Neuropathic pain in patients with rotator cuff tears

Karasugi, Tatsuki; Ide, Junji; Kitamura, Toshio; Okamoto, Naoya; Tokunaga, Takuya; Mizuta, Hiroshi

doi:10.1186/s12891-016-1311-5

Cited by 22 publications

(27 citation statements)

References 36 publications

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“…4 In patients with rotator cuff tears, the prevalence of neuropathic pain has been found to be as high as 15.8%. 15,17,18 The DN4 score is a reliable, validated, quick, and sensitive tool for evaluating neuropathic pain. 37 However, the effect of neuropathic pain on acute pain and analgesic use after surgery has never before been evaluated.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Prolonged Postoperative Pain and Analgesic Use After Arthroscopic Full-Thickness Rotator Cuff Repair

Mısır

Uzun

Kızkapan

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Postoperative pain and analgesic use after arthroscopic rotator cuff repair remain important issues that affect rehabilitation and overall outcomes. Purpose: To evaluate the pre- and intraoperative factors that may cause prolonged duration of postoperative pain and analgesic use. Study Design: Case-control study; Level of evidence, 3. Methods: We included 443 patients who underwent arthroscopic rotator cuff repair and subacromial decompression. Visual analog scale (VAS) scores for pain were obtained preoperatively and at 30 and 90 days postoperatively. Patients were divided into a group who had prolonged postoperative pain (duration ≥1 and <3 months; n = 86 patients) and a group with nonprolonged pain (duration <1 month; n = 357 patients). The following factors were compared between groups: age, sex, body mass index, repair technique, tear size, retraction amount, repair tension, tendon degeneration, preoperative pseudoparesis, symptom duration, application of microfracture to the rotator cuff footprint for marrow stimulation, smoking, degree of fatty degeneration, preoperative narcotic analgesic use, diabetes, acromioclavicular joint degeneration, and preoperative Douleur Neuropathique 4 (DN4) and American Shoulder and Elbow Society (ASES) scores. Results: Significant differences were seen between the prolonged and nonprolonged groups regarding the median duration of pain (54 vs 27 days, respectively; P < .001) and analgesic use (42 vs 28 days, respectively; P < .001). Significant differences were noted between the groups for symptom duration ( P = .007), smoking status ( P = .001), degree of fatty degeneration ( P = .009), preoperative narcotic analgesic use ( P < .001), preoperative DN4 and ASES scores, 30-day VAS score ( P < .001), duration of opioid and nonopioid analgesic use ( P < .001), tear size ( P = .026), and retraction stage ( P = .032). Tear size ( P = .009), retraction amount ( P = .005), preoperative narcotic analgesic use ( P < .001), degree of fatty degeneration ( P < .001), and preoperative DN4 score ( P = .024) were factors independently associated with prolonged postoperative pain and analgesic use. Conclusion: Patients with larger size tears, retracted tendons, preoperative use of narcotic analgesics, higher tensioned tendon after repair, and Goutallier grade 3 or 4 fatty degeneration faced an increased risk of prolonged postoperative pain and analgesic use after arthroscopic rotator cuff repair. These factors might be mitigated by psychosocial support; gentle, controlled, and individualized postoperative rehabilitation approaches; detailed preoperative evaluation; and closer follow-up of patients who are treated operatively.

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Section: Discussionmentioning

confidence: 99%

Factors Affecting Prolonged Postoperative Pain and Analgesic Use After Arthroscopic Full-Thickness Rotator Cuff Repair

Mısır

Uzun

Kızkapan

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…e free nerve fibers, which are rich in the subacromial tissues (subacromial capsule, rotator cuff tendon, and biceps long head tendon), are activated in the case of inflammation or injury and thus led to shoulder pain [14]. In addition to nociceptive pain, studies have shown that 10.9% of patients with rotator cuff injury may also suffer from neuropathic pain [15]. Peripheral nerves, such as suprascapular nerve, can be injured by inflammation or stimulated by prostaglandin, substance P, and other chemicals released from damaged cells and inflammatory cells, leading to the sensitization of nociceptors which amplified its afferent nerve signals, and then resulted in peripheral sensitization.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation of An Analgesic Bracelet Based on Wrist-Ankle Acupuncture in Patients with Rotator Cuff Injury: A Randomized Trial

Song

Wang²,

Zhou

et al. 2021

Pain Research and Management

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Objective. To evaluate the effect of transcutaneous electrical nerve stimulation (C-TENS) in the rehabilitation of rotator cuff injury. Methods. A total of 60 patients diagnosed with mild to moderate rotator cuff injury were randomly divided into the control group and test group. Both groups received conventional rehabilitation treatment including physical therapy, joint mobilization, interventional therapy, and family recovery training. The test group additionally received TENS treatment on the upper area 4 or 5 of the wrist, based on the wrist-ankle acupuncture (WAA) theory. The results of the visual analogue scale (VAS), shoulder range of motion (ROM), and Constant-Murley score (CMs) were collected before and after the 1st treatment and after the 5th treatment. The differences of those indicators between the two groups were analyzed statistically. Results. The VAS scores of measurement points after treatment were all improved compared with those at baseline. There was a significant difference between the two groups after the 1st and the 5th treatment ( p < 0.05 ), and the improvements in the test group were better than those in the control group. The ROM of flexion, extension, abduction, adduction, internal rotation, and external rotation after the 1st treatment and 5th treatment in both groups were all improved compared with those at baseline. There was no significant difference between two groups. The CMs of the two groups after the 5th treatment were all improved compared with those at baseline. There was no significant difference between two groups. No adverse events occurred during the treatment. Conclusion. Electrical stimulation on the wrist combined with conventional rehabilitation is more effective in relieving pain than the conventional rehabilitation alone. Electrical stimulation on the wrist combined with conventional rehabilitation has no obvious effect in improving shoulder joint mobility and shoulder function.

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“…Patients with rotator cuff tears, in particular, exhibit neuropathic features [ 6 - 7 , 22 ]. Relevant reports for patients with NeuP in rotator cuff ruptures demonstrate percentages of 10.9 % [ 20 ] and 15.8% [ 6 ], respectively, but in our study, the proportion climbed to 18.8%.…”

Section: Discussionmentioning

confidence: 99%

“…This study aimed to investigate the existence of NeuP in patients with a rotator cuff tear, as well as factors that may be prognostic of NeuP development. So far, investigations in patients with rotator cuff diseases have employed pain measurement tools like visual analog scale (VAS), as well as more NeuP specific ones like Douleur Neuropathique 4 Question (DN4) and Pain Detect [ 6 , 7 ]. To the best of our knowledge, no studies have investigated whether a questionnaire such as Shoulder Pain and Disability Index (SPADI) might be used as a prognostic factor for the development of NeuP in chronic shoulder pain.…”

Section: Introductionmentioning

confidence: 99%

Is Shoulder Pain and Disability Index a Prognostic Factor for Neuropathic Shoulder Pain?

Vrouva¹,

Sopidou²,

Chanopoulos³

et al. 2021

Cureus

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Introduction So far, investigations in patients with rotator cuff diseases have used pain measurement tools such as visual analog scale (VAS) for nociceptive pain as well as neuropathic pain (NeuP) specialized ones like Douleur Neuropathique 4 Question (DN4) and Pain Detect. The study’s goal was to look at the existence of NeuP in patients with chronic shoulder pain, as well as variables that may be predictive of its progression. Methods There were 112 outpatients in all. Current and previous pain intensity levels were documented with the numerical rating scale (NRS), the Shoulder Pain and Disability Index (SPADI) was used to assess pain and disability levels, and the S-LANSS (self-completed Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale) was used to diagnose NeuP. The Pearson Chi-Square test was employed to check for any relationships between variables. The Mann-Whitney U test was also employed to check for between-group differences (with or without NeuP). To investigate factors that may be utilized as a prognostic for NeuP, logistic regression was performed, with those components (from the univariate analysis) that were statistically significant being included. Results According to the S-LANSS questionnaire for NeuP diagnosis, 21 patients had NeuP. According to S-LANSS, chi-square test findings revealed that NeuP is independent of sex, smoking, size, and location or rotator cuff tear. Univariate analysis with Mann-Whitney U test revealed statistically significant differences in SPADI and NRS scores between the two patient groups (p < 0.001). Α multivariate analysis using S-LANSS as the binary dependent variable and NRS currently, NRS average last month and SPADI total score as independent variables (with statistical significance) revealed that total SPADI score may be considered as an independent prognostic factor for NeuP (odds ratio = 1.189, p < 0.001). Limitations Due to the limited number of patients who participated in the study, the findings were deemed insufficient in terms of statistical power. In particular, the power analysis of the study (type I error probability being [a] = .05) was less than 80% (for the total SPADI score), hence relatively small. As a result, there is a limited probability of a type I error. Conclusions Using S-LANSS, we discovered that 18.8% of patients with rotator cuff tears had NeuP. The SPADI scores (pain and disability) in the NeuP group were substantially greater than in the nociceptive pain group. As previous studies have suggested utilizing certain levels of the VAS for pain assessment and specialized questionnaires for NeuP evaluation, we recommend that SPADI be included as a tool for emphasizing the neuropathic features of shoulder pain.

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Neuropathic pain in patients with rotator cuff tears

Cited by 22 publications

References 36 publications

Factors Affecting Prolonged Postoperative Pain and Analgesic Use After Arthroscopic Full-Thickness Rotator Cuff Repair

Factors Affecting Prolonged Postoperative Pain and Analgesic Use After Arthroscopic Full-Thickness Rotator Cuff Repair

Rehabilitation of An Analgesic Bracelet Based on Wrist-Ankle Acupuncture in Patients with Rotator Cuff Injury: A Randomized Trial

Is Shoulder Pain and Disability Index a Prognostic Factor for Neuropathic Shoulder Pain?

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