Shoulder Pain In Group Research Articles

Prevalence and risk factors for work-related shoulder pain among informal garment workers in the northeast of Thailand

This cross-sectional study investigated the prevalence of work-related shoulder pain (SP) and risk factors associated with SP among 446 informal garment workers, mainly in small or home businesses in the northeast of Thailand. Data were collected by face-to-face interviews using a structured questionnaire and a survey form about the working environment. Risk factors for SP were indicated by multiple logistic regression analysis. The six month-prevalence of SP was 46.9%. The significant risk factors for SP included worked less than 10 years (ORadj = 1.5), no change of working posture each hour (ORadj = 2.0) and inappropriate seat width (ORadj = 3.0). It is concluded that the prevalence of SP is high in Thai garment workers and that work posture and workstation are contributing risk factors. In order to help reduce or prevent SP in this occupational group, it is proposed that ergonomics education and redesign of seats at workstations should be routinely implemented.

Somatosensory impairments are common after stroke but have only a small impact on post-stroke shoulder pain

To investigate whether somatosensory impairments are more common in individuals with post-stroke shoulder pain than in those without post-stroke shoulder pain and healthy controls. Descriptive analysis of a convenience sample. Forty-nine individuals with stroke, 24 with and 25 without post-stroke shoulder pain (median age 65 years), and 11 age- and sex-matched healthy controls. Perception and pain thresholds for cold, warm and heat (thermal thresholds), and pain thresholds for pressure and pin prick (mechanical thresholds) were assessed using quantitative sensory testing (QST). Passive range of motion, motor function, resistance to passive movements, light touch and proprioception were assessed in the upper extremities. Shoulder pain characteristics were recorded in the post-stroke shoulder pain group. There were no significant differences between the group with post-stroke shoulder pain and the group without post-stroke shoulder pain in any of the QST assessments, but more participants in the post-stroke shoulder pain group reported abnormal cold sensation in the affected side. Both stroke groups had generally higher thermal thresholds and more extreme low or high mechanical thresholds than the healthy controls. Somatosensory impairments are common among individuals with stroke compared with healthy controls. The non-significant differences in QST thresholds between the group with post-stroke shoulder pain and the group without post-stroke shoulder pain indicate that somatosensory impairments have only a small impact on post-stroke shoulder pain.

Balance ability and postural stability among patients with painful shoulder disorders and healthy controls

BackgroundIn therapeutic settings, patients with shoulder pain often exhibit deficient coordinative abilities in their trunk and lower extremities. The aim of the study was to investigate 1) if there is a connection between shoulder pain and deficits in balance ability and postural stability, 2) if pain intensity is related to balance ability and postural stability, and 3) if there is a connection between body mass index (BMI) and balance ability and postural stability.MethodsIn this case–control study, patients (n = 40) with pathological shoulder pain (> 4 months) were matched with a healthy controls (n = 40) and were compared with regard to their balance ability and postural stability. Outcome parameters were postural stability, balance ability and symmetry index which were measured using the S3-Check system. In addition, the influence of shoulder pain intensity and BMI on the outcome parameters was analysed.ResultsPatients with shoulder pain showed significantly worse results in measurements of postural stability right/left (p < 0.01) and front/back (p < 0.01) as well as balance ability right/left (p = 0.01) and front/back (p < 0.01) compared to healthy controls. There were no significant group differences with regard to symmetry index. However, there was a significant (p < 0.01) symmetry shift towards the affected side within the shoulder pain group. There was no correlation between pain intensity and measurements of balance ability or postural stability. Likewise, no correlation between BMI and deficiencies in balance ability and postural stability was established.ConclusionsPatients with pathological shoulder pain (> 4 months) have deficiencies in balance ability and postural stability; however the underlying mechanisms for this remain unclear. Neither pain intensity nor BMI influenced the outcome parameters. Patients with shoulder pain shift their weight to the affected side. Further research is needed to determine if balance training can improve rehabilitation results in patients with shoulder pathologies.

Biomechanical properties of the glenohumeral joint capsule in hemiplegic shoulder pain

BackgroundAlthough many hemiplegic shoulder patients have been suffering from limited range of motion, it is not fully established whether the pathologic biomechanics are same in hemiplegic shoulder pain and adhesive capsulitis. Therefore we aimed to investigate biomechanical properties of glenohumeral joint capsules of hemiplegic shoulder pain with limited range of motions. MethodsParticipants were 14 patients with hemiplegic shoulder pain, 10 controls, and 42 adhesive capsulitis patients matched with the hemiplegic shoulder pain group for sex, age, and range of motion. Demographic data, clinical variables, and sonographic findings were comparable between hemiplegic shoulder pain and adhesive capsulitis groups. We compared capsular capacity, maximal pressure, and capsular stiffness of glenohumeral joint capsule among the 3 groups. FindingsHemiplegic shoulder pain and adhesive capsulitis groups had smaller capsular capacity and higher maximal pressure than controls. The capsular stiffness of hemiplegic shoulder pain group was higher than that of controls (P=0.001) but lower than that of adhesive capsulitis group (P<0.001). InterpretationThe stiffness of glenohumeral joint capsules in hemiplegic shoulder pain and adhesive capsulitis patients was substantially higher than that in controls, suggesting that hemiplegic shoulder pain patients had stiffer capsules as adhesive capsulitis patients did although the severities were different. This finding implicates that hemiplegic shoulder pain may share common pathologic properties of tighter capsules with adhesive capsulitis. However, there may be additional mechanisms contributing to range of motion limitation in hemiplegic shoulder pain because capsular stiffness in those patients was not as severe as that in adhesive capsulitis patients with similar range of motion limitation.

MRI evaluation of painful hemiplegic shoulder in patients after stroke: A pilot study

Objective To observe the structural abnormalities of the painful shoulder in patients soon after stroke by M RI,and to identify the possible causes of post-stroke shoulder pain (PSSP).Methods Patients with hemiplegia following their first cerebrovascular accident were divided into 2 groups:PSSP group (32 patients) and post-stroke no shoulder pain (PSNSP) group (20 patients).Physical findings of affected shoulder and MRI findings of both affected and unaffected shoulders were evaluated.Results Shoulder subluxation was significantly more frequent in PSSP group than in PSNSP group (53％ vs 15％,P ＜0.05).In PSSP group,the incidence rate of rotator cuff injury,subacromial-subdeltoid bursa effusion,glenohumeral joint effusion,effusion of long head of biceps tendon was higher in affected side than that in unaffected side(63％ vs 13％,53％ vs 13％,75％ vs 31％,41％ vs 13％,respectively).In PSNSP group,the incidence rate of glenohumeral joint effusion was higher in affected side than that in unaffected side (70％ vs 17％).But compared with no pain hemiplegic shoulder,only rotator cuff injury and subacromial-subdeltoid bursa effusion were significantly higher in PSSP patients (63％ vs15％,53％ vs 25％,respectively),and there was significant difference between the two groups (P ＜0.05).Conclusion Rotator cuff injury was found to be a possible cause of PSSP. Key words: Poststroke shoulder pain; Stroke; MRI

Influences of Chronic Shoulder Pain on Muscle Tone Changes in Trunk Muscles

The purpose of this study was to examine the influences of chronic shoulder pain on the muscle tone in trunk muscles. The study's subjects were 40 men and women in their 30 to 50s, which were divided into two groups. A chronic shoulder pain group consisted of 20 subjects who had been diagnosed with chronic shoulder pain by doctors, and a painless group consisted of 20 subjects who had experienced no such pain. An analysis was performed using electromyography on the muscle tone in the rectus abdominalis, external oblique, internal oblique, and erector spinae muscles under the same conditions between the two groups. The analysis results were as follows. The chronic shoulder pain group exhibited an overall high level of trunk muscle tone than the painless group, along with a statistically significant difference in the rectus abdominalis(p<.05). Moreover, the chronic shoulder pain group showed differences in the trunk muscle tone depending on the affected side. The chronic left shoulder pain group yielded higher levels of muscle tone in the right-side trunk muscles. In particular, the group revealed statistically significant differences in the rectus abdominalis and internal oblique(p<.05). The chronic right shoulder pain group exhibited higher levels of muscle tone in the left-side trunk muscles with a statistically significant difference in the internal oblique(p<.05). The above results suggested that chronic shoulder pain influences increases in the muscle tone in the trunk muscles on the opposite side to the affected shoulder.

Myofascial Pain Syndrome: Trigger Points

SUMMARY The aim of this observational study from Spain was to determine the prevalence of mechanical hypersensitivity and active and latent trigger points [TrPs] in elite swimmers with and without unilateral shoulder pain. Seventeen elite swimmers with and 18 without shoulder pain were included, while 15 elite athletes acted as matched controls. The subjects were assessed for pressure pain thresholds [PPT] and the presence of active and latent TrPs in the levator scapulae, sternocleidomastoid, upper trapezius, infraspinatus, subscapularis and scalene muscles. The PPT was also assessed over the tibialis muscle. Subjects were included when aged between 18 and 30 years of age and swimming more than 6 h per week. The subjects with shoulder pain had these complaints for more than 3 months. Pain was described as pain felt in the shoulder or arm with an intensity of at least 4 on an 11-point numerical pain rating scale. They had to report a positive Neer test and Hawkins-Kennedy test at physical examination. Subjects were excluded with a history of shoulder or neck surgery, fracture of the shoulder region, bilateral shoulder symptoms, cervical radiculopathy, previous steroid injections or any type of physical intervention within the last year. The age-matched controls were right-handed elite athletes without shoulder complaints and with a negative Neer test and Hawkins-Kennedy test and the abovementioned exclusion criteria were used. A mechanical pressure algometer was used to establish PPT, which was defined as the minimal amount of pressure needed to elicit pain. The PPT was measured at predefined points within the muscles. The TrPs were explored by a blinded assessor with more than 8 years of experience in TrPs diagnosis following the guidelines described by Simons et al. (1) and by Gerwin et al. (2). The TrPs were considered active, when local and referred pain PPTs were significant reduced in the swimmers with shoulder pain group compared with the healthy controls in all muscles, but not when compared to the swimmers without shoulder pain group. Furthermore, much higher numbers of active and latent TrPs were found in swimmers with and without shoulder pain compared to healthy athletes.

Effects of acupuncture treatment on natural killer cell activity, pulse rate, and pain reduction for older adults: an uncontrolled, observational study

ObjectiveThe aim of this study was to examine the changes in natural killer (NK) cell activity, pulse rate, and pain intensity among older adults before and after acupuncture treatment. MethodsFifty-six individuals (16 males and 40 females), aged 60 to 82 years (mean age 72.4 ± 5.0), who were experiencing pain in the shoulder, low back, or knee, participated in the study. NK cell activity, leukocyte differentiation (granulocytes and lymphocytes), pulse rate, and blood pressure values were obtained. Pain intensity was evaluated by using the visual analog scale (VAS). The Wilcoxon test was used to analyze NK cell activity, leukocytes (granulocyte counts and granulocyte-to-lymphocyte ratio), and the VAS score in accordance with the location of pain complaints before and after acupuncture treatment. ResultsNK cell activity decreased after acupuncture treatment for pain in the shoulder-pain and knee-pain groups. Further, the lymphocyte and granulocyte counts increased after acupuncture treatment for the shoulder-pain group. Pulse rate decreased for the shoulder-pain, low-back-pain, and knee-pain groups after acupuncture treatment. The VAS score decreased after acupuncture treatment for the shoulder-pain, low-back-pain, and knee-pain groups. ConclusionThis study showed that in older adults, acupuncture treatment decreases pulse rate, relieves pain in the shoulder, low back, and knee, and reduces NK-cell activity.

Multiple-, But Not Single-, Dose of Parecoxib Reduces Shoulder Pain after Gynecologic Laparoscopy

Background: The aim of this study was to investigate effect of single- and multiple-dose of parecoxib on shoulder pain after gynecologic laparoscopy.Methods: 126 patients requiring elective gynecologic laparoscopy were randomly allocated to three groups. Group M (multiple-dose): receiving parecoxib 40mg at 30min before the end of surgery, at 8 and 20hr after surgery, respectively; Group S (single-dose): receiving parecoxib 40mg at 30min before the end of surgery and normal saline at the corresponding time points; Group C (control): receiving normal saline at the same three time points. The shoulder pain was evaluated, both at rest and with motion, at postoperative 6, 24 and 48hr. The impact of shoulder pain on patients' recovery (activity, mood, walking and sleep) was also evaluated. Meanwhile, rescue analgesics and complications were recorded.Results: The overall incidence of shoulder pain in group M (37.5%) was lower than that in group C (61.9%) (difference=-24.4%; 95% CI: 3.4~45.4%; P=0.023). Whereas, single-dose regimen (61.0%) showed no significant reduction (difference with control=-0.9%; 95% CI: -21.9~20.0%; P=0.931). Moreover, multiple-dose regimen reduced the maximal intensity of shoulder pain and the impact for activity and mood in comparison to the control. Multiple-dose of parecoxib decreased the consumption of rescue analgesics. The complications were similar among all groups and no severe complications were observed.Conclusions: Multiple-, but not single-, dose of parecoxib may attenuate the incidence and intensity of shoulder pain and thereby improve patients' quality of recovery following gynecologic laparoscopy.

Pain relief due to physiotherapy doesn’t change the motor function of the shoulder

The purpose of this study is to evaluate the effect of different training methods in physiotherapy on pain relief and change in proprioception and kinesthesia of the shoulder. Further, the connections between pain relief and change in motor function of the shoulder will be investigated. Randomised trial. Ambulatory care. Two groups of unspecific shoulder pain patients (group1 n=12, group2 n=10). One group (n=8) of non-symptomatic subjects. The first shoulder-pain group was trained using flexible foil, whilst flexible bands were used to train the patients in the second group. Training period was 12 weeks. Pain of the shoulder was evaluated through functional pain assessment (Constant-Murley score) before, halfway through and after intervention. Proprioceptive and kinaesthetic ability was measured by an active-active angle-replication test for the shoulder before and after intervention. The data of the shoulder patients was compared to the group of non-symptomatic subjects. Pain was reduced significantly in both groups (p<.05) whereas no changes were measured for the ability to replicate angles of the shoulder. This suggests that pain relief in the shoulder is not associated with enhancement of the investigated parameters in motor function.

Anterior acromioplasty: Effect of litigation and workers' compensation

Seventy-five consecutive anterior acromioplasties were performed in 74 patients with chronic inflammation of the supraspinatus tendon caused by the impingement syndrome. Thirty-six patients (49%) had filed workers' compensation claims (group 1), 21 patients (28%) were involved in accident litigation (group 2), and 17 patients (23%) had no financial gain associated with their shoulder pain (group 3). The patients were followed up for a minimum of 12 months after surgery (range 12 to 48 months). Sixty-one patients (82%) had excellent results, 11 patients (15%) had good results, and 2 patients (3%) failed to improve from surgery. Ninety-one percent of employed patients were able to return to full employment. Although group 1 patients required a significantly longer time to return to work (average 14.2 weeks vs. 4.7 weeks in group 2 and 2.5 weeks in group 3), these patients were all involved in heavy labor demanding a more complete return of shoulder endurance. Satisfactory pain relief and return to preinjury work activities can be achieved by acromioplasty in patients who have the potential for secondary gain.

Der chronische Schulterschmerz des Volleyballangriffsspielers

30 competitive volleyball attackers of the German third league, 15 with shoulder pain (group I) and 15 without shoulder pain (group II) were examined clinically and sonographically. Anamnesis was also carried out. The results were compared with those of a control of 15 non-volleyball players not subject to stress caused by overhead use of their arms. On the visual analog scale the average pain was 5.1 (SD 1.4). The average history of pain was 2.7 (SD 2.7) years. Cause for the pain was "spiking without warming up" (n = 7) or "unknown" (n = 8). Spiking respectively serving caused new pain sensation in 14 (11) attackers. Players of group I stretched shorter than those of group II. Pain was located laterally to the greater tuberculum (n = 8), at the origin of the deltoid muscle (n = 3), at the bicipital groove (n = 2) or in the area of the ventral glenoid (n = 2). Pain was caused by active anteversion above 160 degrees (n = 3), active abduction above 140 degrees (n = 2) or both (n = 10). The playing shoulder was depressed in all 30 volleyball attackers. By measuring the distance from the epicondylus radii to the acromion of the other side by maximal forced horizontal adduction, the distance from the margo medialis scapula to the spine, the distance from the tip of middle finger to the lumbar spine by maximal internal rotation of the shoulder up the back showed significant differences between both sides and between the groups. The spiking arm scapula is significantly lateralised compared to the opposite side and compared to sportsmen.(ABSTRACT TRUNCATED AT 250 WORDS)