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In the Shoulder or in the Brain? Behavioral, Psychosocial and Cognitive Characteristics of Unilateral Chronic Shoulder Pain with Symptoms of Central Sensitization.

ABSTRACT: The recognition of central sensitization (CS) is crucial, as it determines the results of rehabilitation. The aim of this study was to examine associations between CS and catastrophizing, functionality, disability, illness perceptions, kinesiophobia, anxiety, and depression in people with chronic shoulder pain (SP). In this cross-sectional study, 64 patients with unilateral chronic SP completed a few questionnaires including the Central Sensitization Inventory, the Oxford Shoulder Score, the Tampa Scale for Kinesiophobia, the Hospital Anxiety and Depression Scale, the Pain Catastrophizing Scale, the Brief Illness Perception Questionnaire and the “arm endurance” test. On the basis of three constructed linear regression models, it was found that pain catastrophizing and depression (model 1: p < 0.001, R = 0.57, R2 = 0.33), functionality (model 2: p < 0.001, R = 0.50, R2 = 0.25), and helplessness (model 3: p < 0.001, R = 0.53, R2 = 0.28) were significant predictors for CS symptoms in chronic SP. Two additional logistic regression models also showed that depression (model 4: p < 0.001, Nagelkerke R2 = 0.43, overall correct prediction 87.5%) and functionality (model 5: p < 0.001, Nagelkerke R2 = 0.26, overall correct prediction 84.4%) can significantly predict the classification of chronic SP as centrally sensitized. Patients who were classified as centrally sensitized (n = 10) were found to have significantly worse functionality, psychological factors (anxiety, depression, kinesiophobia, catastrophizing), and pain intensity (p < 0.05). Catastrophizing, depression, and functionality are predictive factors of CS symptoms in patients with chronic shoulder pain. Health care providers should adopt a precision medicine approach during assessment and a holistic rehabilitation of patients with unilateral chronic SP.

SUBMITTER: Bilika P

PROVIDER: S-EPMC9498916 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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In the Shoulder or in the Brain? Behavioral, Psychosocial and Cognitive Characteristics of Unilateral Chronic Shoulder Pain with Symptoms of Central Sensitization.

Bilika Paraskevi P Nijs Jo J Fandridis Emmanouil E Dimitriadis Zacharias Z Strimpakos Nikolaos N Kapreli Eleni E

Healthcare (Basel, Switzerland) 20220830 9

The recognition of central sensitization (CS) is crucial, as it determines the results of rehabilitation. The aim of this study was to examine associations between CS and catastrophizing, functionality, disability, illness perceptions, kinesiophobia, anxiety, and depression in people with chronic shoulder pain (SP). In this cross-sectional study, 64 patients with unilateral chronic SP completed a few questionnaires including the Central Sensitization Inventory, the Oxford Shoulder Score, the Tam ...[more]

PMID: 36141270

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Project description:AimModern office workers are often impacted by chronic neck/shoulder pain. Most of the previous studies which investigated the relationship of the occupational factors and musculoskeletal symptoms had adopted questionnaire survey. In this study the microcirculatory characteristics and perceived symptoms in neck/shoulder region were compared among office workers with sedentary lifestyle.MethodsThirty-seven female office workers were recruited in this study. Microcirculatory flow in neck/shoulder region characterized by the mean blood flow (MMBF value), pulsatile blood flow (PMBF value), and the PMBF/MMBF ratio (perfusion pulsatility, PP) were investigated using Laser Doppler Flowmetry (LDF). A Chinese version of the Standardized Nordic Musculoskeletal Questionnaire (NMQ) were also administered to collect the information of perceived neck/shoulder symptoms. Correlations between the perfusion characteristics and the individual/occupational factors were analyzed using the Spearman test. The difference of the MMBF values between the low-pain group (pain level≤2) and the high-pain group (pain level>2) were compared using the Mann-Whitney U test.ResultsThere were 81% participants reported neck or shoulder pain symptoms. The duration of shoulder pain was significantly correlated with the workers' age and the duration of employment (p<0.01) (n = 37). While both the MMBF and PMBF values in shoulder region were significantly reduced with the workers' age and the duration of employment (p<0.05) (n = 27). And there was a 54% reduction in the MMBF value of the workers from age of 23 to 47. And the MMBF value of the high-pain group (n = 15) was significantly lower than the value of the low-pain group (n = 15) (p<0.05). The duration of shoulder pain showed a moderately negative correlation with PMBF values (n = 19). Besides, the PP value was moderately correlated with shoulder pain level attributed by the rapid reduction of MMBF values (p = 0.07).ConclusionIn this study, the LDF method was used for the first time in the workplace in Taiwan. It was demonstrated that the MMBF in shoulder region were affected by aging effect and towards lower value at higher pain level. Impaired microcirculation caused by age effect, when coupled with sedentary lifestyle, was found to be more likely to evoke ischemia shoulder pain. Further studies are needed to assess current indicator, PP value, and the underlying mechanism of pain caused by sedentary lifestyle.

Project description:BackgroundCentral sensitization (CS) is a condition characterized by a disproportionate response to pain stimuli, and is associated with chronic pain conditions such as fibromyalgia, but also with inflammatory arthropathies such as rheumatoid arthritis and psoriatic arthritis (PsA). CS has never been investigated in patients with psoriasis. The aim of this study is to investigate CS in patients with chronic plaque psoriasis.MethodsThis research involved a cross-sectional observational study of adult patients with moderate-to-severe psoriasis consecutively attending the outpatient clinic of the University Hospital of Verona. Demography, measures of disease severity or activity [i.e., Psoriasis Area and Severity Index (PASI), Disease Activity in Psoriatic Arthritis (DAPSA)], diagnosis of PsA, hypertension, and diabetes were collected. Central Sensitization Inventory (CSI), Dermatology Life Quality Index (DLQI), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) were administered.ResultsA total of 194 patients, including 115 (59%) men, with mean age of 54 ± 13 years, mean PASI of 12.7 ± 6.7, and mean DAPSA of 14.4 ± 3.8 were included. In total, 134 patients (79%) had only psoriasis while 60 (31%) had psoriasis and PsA; 19 (10%) patients had CSI score ≥ 40, which is the threshold for diagnosing CS. The proportion of CS ≥ 40 was higher in patients with PsA compared with psoriasis (17% versus 7%, p = 0.031). The mean CSI score in patients with PsA was higher compared with those with only psoriasis (27.5 ± 13.5 versus 20.7 ± 13.7, p = 0.002). An association between CSI and DLQI [β = 1.25 (95% CI 0.85-1.66)], PASI [β = 1.22 (95% CI 0.74-1.65)], GAD-7 [β = 2.07 (95% CI 1.69-2.45)] and PHQ-9 [β = 2.16 (95% CI 1.76-2.54)] was found independently from age, gender, diabetes, and PsA.ConclusionsCentral sensitization may be associated with psoriasis, particularly in those with high PASI, concomitant PsA, anxiety, depression, and severe quality of life impairment.

Dataset Information

In the Shoulder or in the Brain? Behavioral, Psychosocial and Cognitive Characteristics of Unilateral Chronic Shoulder Pain with Symptoms of Central Sensitization.

Publications

In the Shoulder or in the Brain? Behavioral, Psychosocial and Cognitive Characteristics of Unilateral Chronic Shoulder Pain with Symptoms of Central Sensitization.

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