of voluntary muscles with subjective and symptomatic improvements.

Impacts of Differences in Epidemiological Case Definitions on Prevalence for Upper-Extremity Musculoskeletal Disorders

The aim of this study was to systematically evaluate prevalence based on variations in case definitions used for epidemiological studies of musculoskeletal disorders (MSDs). Prior studies of MSDs have mostly relied on a single case definition based on questionnaires. In a multicenter prospective cohort study, we systematically collected data to evaluate impacts of differences in case definitions of MSDs on prevalence of three common musculoskeletal disorders: (a) shoulder tendinosis, (b) lateral epicondylalgia, and (c) carpal tunnel syndrome. Production workers were from 21 employment settings in three diverse U.S. states and performed widely varying work. All workers completed laptop-administered structured interviews, two standardized physical examinations, and nerve conduction studies (NCS). Case definitions included symptoms only, and symptoms plus physical examinations and/or NCS. A total of 1,227 subjects had complete health data at baseline. The prevalence for shoulder tendinosis is 23.0% if only glenohumeral pain is used for a case definition, compared with 8.0% if a combination of pain plus a positive supraspinatus test is used. The prevalence for lateral epicondylalgia varied on the basis of lateral elbow pain (12.0%), pain plus tenderness on palpation (9.9%), or pain plus tenderness on palpation plus resisted wrist or middle finger extension (3.5%). Carpal tunnel syndrome prevalence varied on the basis of tingling or numbness in a median nerve-served digit (29.9%) or tingling or numbness plus NCS abnormalities consistent with carpal tunnel syndrome (9.0%). Variations in epidemiological case definitions have major impacts on prevalence of common MSDs. Wide-ranging differences in prevalence may have impacts on purported risk factors that need to be determined.

Postsurgical Glenohumeral Arthritis in Young Adults

Background Chondrolysis has been reported as a sequela of arthroscopic shoulder surgery. Although the causes have yet to be fully elucidated, basic science and clinical evidence suggest a multifactorial origin. Surgical treatment in young patients with glenohumeral chondrolysis is particularly challenging, with little outcome data. Hypothesis Glenohumeral chondrolysis has several causes and patterns of presentation. Biological resurfacing is a viable treatment option for symptomatic glenohumeral arthritis. Study Design Case series; Level of evidence, 4. Methods Twenty patients (mean age, 19.7 years; range, 13.1-33.8) were referred for management of extensive glenohumeral arthritis after arthroscopy glenohumeral surgery (mean time postoperatively, 26 months; range, 3-73). Sixteen patients had an intra-articular pain pump placed for 2 to 3 days; 2 patients demonstrated prominent implants; and 2 had thermal treatment. Patients underwent revision surgery, including 7 biological resurfacings of the glenoid and humeral head, 4 biological resurfacings of the humeral head alone, and 7 other procedures. Eight patients having biological resurfacing were assessed just before the revision surgery, at a mean time of 3.1 years after revision (range, 1.9-6.5), with the American Shoulder and Elbow Surgeon scale and Simple Shoulder Test, Short Form 12 (physical and mental components), and visual analog scale score for pain. Results Patient outcomes scores improved from 51 to 71 (American Shoulder and Elbow Surgeon scale, P < .01), 7 to 10 (Simple Shoulder Test, P < .02), and 5 to 3 (visual analog scale, P < .01). Preoperative range of motion demonstrated modest improvements from 119° to 132° of flexion, 42° to 41° of external rotation, and internal rotation from L2 to T12 level. Two patients required an additional surgery: 1 total shoulder arthroplasty and 1 capsular release with debridement. Conclusion Severe glenohumeral arthritis is a devastating postoperative complication of glenohumeral arthroscopy. Although not a universal finding, the use of glenohumeral pain pumps is a concern, as well as suboptimal anchor placement. Biological resurfacing permits modest functional improvement in a challenging shoulder condition.

Nonarthroplasty alternatives for the treatment of glenohumeral arthritis

Although most glenohumeral cartilaginous lesions are incidental findings and well tolerated, a symptomatic cartilage injury in a young, active individual remains a challenge. The diagnosis of this symptomatic lesion is difficult, and is usually only arrived at once other shoulder comorbidities and sources of glenohumeral pain are ruled out. Once diagnosed, a variety of treatment options are available which include palliative, reparative, restorative, and reconstruction techniques. The smallest lesions are amenable to reparative strategies such as marrow-stimulation, stimulating a fibrocartilaginous response. Larger lesions and those that have failed reparative techniques may be candidates for restorative or reconstruction procedures to replace damaged cartilage with hyaline-like tissue. The presence of bipolar injury may require the use of biologic interpositional arthroplasty. This review describes the challenges associated with the diagnosis and management of glenohumeral arthritis, and provides a treatment framework for use in these challenging patients.

Humeral Head Resurfacing in the Rheumatoid Shoulder

Summary: The rheumatoid shoulder and elbow should be assessed in an early stage concerning the possibility of surgical intervention. The cause of the shoulder pain can be localized elsewhere in the shoulder girdle or in the neck. In patients with glenohumeral pain, resurfacing of the humeral head with a cup seems to be a good alternative to conventional stemmed prostheses. It diminishes the risk of peroperative complications involving the humeral shaft and late periprosthetic fractures. Revision or arthrodesis can be undertaken easily because the bone stock has been maintained with no loss of length. The main advantages of humeral head resurfacing are preservation of bone and the relatively simple surgical technique.