Abstract
Background:
Persistent shoulder pain is a common problem and people with this condition are often referred for orthopaedic specialist management in tertiary care. Protracted waiting times for a consultation occur frequently within these services, yet surgical conversion rates remain relatively low. Developing models of care that can distinguish between prospective surgical candidates and people who may benefit from an alternative care pathway could improve service efficiency, optimise healthcare expenditure, and enhance patient outcomes. Altered sensory processing may be present in this patient group and influence treatment outcomes, however the current evidence regarding this is limited. Furthermore, the sociodemographic, clinical, general health and lifestyle, and psychological characteristics of this group are yet to be comprehensively explored. Investigation of these characteristics could provide insight into factors that may impact the experience and trajectory of shoulder pain in this population.
Purpose:
The primary objective of this study was to compare sensory processing measures in people attending tertiary care for shoulder pain with control participants. A secondary objective was to compare the groups’ sociodemographic, clinical, general health and lifestyle, and psychological characteristics.
Methods:
Participants with shoulder pain ≥ 3 months attending a tertiary orthopaedic clinic (n = 119) and community participants without shoulder pain (n = 44) underwent a standardised quantitative sensory testing protocol, measuring pressure pain threshold (PPT), temporal summation (TS), and conditioned pain modulation (CPM). Sociodemographic, clinical, general health and lifestyle, and psychological characteristics were assessed via a participant interview, self-report questionnaires, and a physical assessment. All measures were conducted in a single session.
Results:
Participants with shoulder pain demonstrated significantly lower PPTs at all sites (i.e., local, and widespread mechanical hyperalgesia) and significantly decreased CPM effect during the cold pressor test (i.e., descending inhibition of nociception) than the control participants. There was no significant difference between groups for TS. Participants with shoulder pain displayed decreased general health and function, less healthy lifestyles, and poorer psychological health compared with the control group.
Conclusion:
Features of impaired sensory processing were evident in people attending a tertiary care orthopaedic clinic for management of shoulder pain compared with a control group. The impact of sensory function on treatment outcomes in similar patient cohorts requires investigation.
Implications:
Pain mechanisms in people with persistent shoulder pain appear more complex than being an isolated musculoskeletal (i.e., nociceptive) complaint. The value of a multidisciplinary approach to care should be considered, with a view to improving an individual’s physical and psychological wellbeing in addition to any relevant biomechanical or medical interventions.
Persistent shoulder pain is a common problem and people with this condition are often referred for orthopaedic specialist management in tertiary care. Protracted waiting times for a consultation occur frequently within these services, yet surgical conversion rates remain relatively low. Developing models of care that can distinguish between prospective surgical candidates and people who may benefit from an alternative care pathway could improve service efficiency, optimise healthcare expenditure, and enhance patient outcomes. Altered sensory processing may be present in this patient group and influence treatment outcomes, however the current evidence regarding this is limited. Furthermore, the sociodemographic, clinical, general health and lifestyle, and psychological characteristics of this group are yet to be comprehensively explored. Investigation of these characteristics could provide insight into factors that may impact the experience and trajectory of shoulder pain in this population.
Purpose:
The primary objective of this study was to compare sensory processing measures in people attending tertiary care for shoulder pain with control participants. A secondary objective was to compare the groups’ sociodemographic, clinical, general health and lifestyle, and psychological characteristics.
Methods:
Participants with shoulder pain ≥ 3 months attending a tertiary orthopaedic clinic (n = 119) and community participants without shoulder pain (n = 44) underwent a standardised quantitative sensory testing protocol, measuring pressure pain threshold (PPT), temporal summation (TS), and conditioned pain modulation (CPM). Sociodemographic, clinical, general health and lifestyle, and psychological characteristics were assessed via a participant interview, self-report questionnaires, and a physical assessment. All measures were conducted in a single session.
Results:
Participants with shoulder pain demonstrated significantly lower PPTs at all sites (i.e., local, and widespread mechanical hyperalgesia) and significantly decreased CPM effect during the cold pressor test (i.e., descending inhibition of nociception) than the control participants. There was no significant difference between groups for TS. Participants with shoulder pain displayed decreased general health and function, less healthy lifestyles, and poorer psychological health compared with the control group.
Conclusion:
Features of impaired sensory processing were evident in people attending a tertiary care orthopaedic clinic for management of shoulder pain compared with a control group. The impact of sensory function on treatment outcomes in similar patient cohorts requires investigation.
Implications:
Pain mechanisms in people with persistent shoulder pain appear more complex than being an isolated musculoskeletal (i.e., nociceptive) complaint. The value of a multidisciplinary approach to care should be considered, with a view to improving an individual’s physical and psychological wellbeing in addition to any relevant biomechanical or medical interventions.
| Original language | English |
|---|---|
| Pages | 1-1 |
| Number of pages | 1 |
| Publication status | Published - 5 Jul 2024 |
| Event | IFOMPT (International Federation of Orthopaedic Manual Physical Therapists) Conference - Basel, Switzerland Duration: 4 Jul 2024 → 6 Jul 2024 https://www.ifomptbasel2024.org/frontend/index.php?sub=177 (Conference website) |
Conference
| Conference | IFOMPT (International Federation of Orthopaedic Manual Physical Therapists) Conference |
|---|---|
| Country/Territory | Switzerland |
| City | Basel |
| Period | 4/07/24 → 6/07/24 |
| Other | Over 1'600 participants from 57 countries met for 3 days in Basel for the IFOMPT 2024. Under the main topic "Crossing bridges" 3 keynote speakers and over 100 other speakers presented. 8 years after the last conference, there was of course also plenty of networking. In the exhibition, over 30 exhibitors and sponsors invited visitors to discover the latest innovations directly at their booths. |
| Internet address |
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