The Prevalence of Neck and Shoulder Symptoms and Associations with Comorbidities and Disability: The Johnston County Osteoarthritis Project

Abstract

Objectives Neck and shoulder pain are common but underreported by older people, raising important questions of frequency, medical comorbidities, gender and racial disparities and functional impact associated with neck and shoulder symptoms in elders, which we examined in this analysis. Methods We performed a cross-sectional analysis in the community-based Johnston County Osteoarthritis Project, a cohort that is representative of the U.S. population, utilizing data from 1672 participants with a mean age of 68 years; 69% were white and 68% were women. Trained staff obtained data on participant-reported: symptoms, comorbidities, depression, and functional status; and performance-based functional assessments. Regression models of neck and shoulder symptoms and functional measures were adjusted for age, sex, race, and body mass index, and additionally for other joint symptoms and comorbidities. Results Symptoms of neck (8%), shoulder (13%) or both (13%) were reported by participants. Neck symptoms were most frequently reported by White women; shoulder symptoms were evenly distributed among race and gender subgroups. Neck and shoulder symptoms were associated with cancer, diabetes mellitus, depression, and lung, cardiovascular, and other musculoskeletal problems, as well as pain, aching or stiffness at other sites, and independently with self-reported and performance –based functional measures. Conclusions These findings suggest that primary health care providers should inquire about neck and shoulder symptoms and address potential underlying causes to improve functional status and decrease disability in older people.

Is there an association between diabetes and neck pain and lower back pain? Results of a population-based study

“…Regarding NP, previous studies on the relationship between NP and DM have yielded conflicting results. 12 , 16 , 17 Our results agree with Molsted et al, 15 who compared 951 patients with type 2 DM with data for 2,923 matched subjects from the general population and observed that patients with type 2 DM had a significantly higher prevalence of musculo-skeletal pain in all areas of the body, including cervical pain. In the US, using the 2002 National Health Interview Survey, it was found that the 3-month prevalence rate of back and/or NP had a significant association with concomitant LBP and NP for people with DM.…”

“…However, in the Johnston County Osteoarthritis Project, neck and shoulder symptoms were associated with DM; however, the association between DM and NP was not significant after full adjustment. 17 …”

“…Previous studies on the relationship between NP and DM have yielded inconclusive results. 15 – 17 Some argue that LBP and DM may have a spurious association that can be explained by obesity, a confounding variable that is an established risk factor for type 2 DM. 18 NP is of particular interest in this debate because it is a non-weight bearing region and is thus less susceptible to symptoms caused by increased weight bearing.…”

“…However, in addition to obesity, differences in the sociodemographic characteristics, coexisting physical and mental conditions, and lifestyles may explain the associations of DM with LBP and NP described by other authors. 12 – 17 …”

A genome-wide association study finds genetic variants associated with neck or shoulder pain in UK Biobank

“…Epidemiological studies have suggested that the prevalence of neck pain is 6-22% and 7-27% for shoulder pain (7–9). The Global Burden of Disease Study 2010 found that of the 291 conditions studied, neck or shoulder pain as a single entity ranked 21st in overall burden on society, and 4th in terms of overall disability (8).…”