Prognosis of shoulder tendonitis in repetitive work: a follow up study in a cohort of Danish industrial and service workers

Abstract

Background: The physical and psychosocial work environment is expected to modify recovery from shoulder disorders, but knowledge is limited. Methods: In a follow up study of musculoskeletal disorders in industrial and service workers, 113 employees were identified with a history of shoulder pain combined with clinical signs of shoulder tendonitis. The workers had yearly reexaminations up to three times. Quantitative estimates of duration, repetitiveness, and forcefulness of current tasks were obtained from video recordings. Perception of job demands, decision latitude, and social support was recorded by a job content questionnaire. Recovery of shoulder tendonitis was analysed by Kaplan-Meier survival technique and by logistic regression on exposure variables and individual characteristics in models, allowing for time varying exposures. Results: Some 50% of workers recovered within 10 months (95% CI 6 to 14 months). Higher age was strongly related to slow recovery, while physical job exposures were not. Perception of demands, control, and social support at the time when the shoulder disorder was diagnosed, were associated with delayed recovery, but these psychosocial factors did not predict slow recovery in incident cases identified during follow up. Conclusion: The median duration of shoulder tendonitis in a cross sectional sample of industrial and service workers was in the order of 10 months. This estimate is most likely biased towards too high a value. Recovery was strongly reduced in higher age. Physical workplace exposures and perceived psychosocial job characteristics during the period preceding diagnosis seem not to be important prognostic factors.

The central nervous system – An additional consideration in ‘rotator cuff tendinopathy’ and a potential basis for understanding response to loaded therapeutic exercise

“…Studies investigating prognosis (van der Windt et al, 1996;Bonde et al, 2003;Ekeberg et al, 2010) have suggested that the biomedical diagnosis, relating to specific tissues at fault, was not associated with clinical outcomes. Furthermore, it has been reported that structural change does not explain response to therapeutic exercise because as clinical outcomes improve a corresponding change in observable structural pathology is not seen (Drew et al, 2012).…”

The influence of work-related exposures on the prognosis of neck/shoulder pain

“…The prognosis for those suffering from neck/shoulder pain is relatively poor. Not more than about the half of the subjects with neck/ shoulder pain are pain-free after 1-5 years [2,4,6,13,14,19,21,23,32,34].…”

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“…A organização do trabalho e o processo produtivo nos ramos de atividade estudados não permitem que o trabalhador tenha controle sobre seu modo de trabalhar, podendo tornar o trabalho extremamente estressante, o que contribui para o aumento do risco de agravos físicos e mentais no trabalhador, especialmente para a ocorrência de lesões e doenças do sistema osteomuscular e do tecido conjuntivo identificadas neste estudo 3,4,8,18 .…”

“…A maior ocorrência de incapacidade para o trabalho entre as mulheres e o aumento de tal ocorrência com a idade, encontrada neste estudo, é confirmada tanto pela literatura nacional 3,7,8,9 quanto internacional 4,11,19,20,21,22,23 .…”

“…A maioria das empresas frigoríficas possuem fatores de risco que devem ser considerados no contexto da saúde do trabalhador e da incapacidade para o trabalho, como as características do processo produtivo, a organização de trabalho, as características socioeconômicas e educacionais, os sistemas de compensações e gratificações e as relações de poder entre empregador/ empregado 4 .…”