Do Comorbidities and Body Mass Index Influence Shoulder Pain, Disability and Joint Range of Motion?
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1 Ankara Etlik City Hospital, Ankara, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 21, Issue 4, pp. 52-58.
https://doi.org/10.23950/jcmk/14973
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Author Contributions: This research was conducted by Yasemin Tombak hence, conception and design of the study, acquisition of data, analysis and interpretation of data, drafting the article, critical revising and final approval were all carried out by the same author. The author has read and agreed to the published version of the manuscript.
Statement of Ethics: The research was approved by the ethics committee of the local institute, Ankara Etlik City Hospital, Ankara, Turkey (date: 24.04.24 Decision no:AESH-BADEK-2024-318 ) and was conducted in accordance with the principles of the Declaration of Helsinki.
Informed Consent: The procedure of the study was explained to the participants and their written consent was obtained in the format required by the ethics committee of the aforementioned local institute.
Data Availability Statement: The author confirms that the data supporting the findings of this study are available within the article. The data associated with the paper are not publicly available but are available from the corresponding author on reasonable request.
ABSTRACT
Aim: Shoulder diseases are believed to be associated with metabolic factors including diabetes and obesity. Our research aimed to determine how age-related comorbidities and rising body mass index (BMI) affected shoulder pain, disability, and joint range of motion (ROM).
Methods: The study included 137 individuals aged 20–80 who sought treatment for chronic shoulder pain at the physical medicine and rehabilitation outpatient clinic and, they were recorded for their demographics, BMI, comorbidities, pain duration, dominant shoulder, affected shoulder, history of treatment, joint ROM, visual analogue scale pain score, and shoulder pain and disability index score.
Results: The study found that the obese group had a high mean age (p=0.047) and substantially more common thyroid dysfunction (p=0.031). When individuals with and without diabetes mellitus (DM) were compared, it was observed that the DM group had significantly less ROM. Similarly, ROM was found to be considerably lower in the group with hypertension (HT) when a comparison was made for having or not having HT. In comparison of patients with or without hyperlipidemia (HL), the group with HL had significantly lower BMI compared to the group without HL (p=0.047). Upon comparing the groups with and without thyroid disease, it was discovered that the former had a considerably higher BMI (p=0.012).
Conclusion: We found that the two most prevalent disorders associated with shoulder pain, DM and HT, have a particularly positive influence on joint range of motion. We also observed a connection between thyroid problems and BMI. In the management of shoulder discomfort, managing comorbidities and BMI are crucial.
CITATION
Tombak Y. Do Comorbidities and Body Mass Index Influence Shoulder Pain, Disability and Joint Range of Motion?. J CLIN MED KAZ. 2024;21(4):52-8.
https://doi.org/10.23950/jcmk/14973
REFERENCES
- Britt HMG, Henderson J, Bayram C. General practice activity in Australia 2015–16. general practice series No. 40. Sydney: Sydney University Press, 2016.
- Wolf JM, Green A. Influence of comorbidity on self-assessment instrument scores of patients with idiopathic adhesive capsulitis. J Bone Joint Surg Am. 2002; 84-A(7): 1167–1173. https://doi.org/10.2106/00004623-200207000-00012.
- Jiang L, Tian W, Wang Y, Rong J, Bao C, Liu Y, et al. Body mass index and susceptibility to knee osteoarthritis: A systematic review and meta-analysis. Joint Bone Spine. 2012; 79(3): 291–297. https://doi.org/10.1016/j.jbspin.2011.05.015.
- Jiang L, Rong J, Wang Y, Hu F, Bao C, Li X, et al. The relationship between body mass index and hip osteoarthritis: a systematic review and meta-analysis. Joint Bone Spine. 2011; 78(2): 150–155. https://doi.org/10.1016/j.jbspin.2010.04.011.
- Gaida JE, Ashe MC, Bass SL, Cook JL. Is adiposity an under-recognized risk factor for tendinopathy? A systematic review. Arthritis and rheumatism. 2009; 61(6): 840–849. https://doi.org/10.1002/art.24518.
- Viikari-Juntura E, Shiri R, Solovieva S, Karppinen J, Leino-Arjas P, Varonen H, et al. Risk factors of atherosclerosis and shoulder pain - Is there an association? A systematic review. Eur J Pain. 2008; 12: 412–426. https://doi.org/10.1016/j.ejpain.2007.08.006.
- Gandhi R, Perruccio AV, Rizek R, Dessouki O, Evans HMK, Mahomed NN. Obesity-related adipokines predict patient- reported shoulder pain. Obes Facts. 2013; 6(6): 536–541. https://doi.org/10.1159/000357230.
- Blaine TA, Kim YS, Voloshin I, Chen D, Murakami K, Chang SS, et al. The molecular pathophysiology of subacromial bursitis in rotator cuff disease. Journal of shoulder and elbow surgery/American Shoulder and Elbow Surgeons. 2005; 14 (1 Suppl S): 84S-89S. https://doi.org/10.1016/j.jse.2004.09.022.
- Voloshin I, Gelinas J, Maloney MD, O’Keefe RJ, Bigliani LU, Blaine TA. Proinflammatory cytokines and metalloproteases are expressed in the subacromial bursa in patients with rotator cuff disease. Arthroscopy. 2005; 21(9): 1076. https://doi.org/10.1016/j.arthro.2005.05.017.
- Nakama K, Gotoh M, Yamada T, Mitsui Y, Yasukawa H, Imaizumi T, et al. Interleukin-6-induced activation of signal transducer and activator of transcription-3 in ruptured rotator cuff tendon. The Journal of international medical research. 2006; 34(6): 624–631.
- Lau DC, Dhillon B, Yan H, Szmitko PE, Verma S. Adipokines: molecular links between obesity and atheroslcerosis. American journal of physiology. 2005, 288(5): H2031–2041. https://doi.org/10.1152/ajpheart.01058.2004.
- Statz JM, Wagner ER, Houdek MT, Cofield RH, Sanchez-Sotelo J, Elhassan BT, et al. Outcomes of primary reverse shoulder arthroplasty in patients with morbid obesity. J Shoulder Elbow Surg. 2016; 25(7): e191–198. https://doi.org/10.1016/j.jse.2015.12.008.
- Boileau P, Morin-Salvo N, Bessière C, Chelli M, Gauci MO, Lemmex DB. Bony increased-offset-reverse shoulder arthroplasty: 5 to 10 years' follow-up. J Shoulder Elbow Surg. 2020; 29(10): 2111–2122. https://doi.org/10.1016/j.jse.2020.02.008.
- Rechardt M, Shiri R, Karppinen J, Jula A, Heliövaara M, Viikari-Juntura E. Lifestyle and metabolic factors in relation to shoulder pain and rotator cuff tendinitis: a population-based study. BMC Musculoskelet Disord. 2010; 11: 165. https://doi.org/10.1186/1471-2474-11-165.
- Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain. 2014; 155: 2545–2550. https://doi.org/10.1016/j.pain.2014.09.014.
- Paul A, Lewis M, Shadforth MF, Croft PR, Van Der Windt DA, Hay EM. A comparison of four shoulder-specific questionnaires in primary care. Ann Rheum Dis. 2004; 63: 1293–1299. https://doi.org/10.1136/ard.2003.012088.
- Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991; 4: 143–149.
- Bicer A, Ankarali H. Shoulder pain and disability index: a validation study in Turkish woman. Singapore Med J. 2010; 51: 865–870.
- Weir CB, Jan A. BMI Classification Percentile And Cut Off Points. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. https://www.ncbi.nlm.nih.gov/books/NBK541070/.
- Yektas A, Gumus F, Alagol A. Effects of triple shoulder injection accompanied by fluoroscopy on pain experienced by patients with chronic shoulder pain. Agri Dergisi. 2014; 26(4): 165–170.
- Aydin L. The Effect of High-Intensity Laser Therapy on Pain and Functionality in Patients with Chronic Shoulder Pain [Dissertation]. Istanbul: Istanbul Medipol University Health Sciences Institute, 2019.
- Cuce I, Yildizhan R, Veziroglu E, Kara H, Sayin SC, Calis M. The Association of Central Sensitization with Shoulder Pain and Disability in Patients with Symptomatic Rotator Cuff Tear: A Case-Control Study. Hitit Med J. 2023; 5(2): 110–116. https://doi.org/10.52827/hititmedj.1285524.
- Pak SS, Janela D, Freitas N, Costa F, Moulder R, Molinos M, et al. Comparing Digital to Conventional Physical Therapy for Chronic Shoulder Pain: Randomized Controlled Trial. J Med Internet Res. 2023; 25: e49236. https://doi.org/10.2196/49236.
- Özkuk K, Ateş Z. The effect of obesity on pain and disability in chronic shoulder pain patients. J Back Musculoskelet Rehabil. 2020; 33(1): 73-79. https://doi.org/10.3233/BMR-181384.
- Riley G: The pathogenesis of tendinopathy. A molecular perspective. Rheumatology (Oxford, England). 2004; 43(2): 131–142. https://doi.org/10.1093/rheumatology/keg448.
- Buyuksireci M, Kacar M, Buyuksireci ED, Kazci O. Association between age, gender, HbA1c level, fasting plasma glucose level, and the ultrasonographic findings in patients with shoulder tendinosis. Arch Basic Clin Res. 2023; 5(2): 279–283.
- Reid JJ, Kunkle BF, Kothandaraman V, Roche C, Eichinger JK, Friedman RJ. Effects of obesity on clinical and functional outcomes following anatomic and reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2022; 31(1): 17–25. https://doi.org/10.1016/j.jse.2021.06.011.
- Miranda H, Viikari-Juntura E, Heistaro S, Helio ̈ vaara M, Riihima ̈ ki H. A population study on differences in the determinants of a specific shoulder disorder versus non-specific shoulder pain without clinical findings. Am J Epidemiol. 2005; 161: 847–855. https://doi.org/10.1093/aje/kwi112.
- Vincent HK, Struk AM, Reed A, Wright TW. Mid-term shoulder functional and quality of life outcomes after shoulder replacement in obese patients. SpringerPlus. 2016; 5(1): 1929. https://doi.org/10.1186/s40064-016-3624-0.
- Kane S, Conus S, Haltom D, Hirshorn K, Pak Y, Vigdorchik J. A shoulder health survey: correlating behaviors and comorbidities with shoulder problems. Sports health. 2010; 2(2): 119–134. https://doi.org/10.1177/1941738109338358.
- Eichinger JK, Rao MV, Lin JJ, Goodloe JB, Kothandaraman V, Barfield WR, et al. The effect of body mass index on internal rotation and function following anatomic and reverse total shoulder arthroplasty. Journal of shoulder and elbow surgery. 2021; 30(2): 265–272. https://doi.org/10.1016/j.jse.2020.06.008.
- Fernandes MR, Assis FM, Spagnol JE, Chaves VB. Immobilization, Lymphedema, and Obesity are Predictive Factors in the Development of Adhesive Capsulitis in Breast Cancer Patients. Revista brasileira de ginecologia e obstetrician. 2023; 45(10): e594–e602. https://doi.org/10.1055/s-0043-1772479.
- Buyuksireci ED, Tecer D, Bolayir B, Yon MEE, Akturk M, Gunendi Z et al. Ultrasonographic evaluation of shoulder tendons in patients with Hashimoto's disease. International journal of rheumatic diseases, 2020; 23(11): 1497–1504. https://doi.org/10.1111/1756-185X.13956.