The role of sensitization in musculoskeletal shoulder pain

Borstad, John D.; Woeste, Christopher

doi:10.1590/bjpt-rbf.2014.0100

Cited by 61 publications

(56 citation statements)

References 29 publications

(46 reference statements)

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“…Additionally, the exclusion criteria did not account for the potential inclusion of individuals with CNS sensitization. Two recent reviews 6,64 suggest that a subgroup of individuals with shoulder pain may exhibit hyperexcitability of the CNS. Gwilym and colleagues 28 reported that a subgroup of individuals with shoulder impingement syndrome and signs of CNS hyperexcitability had significantly worse outcomes postoperatively compared to those without CNS involvement.…”

Section: Discussionmentioning

confidence: 99%

Cervicothoracic Manual Therapy Plus Exercise Therapy Versus Exercise Therapy Alone in the Management of Individuals With Shoulder Pain: A Multicenter Randomized Controlled Trial

Mintken¹,

McDevitt²,

Cleland³

et al. 2016

J Orthop Sports Phys Ther

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Study Design Multicenter randomized controlled trial. Background Cervicothoracic manual therapy has been shown to improve pain and disability in individuals with shoulder pain, but the incremental effects of manual therapy in addition to exercise therapy have not been investigated in a randomized controlled trial. Objectives To compare the effects of cervicothoracic manual therapy and exercise therapy to those of exercise therapy alone in individuals with shoulder pain. Methods Individuals (n = 140) with shoulder pain were randomly assigned to receive 2 sessions of cervicothoracic range-of-motion exercises plus 6 sessions of exercise therapy, or 2 sessions of high-dose cervicothoracic manual therapy and range-of-motion exercises plus 6 sessions of exercise therapy (manual therapy plus exercise). Pain and disability were assessed at baseline, 1 week, 4 weeks, and 6 months. The primary aim (treatment group by time) was examined using linear mixed-model analyses and the repeated measure of time for the Shoulder Pain and Disability Index (SPADI), the numeric pain-rating scale, and the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). Patient-perceived success was assessed and analyzed using the global rating of change (GROC) and the Patient Acceptable Symptom State (PASS), using chi-square tests of independence. Results There were no significant 2-way interactions of group by time or main effects by group for pain or disability. Both groups improved significantly on the SPADI, numeric pain-rating scale, and QuickDASH. Secondary outcomes of success on the GROC and PASS significantly favored the manual therapy-plus-exercise group at 4 weeks (P = .03 and P<.01, respectively) and on the GROC at 6 months (P = .04). Conclusion Adding 2 sessions of high-dose cervicothoracic manual therapy to an exercise program did not improve pain or disability in patients with shoulder pain, but did improve patient-perceived success at 4 weeks and 6 months and acceptability of symptoms at 4 weeks. More research is needed on the use of cervicothoracic manual therapy for treating shoulder pain. Level of Evidence Therapy, level 1b. Prospectively registered March 30, 2012 at www.ClinicalTrials.gov (NCT01571674). J Orthop Sports Phys Ther 2016;46(8):617-628. doi:10.2519/jospt.2016.6319.

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Section: Discussionmentioning

confidence: 99%

Cervicothoracic Manual Therapy Plus Exercise Therapy Versus Exercise Therapy Alone in the Management of Individuals With Shoulder Pain: A Multicenter Randomized Controlled Trial

Mintken¹,

McDevitt²,

Cleland³

et al. 2016

J Orthop Sports Phys Ther

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“…Sensitisation, a nervous system phenomenon, is in concurrence with pain where normally innocuous input is perceived as painful due to increased nociception (Borstad & Woeste, 2015 ). It is classified into two types - peripheral sensitisation and central sensitisation, which play a significant role in development of musculoskeletal pain (Arendt-Nielsen, Fernández-de-Las-Peña, & Graven-Nielsen, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

Psychosocial factors, disability and quality of life in chronic shoulder pain patients with central sensitization

2020

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Chronic shoulder pain is a complex and multidimensional phenomenon with multiple causative factors involved in its perpetuation. Alteration of central nervous system processing along with the central sensitization is a predominant feature in chronic pain. Reduction in physical function has an impact on the psychological well-being of an individual. The aim of the study was to compare pain, kinesiophobia, catastrophizing, disability and quality of life in chronic shoulder pain patients with and without central sensitization. Eighty chronic unilateral shoulder pain patients in the age group of 40 to 60 years were recruited. Of them, 38 were chronic shoulder pain with central sensitization and 42 without central sensitization, classified on the basis of central sensitization inventory. Pain catastrophizing was measured using the pain catastrophizing scale, kinesiophobia using Tampa scale of kinesiophobia, disability using Shoulder pain and disability index and quality of life using 36-Item Short Form Health Survey questionnaire was evaluated in both the groups. Increased pain catastrophizing (p=0.000), kinesiophobia (p=0.000) and disability (p=0.000) was observed in centrally sensitized chronic shoulder pain patients. Also, physical component summary (p=0.000) and mental component summary (p=0.000) of SF-36 quality of life were reduced in chronic shoulder pain with central sensitization as compared to without central sensitization. Hence, these components should be included during assessment which will provide a holistic and multimodal approach towards the understanding, planning and management of chronic shoulder pain patients.

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“…Tmax total delay = Tmax travel + Tmeasure = 24 + 100 = 124 (ms), (Figure 4, c), which is close to the inverse of pain sensitization in its shape [72,73] and demonstrated the best efficiency in most common tasks ( Figure 5). (i) Interact with known objects.…”

Section: Operational Principlesmentioning

confidence: 65%

Low-Cost Open Source Ultrasound-Sensing Based Navigational Support for Visually Impaired

Petsiuk¹,

Pearce²

2019

Preprint

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Nineteen million Americans have significant vision loss. Over 70% of these are not employed full-time, and more than a quarter live below the poverty line. Globally, there are 36 million blind people, but less than half use white canes or more costly commercial sensory substitutions. The quality of life for visually impaired people is hampered by the resultant lack of independence. To help alleviate these challenges this study reports on the development of a low-cost (<$24), open-source navigational support system to allow people with the lost vision to navigate, orient themselves in their surroundings and avoid obstacles when moving. The system can be largely made with digitally distributed manufacturing using low-cost 3-D printing/milling. It conveys point-distance information by utilizing the natural active sensing approach and modulates measurements into haptic feedback with various vibration patterns within the distance range of 3 m. The developed system allows people with lost vision to solve the primary tasks of navigation, orientation, and obstacle detection (>20 cm stationary, moving up to 0.5 m/s) to ensure their safety and mobility. Sighted blindfolded participants successfully demonstrated the device for eight primary everyday navigation and guidance tasks including indoor and outdoor navigation and avoiding collisions with other pedestrians.

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The role of sensitization in musculoskeletal shoulder pain

Cited by 61 publications

References 29 publications

Cervicothoracic Manual Therapy Plus Exercise Therapy Versus Exercise Therapy Alone in the Management of Individuals With Shoulder Pain: A Multicenter Randomized Controlled Trial

Cervicothoracic Manual Therapy Plus Exercise Therapy Versus Exercise Therapy Alone in the Management of Individuals With Shoulder Pain: A Multicenter Randomized Controlled Trial

Psychosocial factors, disability and quality of life in chronic shoulder pain patients with central sensitization

Low-Cost Open Source Ultrasound-Sensing Based Navigational Support for Visually Impaired

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