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At least 19 recordsLinked to original sources
PubMed1992

[Etiology and diagnosis of chronic shoulder pain].

Shoulder pain of more than three months' duration is regarded as chronic. Activity with an elevated arm is a risk factor, due to reduced local flow of blood to the supraspinatus muscle. Knowledge about normal shoulder biomechanics and dysfunctional behaviour patterns is essential when treating patients with chronic pain. It is necessary to consider psychosocial factors in addition to local pathology. The clinical examination should enable the physician to distinguish between referred and true shoulder pain and between restricted and free passive range of movement. Diagnoses may be classified into eight groups. The association between pain and degenerative changes has yet to be solved. This emphasizes the danger of deciding treatment without matching findings from radiological examinations with clinical signs and symptoms.

Arthritis↗
PubMed1976

A study of painful shoulder in welders.

By means of clinical examination, soft tissue radiography and quantitative electromyography, the effect of heavy industrial work was evaluated on welders at a shipyard. The study revealed that the older workers with shoulder pain have a chronic tendinitis of the rotator cuff. The supraspinatus muscle was shown to be consistently fatigued during overhead welding. It is believed that this is an important factor in the aetiology of the shoulder pain commonly occurring in older welders.

Aged↗
PubMed1976

Management of painful shoulder.

55 patients with 60 shoulders painful at rest, and with limitation of all ranges of movement, were treated with multiple injections of methylprednisolone acetate into the subacromial space and glenohumeral joint cavity. Pain was abolished in 80%, two weeks after starting therapy and 95% were pain-free four weeks after the first injection. Maximum functional recovery (at least 150 degrees abduction, 80 degrees internal rotation, and 45 degrees external rotation), was achieved in 90% of patients eight weeks after starting treatment. It is suggested that the "frozen" shoulder--i.e., pain-free shoulder with severe limitation of all movement--is the end result of a neglected painful shoulder and it is essential that painful shoulders be treated as early as possible if normal function is to be preserved.

Adult↗
PubMedDate not supplied

[Spa treatment of shoulder pains at Swieradów].

The authors present the results of spa treatment of painful shoulder in 50 patients. The mean age of patients was 47 years. Radon baths and peat poultices were given to all, most patients had also massage and therapeutic exercises. In 38 cases improvement was obtained, in 6 cases pains decreased, in another 6 cases no improvement was achieved. The authors recommend possibly early balneological treatment in this syndrome.

Adult↗
PubMed1976

Acupuncture for chronic shoulder pain. An experimental study with attention to the role of placebo and hypnotic susceptibility.

One half of 42 subjects treated for painful shoulders received classic acupuncture, and one half received a placebo in which the needles did not penetrate the skin. Half of each of these groups was treated in a positive setting to encourage the subject, and half in a negative setting designed to keep encouragement at a minimum. All patients were independently rated for susceptibility to hypnosis. Although range of motion did not improve, the majority of patients reported significant improvement in shoulder discomfort to a blind evaluator after treatment; placebo and acupuncture groups did not differ in this respect, however. The positive and negative settings did not affect treatment outcome. In all groups, those who were not rated as highly susceptible to hypnosis tended to fail to achieve the highest levels of relief, but such differences were not statistically significant.

Acupuncture Therapy↗
PubMed1992

The source of shoulder pain in hemiplegia.

Shoulder pain is a common problem in hemiplegia. This preliminary study attempted to identify pain-producing structures by evaluating the results of injecting 1% lidocaine into several sites in the shoulder area. Sixty-seven patients with shoulder problems were identified, examined, and characterized. The amount of pain was related most to loss of motion; it was unrelated to subluxation, spasticity, strength, or sensation. Of 28 patients who received a subacromial injection, approximately one-half obtained moderate or marked relief of pain and improved range of motion, suggesting that the subacromial area of the shoulder is a location of pain-producing structure in a significant number of cases.

Age Factors↗
PubMed1992

Low back and neck/shoulder pain in construction workers: occupational workload and psychosocial risk factors. Part 2: Relationship to neck and shoulder pain.

The prevalence rate of neck and shoulder trouble and considerable neck and shoulder pain in a randomly selected sample of 1773 construction workers were studied. The relationship to physical and psychosocial factors was analyzed. The workers answered a postal questionnaire. Workload was measured by means of eight manual materials handling indices and ten psychosocial indices, based on results from factor analyses. The 1-year prevalence rate of considerable neck and shoulder trouble was 56% and of neck and shoulder pain 12%. To work with hands above shoulder level showed a dose-response relationship to both neck and shoulder trouble and neck and shoulder pain. The psychosocial factors were more prominently associated with neck and shoulder trouble and neck and shoulder pain than the physical workload factors. The psychosocial indices; psychosomatic and psychic symptoms, stress and job satisfaction showed the highest age-standardized prevalence rate ratios for both neck and shoulder trouble and neck and shoulder pain.

Adult↗
PubMed1992

[Ketoprofen efficacy and tolerance in simple painful shoulder].

Thirty patients presenting with painful shoulder syndrome were treated with i.m. ketoprofen 100 mg b.d. for 8 days to assess the efficacy and tolerance of the above treatment regime. The patients' condition was monitored by clinical, instrumental and laboratory examinations. Ketoprofen was found to be significantly effective in all cases of non calcific rotator cuff tendinitis while no improvement was noted in calcific tendinitis. The above data confirm the efficacy and tolerance of ketoprofen in the treatment of painful shoulder syndrome as an alternative to local steroid therapy.

Adult↗
PubMed2026

Effectiveness of an AI-based home exercise app for rehabilitation of rotator cuff-related shoulder pain: A randomized controlled trial.

BACKGROUND: Rotator cuff-related shoulder pain contributes to disability and healthcare use. Although therapeutic exercise is first-line treatment, limited supervision and adherence may reduce its effectiveness; digital rehabilitation with real-time feedback may address these limitations. OBJECTIVES: To evaluate the effectiveness of adding a digital rehabilitation program to standard physiotherapy on pain, function, fear-avoidance beliefs, and healthcare utilization. DESIGN: Single-center, assessor-blinded, randomized controlled trial with two parallel groups. METHOD: Forty-six adults (mean age 59 years) with rotator cuff-related shoulder pain were randomized to 12 weeks of conventional physiotherapy or physiotherapy plus an AI-based digital rehabilitation program using computer vision for real-time feedback and performance monitoring. Outcomes were assessed at baseline and at 2, 4, and 12 weeks. Pain intensity (NPRS) was primary outcome; secondary outcomes included upper limb function (QuickDASH), fear-avoidance beliefs (FABQ), and post-intervention healthcare utilization. Analyses followed an intention-to-treat approach. RESULTS: Pain reduction exceeded the MCID (1.3) at 4 and 12 weeks. Between-group differences favoured the intervention at Weeks 2 and 4 (MD -0.7; 95% CI -1.13 to -0.14 and MD -1.01; 95% CI -1.8 to -0.2, respectively). Upper limb function improved more at Week 4 (MD -7.3; 95% CI -12.3 to -2.2). FABQ scores decreased more at Week 12 (MD -7.6; 95% CI -14 to -0.5). Fewer participants in the experimental group required post-intervention healthcare (3 vs 10; p = 0.02). CONCLUSION: Adding AI-based home exercise app to conventional treatment improve pain and may improve function and reduce healthcare utilization in rotator cuff-related shoulder pain.

Humans↗
PubMed1992

Inflammation of the subacromial bursa in chronic shoulder pain.

Subacromial bursal tissue was studied in 12 patients operated on for painful (10 patients with constant pain and 2 patients with pain on motion) rotator cuff tendinitis/impingement syndrome. The Neer acromioplasty technique was used. Six patients had moderate inflammatory changes and one had a slight inflammation. In three of the five remaining patients, the subacromial bursa did not show any signs of inflammatory involvement, but patients experienced pain at rest and at night, reflecting clinical inflammation in tissues other than the bursa. The two patients with pain only on strain did not show inflammation of the bursa. Immunohistochemical typing of the bursal tissue disclosed a typical chronic mononuclear cell infiltrate consisting mainly of CD2-positive T lymphocytes (50-80% of all inflammatory cells), accompanied by less frequent CD11b (C3bi receptor)-positive monocyte/macrophages (10-40%). The relative paucity of plasmablasts/plasma cells expressing PCA-1 suggests this to be an inflammatory rather than an immune response. Active involvement of some of the local cells is suggested to be the source of algogenic and hyperalgesic substances contributing to pain in chronic shoulder pain syndromes.

Acromion↗
PubMedDate not supplied

Painful shoulder syndromes: diagnosis and management.

Painful shoulder conditions are common primary care problems. Providers should learn the topographical landmarks about the shoulder and understand shoulder mechanics. A careful clinical evaluation will usually provide a likely diagnosis. In unclear cases with marked pain, weakness, and reduced mobility, or with a suspected rotator cuff tear or rupture, arthrography or MRI will usually establish a diagnosis. Therapy of bursitis/tendinitis consists of a steroid injection into the inflamed subacromial area or a 14-day trial of an NSAID. Therapy of bicipital tendinitis, largely empiric because definitive studies are unavailable for any specific treatment, includes judicious peritendinous steroid injections and avoiding aggravating activities. In the management of patients with suspected tendon tears or rupture, primary care practitioners can confirm the diagnosis by ordering MRI or arthrography before referring these patients to an orthopedist for definitive surgical therapy. Optimal management of adhesive capsulitis remains unclear, but an intraarticular steroid injection appears beneficial at least in temporarily diminishing pain. Pendular motion exercising is also an integral part of therapy. Deleterious effects of peribursal or intraarticular steroid infiltration appear minimal; but injections into the tendon or frequent, repetitive injections are contraindicated. Each shoulder condition has a variable course, depending on the structure(s) and extent of involvement.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

Immunoreactive neuropeptide nerves in ligamentous tissue in chronic shoulder pain.

Coracoacromial ligament and periligamentous fatty and loose connective tissue obtained during Neer's acromioplasty in patients with chronic painful rotator cuff tendinitis/impingement syndrome was studied for possible signs of inflammatory involvement and for the presence of neuropeptide-containing nerves, using routine histology and immunoperoxidase staining. No accumulations of inflammatory cells were found in the tissues studied. The dense ligamentous tissue proper was practically aneural, as was seen in staining for the generalized neuronal markers protein gene product 9.5 and synaptophysin. In contrast, the periligamentous fatty and loose connective tissue was innervated. Almost all nerves in such tissue contained C-flanking peptide of neuropeptide Y, whereas substance P, calcitonin gene-related peptide, and vasoactive intestinal peptide-containing nerves were not found at all or were extremely rare. This suggests that the coracoacromial ligament is not a target of irritative inflammation. In the periligamentary sheath, nerves containing markers for the C-type nociceptive pain fibers were practically absent and all local nerves were postganglionic sympathetic vaso-regulatory nerves.

Adult↗