Search Results (140)

Chronic musculoskeletal pain negatively affects patients’ quality of life, and pain perceptions may significantly influence rehabilitation outcomes. This study investigated the relationships among pain intensity, pain perceptions, and kinesiophobia in individuals with chronic musculoskeletal pain. No previous studies have examined these variables in combination. A cross-sectional observational study was conducted with 37 participants with non-specific chronic musculoskeletal pain for at least 6 months, affecting the neck (n = 8), lower back (n = 18), upper limbs (n = 5), lower limbs (n = 5), or shoulder (n = 1). The following validated tools were used: (a) Pain Beliefs and Perceptions Inventory (PBPI), (b) the Tampa Scale for Kinesiophobia (TSK), and (c) the Short-Form McGill Pain Questionnaire (SF-MPQ). Spearman r correlation analyses were performed. Total kinesiophobia scores were positively correlated with (a) total pain intensity (McGill score) (r = 0.37, p = 0.022), (b) present pain intensity (PPI) (r = 0.52, p = 0.001), (c) pain duration (r = 0.51, p = 0.001), (d) the “mystery” factor of pain perception (r = 0.41, p = 0.013), and (e) the Visual Analogue Scale (VAS) (r = 0.42, p = 0.009). The total pain perception scores were positively associated with the “fear of injury” factor of kinesiophobia (r = 0.36, p = 0.028). The McGill pain scores were strongly correlated with both PPI (r = 0.63, p = 0.001) and VAS (r = 0.51, p = 0.001). There is a significant relationship between pain perception and kinesiophobia levels in patients with chronic musculoskeletal pain. Limitations of the study include a small and heterogeneous sample regarding pain localization. Further research is required using larger, more homogeneous populations to confirm the present findings. Full article

Background: Surgical neck nonunions of the proximal humerus present a complex clinical challenge, especially in elderly patients with pre-existing glenohumeral arthritis. Reverse total shoulder arthroplasty (RTSA) offers a reliable treatment option in these cases; however, resection of the tuberosities may compromise joint stability, increase the risk of postoperative dislocation and compromise postoperative function. This article describes a reproducible RTSA technique that preserves and repairs the greater and lesser tuberosities, aiming to enhance construct stability and optimize outcomes. Methods: We present a 74-year-old female with underlying glenohumeral arthritis who underwent RTSA for a symptomatic surgical neck nonunion via an extended deltopectoral approach. The nonunion is first mobilized, and tuberosity osteotomies are performed. After implant placement, the tuberosities are secured to the implant, to each other, and to the humeral shaft. A cerclage suture is also passed circumferentially to reinforce the repair and prevent posterior gapping. Results: The patient regained her pre-injury level of function by her last follow-up. She had pain-free, active forward elevation to 110 degrees and radiographic evidence of maintained tuberosity reduction and healing. There was no evidence of instability. Conclusions: In conclusion, incorporating tuberosity preservation and repair into RTSA for proximal humerus nonunion may reduce dislocation risk and improve functional recovery in elderly, low-demand patients. Full article

Background/Objective: Non-specific chronic neck pain (CNP) greatly affects the social dynamics, the work performance, and the personal independence of patients. Research emphasizes the significant role of sociological factors, psychological stress, and emotional conflicts in the development, regulation, and endurance of chronic pain. This study aims to explore the influence of emotional conflicts on pain experience among CNP patients, drawing from their experiences. Methods: A phenomenological investigation was conducted, grounded in Heideggerian philosophy, involving CNP patients and healthcare professionals in Madrid, Spain. Participants were recruited from Primary Health Care centers. Data collection methods included semi-structured in-depth interviews, focus groups with patients, focus groups with healthcare providers, participant observation, and reflective diaries. Hermeneutic phenomenology guided the data interpretation. Thematic analysis was applied to transcribed audio recordings. Results: This study included 12 patients with CNP who participated in two in-depth interviews conducted at different time points—before and after receiving physiotherapy treatment. Additionally, 23 CNP patients took part in four focus groups, and 46 healthcare professionals (including physicians, nurses, and physiotherapists) participated in three focus groups. A hermeneutic analysis revealed the following three main categories: “Self-concept and pain experience”, “Daily life obligations and pain perception”, and “Emotional conflicts related to CNP”. Patients described themselves as nervous, having communication difficulties, and often prioritizing family or work tasks, leading to stress. They indicated that their interpersonal conflicts with close relations intensified their perceived pain in the neck, head, shoulders, and arms. Conclusions: From the perspective of the participants in this study, interpersonal and emotional conflicts appear to influence their perception of CNP. Full article

Introduction: Musculoskeletal disorders (MSDs) are a significant occupational health concern worldwide, particularly among healthcare professionals such as laboratory technicians. MSDs lead to chronic pain, decreased productivity, and reduced quality of life. This study aimed to investigate the prevalence of MSDs and associated ergonomics risk factors among Saudi clinical laboratory technicians. Methodology: This cross-sectional study was conducted on 167 clinical laboratory technicians in Taif city, Saudi Arabia. Data were collected through an online self-administered questionnaire, distributed via Google Forms. The questionnaire collected demographics information, assessed the prevalence of musculoskeletal pain using the Nordic Musculoskeletal Questionnaire (NMQ), and evaluated ergonomics risk factors using the Dutch Musculoskeletal Questionnaire (DMQ). Results: In total, 77.3% of the sample exhibited musculoskeletal issues in the last 12 months, with lower back (52.1%), neck (48.5%), and shoulders (40.7%) being the most frequent muscular complaints among laboratory technicians. Experience and nationality showed significant associations with MSDs (p ≤ 0.05). Lower back and neck complaints were commonly recorded with multiple laboratory tasks, including sustained sitting and standing and repetitive movement, whereas lower back and shoulder pain were notably prevalent with pipetting work. Conclusions: Work-related musculoskeletal disorders were highly apparent in laboratory practice. Periodic ergonomic training is mandated among laboratory personnel to limit occupational disability. Full article

Background/Objectives: Pneumatocysts, characterized by gas-filled cavities, are commonly found in the spine and pelvis but are rarely observed in the scapula. In this report, we describe two rare cases of scapular pneumatocysts mimicking bone tumors and exhibiting different image findings. Case Report: Case 1. A 47-year-old man who presented with neck pain underwent radiography, followed by magnetic resonance imaging (MRI). MRI showed heterogeneity with low and high signals on fat-suppressed T2-weighted images, suggestive of enchondroma or fibrous dysplasia (FD). However, preoperative computed tomography (CT) revealed gas-filled cavities within the tumor, in continuity with the shoulder joint, confirming the diagnosis of a pneumatocyst. Case 2. A 58-year-old woman who presented with neck pain underwent similar examinations to Case 1. MRI showed homogeneity with high signals on fat-suppressed T2-weighted images, leading to a suspicion of solitary bone cysts and FD. Preoperative CT revealed gas-filled cavities within the tumor, but no continuity with the joint, leading to the diagnosis of a pneumatocyst. While the exact etiology of pneumatocysts remains unclear, two potential causes are as follows: (i) gas migration from the joint to the bone, and (ii) gas replacement in cystic tumors. Thus, CT is particularly valuable in confirming the presence of gas-filled cavities and aiding in diagnosis. Conclusions: This report highlights two extremely rare cases of scapular pneumatocysts, reflecting two potential etiologies. The utility of CT in the diagnosis of pneumatocyst has been clarified. Full article

Background: Among the leading causes of work-related disability, musculoskeletal diseases (MSDs) profoundly affect productivity and quality of life. Workplace changes, equipment adjustments, and training courses, among other ergonomic interventions, seek to lower the frequency and degree of MSDs. This systematic review and meta-analysis evaluated whether ergonomic interventions help prevent and control MSDs in various workplace environments. Methods: A systematic search was conducted in PubMed, Scopus, Embase, Web of Science, and Cochrane Library to identify relevant studies. Inclusion criteria included randomized controlled trials (RCTs) that evaluated ergonomic interventions against conventional conditions. Effect sizes were computed using mean differences and pooled using a random-effects model in case of heterogeneity. A uniform Excel sheet was used for data extraction. Revman software (Cochrane Collaboration, Copenhagen, Denmark) was used for statistical analysis. Results: This meta-analysis included 24 RCTs with 4086 workers with different occupations. A meta-analysis of 10 included studies demonstrated lower pain intensity with a mean difference in VAS score between ergonomic interventions and the control group of −0.28 (95%CI: −0.43, −0.14, p = 0.0001). Also, there was a significant reduction in reported MSD-related pain in the lower back with ergonomic interventions with an OR 0.53 (95%CI: 0.40–0.70, p < 0.00001). Moreover, there were statistically significant results for ergonomic interventions in the upper back, ankles, wrists, and neck. In contrast, there were no significant improvements in the thighs, arms, knees, shoulders, and elbows. Conclusions: Our findings support implementing ergonomic strategies as a practical approach to reducing work-related MSDs. However, further research is needed to improve intervention design and long-term effectiveness. Full article

Work-related musculoskeletal disorders (WMSDs) are a significant public health concern, particularly in professions requiring prolonged static postures. Objectives: This study examined the influence of demographic and occupational factors on the WMSD prevalence and provides evidence-based recommendations for workplace health improvements. Methods: A cross-sectional study (July–September 2024) surveyed 80 office employees in Varna, Bulgaria, using the Prevent 4 Work (P4Wq) questionnaire. ANOVA and t-tests assessed the WMSD prevalence across demographics, while Pearson’s correlations examined associations with age, BMI, and work experience. Data were analyzed in Jamovi v.2.6 (p < 0.05). Results: The sample (92.5% women, mean age 47.2 years) reported a high WMSD prevalence, with cervical pain (88.8%), lower back pain (83.8%), and shoulder pain (75.0%) being the most common. Work experience, age, and BMI were significantly correlated with WMSD severity, while gender showed no significant associations. Conclusions: WMSDs are highly prevalent among office employees, with lower back, neck, and shoulder pain being the most common complaints. Factors such as higher BMI, longer work experience, and increased workload are associated with greater symptom severity. These results emphasize the urgent need for targeted workplace interventions aimed at reducing ergonomic risks, improving posture, and enhancing employee well-being, ultimately fostering a healthier and more productive work environment. Full article

Background and Clinical Significance: The levator claviculae muscle (also known as cleidocervicalis) is a vestigial muscle located in the posterior triangle of the neck, extending from the upper cervical transverse processus to the clavicle. It has been detected in ~2% of humans, but is rarely documented in the radiologic or anatomic literature. When found on physical exam, it is usually mis-identified as lymphadenopathy, metastasis, cysts, an aneurysm, or other masses. It has been implicated in a few cases of thoracic outlet syndrome. Case Presentation: Herein, we describe a 25-year-old man with a weightlifting history, who was found to have a right levator claviculae muscle in the setting of unilateral mixed neurovascular thoracic outlet syndrome. The patient presented with right-sided extremity paresthesias, pain in the neck, shoulder, and arm, and symptom exacerbation with overhead activities. He also described intermittent unilateral pulsatile tinnitus during strenuous exercise. On physical exam, he was found to have a right carotid bruit, unequal systolic blood pressures, and positive Roos and Adson’s testing. The variant muscle was identified with a modified exam maneuver, and was further characterized with sonography and MRI. Symptoms were managed with activity restriction and NSAIDs. We reviewed 17 cases of levator claviculae variant muscles in patients. Conclusions: The presence of levator claviculae muscles has been detected in patients with thoracic outlet syndrome, but never in a patient with an audible bruit and pulsatile tinnitus. This physical exam maneuver, used in conjunction with multimodal imaging, successfully aided diagnosis and direct medical management in this case. Full article

Background: It is important to consider the cervical spine as a potential contributor to shoulder pain, indicating the paramount importance of screening the cervical spine in patients with shoulder pain. Objectives: To study the immediate effects of cervical spine screening (CSS) on the shoulder active range of motion, isometric strength and self-reported function in patients with neck-related shoulder pain. Methods: A secondary analysis was conducted on data from a previous study. A cervical contribution was considered if a ≥30% shoulder symptom modification of pain intensity (Numeric Pain Rating Scales) was recorded during the most painful shoulder movement after CSS. Pre–post measurements of the shoulder active range of motion (inclinometer) and shoulder isometric strength (dynamometer) were recorded in a single session. Self-reported shoulder function (Shoulder Pain and Disability Index) was assessed at a 1-week follow-up. Results: Among 60 participants, statistically significant changes were found for those with a cervical contribution (n = 30) for shoulder flexion and the abduction range of motion (p < 0.001), with a medium size effect (r = 0.55), and in internal rotation (p = 0.02) and external rotation at 0° abduction (p = 0.008), with a small size effect (r = 0.3 and 0.34, respectively). The self-reported shoulder function in those without a cervical contribution significantly declined from the pre to post measurements (p = 0.002), with a small size effect (r = 0.4). No statistically significant changes were found for the isometric strength in either group. Conclusions: In patients with shoulder pain classified as having a cervical contribution, CSS produces intrasession improvements in the active shoulder range of motion but not in the shoulder isometric strength or self-reported shoulder function. Full article

Introduction: In 2021, 10.5% of people aged 20–79 had diabetes, projected to rise to 12.2% by 2045, causing early deaths and straining healthcare systems. Musculoskeletal (MS) pain is common, affecting many workers and the general population. Prediabetes, notably impaired fasting glucose (IFG), is linked to increased MS pain risk. Objective: This study aims to assess IFG’s impact on MS pain and specific pain sites to aid prevention strategies. Methods: This cross-sectional study used the ‘2023 Employee Occupational Safety and Health Management Database’ from a Taichung hospital. It included health checks, demographics, living and work data, and MS pain surveys. Out of 2369 staff members contacted, 1039 valid responses were analyzed, excluding incomplete data, diabetes history, or fasting blood glucose levels above 125 mg/dL. Data on sex, age, marital status, coffee and alcohol consumption, sleep duration, exercise habits, height, weight, chronic diseases, profession, work hours, shift work, and education level were collected. Fasting blood glucose was verified using American Diabetes Association criteria (100–125 mg/dL). The Nordic Musculoskeletal Questionnaire (NMQ) measured MS pain frequency and severity, creating a pain degree index. Results: Overall, 21.17% had IFG. Participants were mostly female (85.18%), averaging 37.50 years. Neck and shoulder pain risk was linked to sex, coffee and alcohol consumption, sleep, exercise, chronic diseases, work hours, and IFG. Ankle pain risk was linked to coffee and alcohol consumption. IFG, coffee, alcohol, sleep under 6 h, chronic diseases, and work hours were independent risk factors for neck and shoulder pain. IFG was a risk factor for those without overweight or obesity. A mediation model tested IFG’s indirect effect on neck and shoulder pain among overweight or obese individuals, showing that IFG mediates the relationship between being overweight or obese and increased neck and shoulder pain risk. Conclusions: Among female-dominated healthcare workers, IFG, daily coffee, recent alcohol consumption, less than 6 h of sleep, chronic diseases (excluding diabetes), and longer work hours are independent risk factors for neck and shoulder pain. IFG mainly affects these areas, increasing pain risk regardless of body weight. Healthy blood glucose levels are associated with a lack of musculoskeletal pain, suggesting a novel prevention approach needing further study. Full article

Background/Objectives: Many patients evaluated by shoulder specialists suffer from intractable pain, neuropathy, and weakness. The pectoralis minor (PM) remains the only scapula muscle to receive lower trunk (C8-T1) input. We propose a novel syndrome: the Human Disharmony Loop. This model portrays how this unique PM innervation causes scapular dyskinesia, which deranges the anatomy of the upper limb girdle and produces a refractory symptom complex of pain, neuropathy, and weakness. We hypothesize that certain patients with historically intractable symptoms of the upper limb girdle may benefit from PM tenotomy. Methods: Ten patients of diverse etiologies presented with a similar constellation of complaints. The patients included a female athlete, a female with macromastia, a male bodybuilder, and patients with post-radiation breast cancer, post-operative shoulder arthroplasty, interscalene block injury, cervical spine disease, persistent impingement after rotator cuff repair, direct traction injury, and occupational disorder. All patients exhibited coracoid tenderness, scapula protraction with internal rotation and anterior tilt, and pain involving the neck, shoulder, and upper back. The patients demonstrated varying degrees of arm neuropathy, subacromial impingement, and occipital headaches. The patients failed all prior treatments by multiple subspecialists, including surgery. Each patient underwent isolated open PM tenotomy. Results: In all ten patients, PM tenotomy substantially reduced shoulder, upper back, and neck pain, cleared concomitant neuropathy, restored full motion, and eradicated occipital headaches. The response to surgery was rapid, dramatic, and durable. Conclusions: The unique asymmetric neurologic innervation to the sole ventral stabilizer of the scapula, the pectoralis minor, predisposes the human shoulder to neurologic and musculoskeletal imbalance. This produces the Human Disharmony Loop: a clinical syndrome spanning from the neck to the fingertips, with chronic pain, neuropathy, and weakness. These challenging patients may benefit dramatically from isolated PM tenotomy. Full article

Background/Objectives: Many patients with neck pain have upper limb disorders, and prolonged use of computers at work commonly induces neck/shoulder pain. The purpose of this study was to investigate the psychometric properties of the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) in patients with neck pain. Methods: A total of 189 patients with neck pain were included in acceptability, reliability, validity, and responsiveness studies. The floor and ceiling effects were used for assessing acceptability. The internal reliability and test–retest reliability were used for assessing reliabilities. The construct validities (convergent/divergent validity and exploratory/confirmatory factor analyses) were used for assessing validity. The effect size (ES) and standardized response mean (SRM) were used for assessing responsiveness. Results: The QuickDASH had a slight floor effect (16.4%). For reliability, the internal consistency (Cα= 0.945) and test–retest reliability (ICC = 0.98; SEM = 3.17, and MDC = 8.79) were excellent. For validity, the convergent and divergent validities were satisfactory. Exploratory factor analysis revealed two factors of the QuickDASH (function factor and symptom factor), and confirmatory factor analysis confirmed the two-factor model. Responsiveness was supported by the high ES (0.85) and SRM (0.82). Conclusions: The QuickDASH is a reliable, valid, and responsive instrument for assessing upper limb disorders in patients with neck pain. Full article

Objective: Upper crossed syndrome (UCS) is an abnormal upper extremity movement pattern characterized by muscle tightness in the neck, shoulders, and upper back, coupled with weakness in opposing muscle groups. This study aimed to investigate the effectiveness of Pilates training combined with fascial massage as an intervention in office workers with UCS. Methods: 34 subjects were recruited and randomly divided into an experimental group (n = 17) and a control group (n = 17). The control group underwent 12 weeks of Pilates training, and the experimental group received 12 weeks of Pilates training combined with fascial massage. Body posture was assessed using the forward head angle (FHA) and forward shoulder angle (FSA), joint mobility was evaluated using cervical spine range of motion (ROM), muscle activity was assessed using surface electromyography (sEMG), and quality of life was evaluated using pain level (VAS) and cervical spine dysfunction index (NDI). Results: After 12 weeks of intervention, the FHA, FSA, VAS, and NDI of the experimental group were significantly lower than those of the pre-intervention group (p < 0.05) and significantly lower than those of the control group (p < 0.05); the extension and left–right rotation cervical spine ROM of the experimental group were significantly higher than those of the pre-intervention group (p < 0.05) and significantly higher than those of the control group (p < 0.05); and sEMG indexes (mean power frequency and median frequency) of the upper trapezius and the pectoralis major in the experimental group were significantly higher than those of the pre-intervention group (p < 0.05) and significantly higher than the control group (p < 0.05). Conclusion: Compared with Pilates training alone, Pilates training combined with fascial massage demonstrated a more significant effect in improving muscle activation, body posture, and pain and enhancing the quality of life for patients with UCS. Full article

Background/Objectives: Classical reverse shoulder arthroplasty (RSA) with a high neck–shaft angle (NSA) of 155° has shown satisfactory outcomes. However, newer RSA designs aim to improve results by modifying the stem design. This study evaluates the 5-year outcomes of a stem design featuring a rectangular metadiaphyseal fixation and a 135° NSA. Methods: This prospective bicentric case series included and longitudinally followed up patients that were treated for cuff arthropathy, massive irreparable rotator cuff tears, or eccentric osteoarthritis using a non-cemented rectangular metadiaphyseal fixation stem with a 135° NSA (Univers Revers, Arthrex, Naples, FL, USA). Subjective and objective functional outcome scores (Constant–Murley Score (CS), Shoulder Pain and Disability Index (SPADI), and Subjective Shoulder Value (SSV)), range of motion (ROM), radiographic outcome, adverse events, complications, and quality of life were investigated. Results: This study enrolled 132 patients (59% female, mean age 75 years, SD 6). At the 5-year follow-up, subjective and objective outcomes significantly improved compared to baseline: CS (32.9 to 71.7, p < 0.001), SPADI (38.7 to 86.2, p < 0.001), and SSV (43.0 to 84.1, p < 0.001). ROM improved in flexion (80° to 142.4°, p < 0.001), abduction (71.5° to 130.2°, p < 0.001), internal rotation (p < 0.001), internal rotation at 90° abduction (12.7° to 45.0°, p < 0.001), and abduction strength (0.8 kg to 5.2 kg, p < 0.001). External rotation remained unchanged (32.1° to 32.0°, p = 0.125), but external rotation at 90° abduction improved (20.9° to 52.7°, p < 0.001). No signs of implant migration, subsidence, shift, tilt, alignment loss, or wear were observed, but scapular bone spur formation (11%), scapular notching grade 1 (10%), bone resorption (10%), and partial humeral radiolucent lines (1%) were reported. Conclusions: Rectangular stems with metadiaphyseal fixation and a 135° neck–shaft angle in RSA consistently improve shoulder function, showing no aseptic loosening and minimal radiological changes at 5 years. Full article

The COVID-19 pandemic led to a rapid shift to remote working, which affected ergonomic conditions and increased the risk of upper body musculoskeletal pain (MSP). This study assessed the prevalence and impact of upper body MSP (affecting the head, neck, shoulders, and back) among academic staff at a University of Technology during the pandemic. Data were collected from 110 participants through an online, descriptive, cross-sectional survey adapted from the Dutch Musculoskeletal Questionnaire, the Standardized Nordic Questionnaire, and the McCaffrey Initial Pain Assessment Tool. The survey examined demographics, ergonomic practices, MSP, and psychological well-being before and during the pandemic. The sample included 59.1% female participants, with most being middle-aged. Persistent MSP was common, with 54.5% reporting neck pain and 59.1% experiencing back pain during the pandemic, alongside a significant decline in wrists in neutral position ergonomics (p = 0.012). Psychological well-being also worsened, as participants reported lower levels of cheerfulness, calmness, and energy than before the pandemic. While 81.9% of 90.9% participants with pre-existing MSP continued to experience pain, a small (9%) but notable proportion saw a decline in MSP during this period. These findings highlight a strong relationship between remote working conditions and MSP, with poor ergonomics and psychological distress contributing significantly to persistent pain. The results emphasise the need for institutions to provide ergonomic support, such as appropriate equipment and workstation adjustments, alongside mental health resources to mitigate the long-term impacts of remote working on physical and mental health. Full article