Shoulder Pain Research Articles

ID: 336440 The Effects of Peripheral Nerve Stimulation on Chronic Shoulder Pain

ID: 336440 The Effects of Peripheral Nerve Stimulation on Chronic Shoulder Pain

Prevalence and Impact of Work-Related Musculoskeletal Disorders Among Dental Students in Iran: A Systematic Review and Meta-Analysis

Background: For medical students, maintaining physical health is crucial for effective practice, but these students are often exposed to both physical and mental health challenges, including work-related musculoskeletal disorders (WMSDs). Dental students are particularly vulnerable due to the physically demanding nature of their training, which involves repetitive movements, heavy workloads, and inadequate rest breaks. These disorders can lead to chronic pain, impairing quality of life and professional productivity. Methods: This systematic review and meta-analysis examined the prevalence of WMSDs among dental students in Iran. Searches were conducted in several domestic and international databases, and articles published between 2000 and 2024 were included if they reported data on the prevalence of musculoskeletal pain in dental students. A total of 289 articles were initially identified, with 4 meeting the inclusion criteria. Data were extracted and analyzed using Comprehensive Meta-Analysis (CMA) software to evaluate WMSD prevalence rates. Results: The meta-analysis revealed that 22.6% of dental students experienced back pain, 38.8% had neck pain, 25.2% reported shoulder pain, and 15.2% experienced hand/elbow pain. Overall, 72.0% of dental students reported pain in at least one part of the body. These findings align with similar global studies, with variations in prevalence possibly due to differences in sample sizes, study designs, and geographical factors. Conclusion: The study highlights a high prevalence of musculoskeletal disorders, particularly in the neck, back, and shoulders, among dental students in Iran. The findings underscore the need for preventive interventions focused on improving ergonomics and occupational health to reduce the risk of WMSDs and enhance the well-being of dental students.

Atypical Shoulder Pain

Atypical Shoulder Pain

Increased Postoperative Deltoid Signal seen after Suprapectoral Biceps Tenodesis: Potential Risk to the Anterior Branch of the Axillary Nerve

BackgroundArthroscopic suprapectoral biceps tenodesis is a common procedure for lesions of the long head of the biceps in the setting of anterior shoulder pain. However, the distal portal poses a theoretical risk to the terminal branches of the axillary nerve as the nerve travels from posterior to anterior to innervate the anterior deltoid. The purpose of this retrospective cohort study was to assess for axillary nerve branch injury, identified by deltoid signal change in postoperative magnetic resonance imaging (MRI) in patients who underwent an arthroscopic suprapectoral biceps tenodesis. MethodsPatients who underwent rotator cuff repair with a concomitant arthroscopic suprapectoral biceps tenodesis, had a postoperative MRI, and at least 1 year of follow-up were included. The incidence of increased deltoid signal consistent with injury to an anterior branch of the axillary nerve on proton density fat saturated sequences was collected. Age, sex, body mass index (BMI), and patient reported outcome measures (PROMs) including the American Shoulder and Elbow Surgeons Shoulder Score (ASES) score, Patient-Reported Outcomes Measurement Information System (PROMIS) pain, physical function (PF), and upper extremity (UE) scores, and Single Assessment Numeric Evaluation (SANE) score were compared in patients with and without increased deltoid signal on postoperative MRI. P<0.05 was used for significance. ResultsTwenty-four patients were eligible for inclusion (9 female, average age 59.0±10.1, BMI 27.6±6.7). Edema-like signal within the anterior deltoid musculature was observed in 9 patients on postoperative MRI. Two patients had a second follow-up MRI performed which demonstrated resolution of signal, and one patient required a second surgery for release of adhesions. Patients with increased deltoid signal had higher BMI (p=0.03). There was no difference in any other demographic or postoperative PROM between patients with increased signal and those without at any follow-up time point. No patient demonstrated persistent weakness or numbness in the axillary nerve distribution at final follow-up. DiscussionOver one third of patients in our cohort had MRI evidence of axillary nerve branch injury as seen on proton density fat saturated MRI sequences postoperatively. The distal arthroscopic portal for a suprapectoral biceps tenodesis may place anterior terminal branches of the axillary nerve at risk for injury. Additional investigation and strategies for avoidance of nerve injury in this area should be pursued.

ID: 313509 PNS with HF-EMC Powered Implanted Receiver for the Treatment of Chronic Shoulder Pain: Case Report

ID: 313509 PNS with HF-EMC Powered Implanted Receiver for the Treatment of Chronic Shoulder Pain: Case Report

ID: 338648 A Case of Successful Relief of Chronic Shoulder Pain with Short-Term Peripheral Nerve Stimulation

ID: 338648 A Case of Successful Relief of Chronic Shoulder Pain with Short-Term Peripheral Nerve Stimulation

Efficacy of Ultrasound-Guided Interscalene Brachial Plexus Block for Acute Post-Hepatectomy Shoulder Pain: A Randomized Controlled Trial [Letter

Efficacy of Ultrasound-Guided Interscalene Brachial Plexus Block for Acute Post-Hepatectomy Shoulder Pain: A Randomized Controlled Trial [Letter

The Clinical Considerations of Interscalene Brachial Plexus Block in the Treatment of Post-Hepatectomy Shoulder Pain [Response to Letter

The Clinical Considerations of Interscalene Brachial Plexus Block in the Treatment of Post-Hepatectomy Shoulder Pain [Response to Letter

ID: 319383 Real-World Results of 60-day PNS Used for Shoulder Pain: Analysis Across Multiple Domains of Health

ID: 319383 Real-World Results of 60-day PNS Used for Shoulder Pain: Analysis Across Multiple Domains of Health

Effectiveness of hydrotherapy on pain and functional status of shoulder joint among individuals undergone intra-articular injections

BackgroundThe shoulder complex with its varied pathology responds differently from patient to patient and so, the best option for progression is a choice of rehabilitation. In the present post-COVID scenario, many patients are referred to acute and sub-acute shoulder pain and dysfunction. It is very difficult to predict the outcome of therapy. Some patients recover even without any modalities. Recurrent or adverse symptoms are also possible. Gender, other demographic features, physiological response, and progressive outcome need to be considered in rehabilitation. This study is intended to evaluate the short-term effects of hydrotherapy post-intra-articular injections of shoulder dysfunctions.Aims and objectivesTo evaluate the effectiveness of hydrotherapy during early rehabilitation of individuals who have undergone intra-articular injections of shoulder joint on pain and function.Materials and methodsIn this prospective study, we have studied a total of 59 cases within the age group of 40–70 years with idiopathic frozen shoulder, acromio-clavicular joint dysfunction, and grade-1 untreated rotator cuff injuries. Group A patients were treated with conventional shoulder exercises and group B patients were treated in a hydrotherapy pool. The chief aim was to obtain earlier pain relief with controlled movement patterns and earlier relief from functional disability. The Constant-Murley score (CMS–100 points scale) composing pain and functional parameters was the outcome measure.ResultsAfter confounding all the demographic factors, it was found that the experimental group B treated by hydrotherapy revealed a statistically extremely significant difference (p value < 0.0001) at the end of the first week as compared to the conventional group. The treatment protocol was continued for 5 weeks. More than 90% of patients in the hydrotherapy group felt it easier and exercise participation progression was best. Better progression and improvement of shoulder function were achieved in the hydrotherapy group compared to the conventional group.ConclusionFrom this study, we conclude that hydrotherapy during early management of shoulder dysfunctions post-intra-articular injections is safer and provides excellent relief from pain as early as the first week. Functional progression is better and avoids complications related to mobilization.

ID: 341882 Bimodal Sensory and Motor 60-day PNS of Suprascapular, Supraclavicular and Axillary Nerves for Shoulder Pain

ID: 341882 Bimodal Sensory and Motor 60-day PNS of Suprascapular, Supraclavicular and Axillary Nerves for Shoulder Pain

The influence of different exercise interventions on supraspinatus tendon thickness in individuals with rotator cuff-related shoulder pain

The influence of different exercise interventions on supraspinatus tendon thickness in individuals with rotator cuff-related shoulder pain

Limited Total Arc Glenohumeral Rotation and Shoulder Biomechanics During Baseball Pitching.

Upper extremity injuries in baseball pitchers cause significant time loss from competing and decreased quality of life. Although shoulder range of motion (ROM) is reported as a key factor to prevent potential injury, it remains unclear how limited glenohumeral ROM affects pitching biomechanics which may contribute to upper extremity injuries. To investigate how pitchers with decreased total arc glenohumeral ROM of the throwing arm differed in upper extremity pitching kinematics and kinetics as well as ball velocity compared with pitchers with greater levels of glenohumeral ROM. Cross-sectional study. Laboratory. Fifty-seven baseball pitchers (ages 18-24) were divided into either control (≥160° total arc) or lower ROM (<160° total arc) groups. The mean glenohumeral ROM deficits, pitching kinematic and kinetic outcomes, and ball velocity were compared between groups. The control group demonstrated significantly less deficit in total arc ROM between arms than the lower ROM (control: -1.5° ± 10.0°; lower ROM: -12.4° ± 13.9°; P < .001). While the lower ROM group displayed less maximal shoulder external rotation (ER) while pitching, the control group had significantly less difference in ROM between maximal shoulder ER while pitching and clinically measured ER (lower ROM: 64.4° ± 12.1°; control: 55.8° ± 16.6°; P = .025). The control group had significantly faster ball velocity than the lower ROM group (control: 85.0 ± 4.3 mph; lower ROM: 82.4 ± 4.8 mph; P = .024). Pitchers with decreased total arc glenohumeral ROM (<160° total arc) may undergo overstretching toward ER in the shoulder during the late cocking phase. Pitchers with higher total arc ROM can pitch the same or faster ball without increasing loading in the upper extremity. Total arc glenohumeral ROM measurement can be a clinical screening tool to monitor shoulder condition over the time, and pitchers with limited total arc ROM might be at higher risk of shoulder injury.

Identifying evidence-practice gaps for shoulder injury risk factors in competitive swimmers: uniting literature and expert opinion

ObjectivesTo identify evidence-practice gaps regarding shoulder injury risk factors in competitive swimmers.MethodsWe gathered insights from 27 swimming experts including elite swimmers, coaches, high-performance staff and applied researchers using Concept Mapping....

MRI findings and clinical testing for preoperative diagnosis of long head of the biceps pathology.

Determine whether combining magnetic resonance imaging (MRI) observations and clinical tests could substantially improve sensitivity for diagnosis of long head of the biceps tendon (LHBT) pathology. The authors retrospectively assessed a consecutive series of 140 patients who underwent arthroscopic rotator cuff repair for isolated supraspinatus tears. The presence of LHBT pathology was assessed preoperatively on MRI using three criteria and four clinical tests specific to shoulder injuries. Binary outcomes of MRI observations and four clinical tests were combined to identify combinations resulting in the best sensitivity using intra-operative arthroscopic findings as reference. The study cohort comprised 100 shoulders (58 men and 42 women) aged 56.6 ± 9.4 years (range, 30-76) at index surgery. A total of 29 combinations were tested to obtain the best diagnostic algorithm for LHBT pathologies. Only four combinations reached a sensitivity ≥0.75, but had a specificity <0.45. The 'Speed or Signal' combination achieved the highest sensitivity (Se: 0.88; 95% confidence interval [CI]: 0.73%-0.96%; Sp: 0.20; 95% CI: 0.10%-0.33%). The most important findings of this study were that, for the diagnosis of LHBT pathology using clinical tests alone, the Speed test had the highest sensitivity (Se, 0.74), and using MRI observations alone, the signal intensity had the highest sensitivity (Se, 0.68). Combination of 'Speed test or Signal intensity' substantially improved the sensitivity (Se, 0.88) but yielded the lowest specificity (Sp, 0.20). The clinical relevance of these findings is that using the combination 'Speed or Signal' for preoperative diagnosis, 88% of pathologic LHBTs would be correctly diagnosed, while 80% of healthy LHBTs could be misdiagnosed as pathologic. Diagnostic study, Level IV.

Superior approach to the glenoid for treating acromion fractures combined with ideberg type III scapular glenoid fractures: a technical note.

Scapular glenoid fractures, categorized based on the Ideberg classification, are commonly addressed surgically through approaches like the anterior deltoid-pectoral approach, posterior Judet approach, modified Judet approach, or posterior axillary approach. However, these methods present limitations in exposing the superior part of the glenoid. Therefore, we propose an approach for patients with concomitant acromion fractures, involving the anterior lateral flipping of the fractured acromion, allowing direct superior visualization of the superior and posterior superior parts of the glenoid. Retrospective analysis was conducted on the data of five patients with shoulder fractures combined with scapular Ideberg III fractures between June 2018 and May 2023. All patients were treated using the shoulder approach above the scapular spine. There were four males and one female, aged 23-54 years with an average age of 36.6 years. One case involved the left shoulder, and four cases involved the right shoulder. X-rays and CT were taken before and after surgery to assess the location of the fractures and the healing status. Clinical evaluation included the assessment of efficacy using the Constant-Murley scoring criteria and analysis of surgical complications. All five patients were followed up for a duration of 14-36 months. All fractures healed completely, with an average healing time of 4.3 months (range: 3-6 months). There were no complications such as suprascapular nerve injury, nonunion, wound infection, or shoulder joint instability observed postoperatively. At the final follow-up, the Constant-Murley shoulder joint function score ranged from 84 to 98 points, with an average of 91.4 points. Three patients achieved an excellent rating in shoulder joint function score, while two patients achieved a good rating. The shoulder approach above the scapular spine exhibits advantages such as easy exposure and reduction, minimal intraoperative trauma, and clear visualization.

Kinect-Based Gait Analysis System Design and Concurrent Validity in Persons with Anterolateral Shoulder Pain Syndrome, Results from a Pilot Study

As part of an investigation to detect asymmetries in gait patterns in persons with shoulder injuries, the goal of the present study was to design and validate a Kinect-based motion capture system that would enable the extraction of joint kinematics curves during gait and to compare them with the data obtained through a commercial motion capture system. The study included eight male and two female participants, all diagnosed with anterolateral shoulder pain syndrome in their right upper extremity with a minimum 18 months of disorder evolution. The participants had an average age of 31.8 ± 9.8 years, a height of 173 ± 18 cm, and a weight of 81 ± 15 kg. The gait kinematics were sampled simultaneously with the new system and the Clinical 3DMA system. Shoulder, elbow, hip, and knee kinematics were compared between systems for the pathological and non-pathological sides using repeated measures ANOVA and 1D statistical parametric mapping. For most variables, no significant difference was found between systems. Evidence of a significant difference between the newly developed system and the commercial system was found for knee flexion–extension (p &lt; 0.004, between 60 and 80% of the gait cycle), and for shoulder abduction–adduction. The good concurrent validity of the new Kinect-based motion analysis system found in this study opens promising perspectives for clinical motion tracking using an affordable and simple system.

A cross-sectional study to assess the prevalence of frozen shoulder among patients with diabetes mellitus

Purpose: Adhesive capsulitis (AC), is also known as frozen shoulder an insidious painful condition of the shoulder persisting more than 3 months. This inflammatory condition that causes fibrosis of the glenohumeral joint capsule is accompanied by gradually progressive stiffness and significant restriction of range of motion (typically external rotation).this study focusses on identifying frozen shoulder among diabetic patients as glycosylation process causes collagen in the shoulder to get stick which leads to frozen shoulder among type 2 diabetes patients. Methods: This was a cross-sectional study with total of 501 participants with the diagnosis of Diabetic Mellitus (DM).The participants underwent range of motion testing and shoulder strength assessment and Pain assessment using Emoji based Visual Analogue Pain scale. Results: Among 501 patients male were 49.9% and female were 50.9%. the value of HbA1c is categorized as uncontrolled diabetes with HbA1c value as &gt;7 is 6.60% and controlled diabetes with Hba1c value as &lt;7 is 93.4%. Through the preliminary assessment, the mean score for risk assessment is &gt;4 , where 62.7% falls under high risk of frozen shoulder. Conclusion: The study concluded that participants with uncontrolled diabetes have high risk towards developing frozen shoulder. Duration of pain in DM was directly proportional to the high risk of frozen shoulder and females were more affected than males.

Real-world outcomes of a dedicated fast-track polymyalgia rheumatica clinic.

To examine the clinical impact of a fast-track PMR clinic to enable early diagnosis and treatment, and to define both patient and disease characteristics in newly diagnosed PMR. Primary care physicians were invited to refer patients with new PMR to our fast-track clinic. Referral criteria included new onset shoulder or pelvic girdle pain and/or stiffness with elevated inflammatory markers in patients over 50 years. All patients were seen within 72 h of referral. Patients with a rheumatology diagnosis of PMR had an ultrasound (US) of their temporal and axillary arteries. 172 patients were referred from primary care over 12 months. 39% of patients referred with suspected PMR had an alternative diagnosis for which PMR regimen glucocorticoids was inappropriate. 55% of the non-PMR diagnoses were other inflammatory rheumatological conditions requiring follow-up. Only 20% of patients referred from primary care already on glucocorticoids were commenced on bone protection. PMR patients were co-morbid with a mean of 2.5 other conditions. 75% of PMR patients experienced a glucocorticoid-related adverse event in the first 12 months of treatment. 16% of patients with new PMR had ultrasound features of subclinical giant cell arteritis. The commencement of glucocorticoid therapy should be deferred until after specialist evaluation to enable an accurate clinical diagnosis. A delay in treatment can only realistically be avoided if GPs have access to a Fast-track PMR clinic. We believe that rheumatologists should consider establishing fast-track PMR clinics and this study provides a strong case for and a template to support this practice innovation.

Off-Label Use of Dalbavancin in Enterococcus spp. Abscess and Streptococcus pneumoniae Bacteremia Secondary to Septic Arthritis: A Retrospective Case Report

Dalbavancin, a semi-synthetic lipoglycopeptide with an extended half-life that allows for weekly dosing, is currently approved for the treatment of bacterial skin and soft tissue infections caused by susceptible gram-positive organisms. This case report discusses the successful treatment of septic arthritis with dalbavancin in a 38-year-old obese male. Septic arthritis, commonly caused by Staphylococcus aureus and Streptococcus species, was diagnosed in this patient following a mechanical fall that led to worsening shoulder pain. Given the patient’s morbid obesity and concerns about antibiotic penetration, dalbavancin 1500 mg IV biweekly was chosen for its extended half-life and ease of administration. This case underscores dalbavancin’s efficacy in managing septic arthritis in obese patients, offering a convenient alternative to traditional therapies that require a peripherally inserted central catheter (PICC line), frequent dosing, therapeutic monitoring, and prolonged hospital stays. Despite its higher cost, dalbavancin’s advantages include reduced need for PICC lines, additional staff and resources to monitor therapeutic drug levels, and fewer complications, which can offset some expenses. To our knowledge, this is the first documented case investigating the use of dalbavancin for enterococcal septic arthritis with a biweekly dosing regimen.