Is there an association between metabolic syndrome and rotator cuff-related shoulder pain? A systematic review

Abstract

ObjectivesRotator cuff-related shoulder pain (RCRSP) is a common upper limb complaint. It has been suggested that this condition is more common among people with cardiometabolic risk factors. This systematic review has synthesised evidence from case–control, cross-sectional and cohort studies on the association between metabolic syndrome (MetS) and RCRSP.Design and data sourcesFive medical databases (MEDLINE, EMBASE, SCOPUS, CINAHL and AMED) and reference checking methods were used to identify all relevant English articles that considered MetS and RCRSP. Studies were appraised using the Newcastle-Ottawa Scale (NOS). Two reviewers performed critical appraisal and data extraction. Narrative synthesis was performed via content analysis of statistically significant associations.ResultsThree cross-sectional, two case–control and one cohort study met the inclusion criteria, providing a total of 1187 individuals with RCRSP. Heterogeneity in methodology and RCRSP or MetS definition precluded a meaningful meta-analysis. Four of the included studies identified associations between the prevalence of MetS and RCRSP. Studies consistently identified independent cardiometabolic risk factors associated with RCRSP. All studies were level III evidence.Summary and conclusionThe low-moderate quality evidence included in this review suggests an association between MetS and RCRSP. Most studies demonstrated moderate quality on appraisal. The direction of association and cardiometabolic factors influencing should be investigated by longitudinal and treatment studies. These preliminary conclusions and clinical utility should be treated with caution due to limitations of the evidence base.

Chronic hyperglycemia, hypercholesterolemia, and metabolic syndrome are associated with risk of tendon injury

“…Metabolic syndrome is related to various chronic degenerative diseases, including cardiovascular disease, stroke, and diabetes. There have only been few studies investigating associations between metabolic syndrome and musculoskeletal disorders, such as tendon injury 10,24,37–39 . Nevertheless, metabolic syndrome has been linked to some distinct tendon‐related disorders; rotator cuff tendinopathy, atraumatic posterosuperior rotator cuff tears, and Achilles enthesopathy 10,40–42 .…”

Management of recent onset tendon‐related pain in a primary contact setting: A survey of practice

“…Moderate alcohol consumption has been suggested as a potential risk factor for Achilles tendon‐related pain (Van Der Vlist et al., 2019), as well as metabolic factors for both shoulder and Achilles tendon‐related pain (Burne et al., 2019; O'Neill et al., 2016). Respondents in this survey were more likely to discuss obesity, smoking and physical activity for the Achilles scenario compared to the shoulder, despite the association between these factors and shoulder pain (Rechardt et al., 2010; Özkuk & Ateş, 2020).…”

Current concepts in the rehabilitation of rotator cuff related disorders

“…Co-morbidities associated with increased risk of shoulder pain such as high BMI or metabolic disorders should be screened for 9 and the individual's 'physiological age' considered. Lifestyle factors associated with the risk of such disorders including diet, smoking, and low activity levels should be discussed.…”