Subacromial impingement syndrome – what does this mean to and for the patient: a qualitative study

Cuff, Andrew; Littlewood, C.

doi:10.1016/j.physio.2017.11.028

Cited by 8 publications

(15 citation statements)

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“…Many patients consult healthcare professionals complaining of shoulder pain, with disorders associated with the rotator cuff (subacromial impingement, subacromial pain, rotator cuff related shoulder pain (RCRSP) and other synonyms) widely regarded as the most common presentation (1,2). The wide range of diagnostic or descriptive terms used to explain this common clinical presentation reflect uncertainty in relation to understanding of the pathology, diagnosis, prognosis, and the most effective treatment options (1, [3][4][5]. A range of diagnostic tests, including imaging, and a range of different treatment options are available including exercise programmes, manual therapy, corticosteroid injections and surgery (6).…”

Section: Introductionmentioning

confidence: 99%

Physiotherapists’ recommendations for examination and treatment of rotator cuff related shoulder pain: A consensus exercise

Littlewood

Bateman

Connor

et al. 2019

Physiotherapy Practice and Research: The Official Journal of Th

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Background: Disorders associated with the rotator cuff are regarded as the most common shoulder pain presentation. The range of diagnostic terms used to explain this problem reflect uncertainty in relation to causative mechanisms, diagnosis, prognosis, and the most effective treatments. The aim of this consensus exercise was to facilitate a shared understanding as a means of reducing mixed messages, informing clinical practice and providing a foundation for future research. Methods: Ten physiotherapists with clinical and academic expertise in shoulder pain participated in an online and face-to-face consensus exercise. Results: This consensus exercise suggests specific factors in the history and physical examination that might raise the index of suspicion of Rotator Cuff Related Shoulder Pain. The suggestions for non-surgical management include a minimal number of exercises prescribed to challenge the functional deficit of the patient over a minimum 12-week period. Apart from aiding exclusion of red flag pathology, imaging is not regarded as useful unless the patient does not respond as expected. Steroid injections wouldn't be considered a first-line intervention unless pain was severe and preventing engagement with exercise. Conclusion: This consensus exercise provides a benchmark for clinical reflection while highlighting areas of uncertainty that still exist and require further research.

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Section: Introductionmentioning

confidence: 99%

Physiotherapists’ recommendations for examination and treatment of rotator cuff related shoulder pain: A consensus exercise

Littlewood

Bateman

Connor

et al. 2019

Physiotherapy Practice and Research: The Official Journal of Th

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show abstract

“…A new Norwegian guideline for treatment of patients with nonspecific shoulder pain in primary care, strongly recommends simple clinical examination and advice for exercises [51]. We may speculate whether many of our patients referred to specialist care had not received adequate treatment in primary care; or whether the referral was based on the need for a "second opinion" [52]? Future studies should explore these assumptions in both primary and specialist health care.…”

Section: Discussionmentioning

confidence: 99%

Shoulder patients in primary and specialist health care. A cross-sectional study

Engebretsen

Robinson

Vøllestad

2021

Scandinavian Journal of Pain

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ObjectivesShoulder pain is a prevalent problem and has a considerable impact on the use of primary and specialist health care in Norway. It is important to improve short-term recovery and reduce long-term consequences regarding pain and disability, the high costs of treatment and the amount of sick-leave. Treatment for non-specific shoulder pain is mainly non-operative. The aims of this study were to investigate if there are differences in main characteristics, pain and disability (SPADI-score) and psycho-social factors between patients in primary and specialist health care.MethodsThis cross-sectional study included patients consulting physiotherapy in primary health care and patients at an outpatient clinic in specialist health care. Well-known and tested questionnaires for these populations were used and variables were divided into clinical, sociodemographic, psycho-social, and shoulder pain and disability. Descriptive statistics were applied. Two-sample t-test and linear regression were used for continuous data whereas chi-square tests and logistic regression were applied to test differences in categorical data between the two study populations.ResultsTwo hundred and 36 patients were recruited from primary health care (FYSIOPRIM, Physiotherapy In Primary Care) and 167 from specialist health care. Patients in primary health care reported less regular use of pain medication (30.7 vs. 61.3%) and fewer patients had symptom duration >12 months (41.9 vs. 51.0%). Furthermore, they reported lower pain intensity, less shoulder pain and disability (SPADI-score), lower scores on psycho-social factors, but higher on expectations of recovery.ConclusionsPatients with shoulder pain treated in primary health care and in specialist health care are different according to factors such as duration of symptoms, pain and disability, and some of the psycho-social variables. However, the differences are small and the variations within the two study samples is large. Patients treated in primary health care seemed to be less affected and to have higher expectations concerning their recovery. However, based on our results we may question why many patients are referred to specialist health care rather than continuing treatment in primary health care.

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“…This is unsurprising; recent expert consensus was gained for the diagnostic label for the Achilles tendon‐related pain, but consensus could not be reached for tendon‐related pain at the shoulder (Scott et al., 2020). Nevertheless, clinicians should be aware the impact of language and diagnostic labels they use with patients and how it may influence understanding, behaviour and therefore outcomes from treatment (Cuff & Littlewood, 2018).…”

Section: Discussionmentioning

confidence: 99%

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

Mitham

Mallows

Yeowell

et al. 2021

Musculoskeletal Care

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Background Tendon‐related pain is a common and debilitating condition that affects a wide range of people. To inform future research, it is important to understand healthcare professional's current practice. Objectives To describe the practice of First Contact Practitioners (FCPs) and Other Clinicians (OCs) for recent onset tendon pain in a primary contact setting. The secondary aim was to understand if practice differed between the locations of pain. Design Cross‐sectional online survey Method The online survey asked for responses relating to one scenario of shoulder pain and one of Achilles pain. Except location of pain, the scenarios were identical. Responses were collected over a four‐week period to December 2020. The Chi‐Square test was used to analyse the difference in proportion of responses between FCPs and OCs, and between locations of pain. Results 118 responses were received. Rotator Cuff Related Shoulder Pain (RCRSP) was preferred by 64/118 (54.2%) for the shoulder scenario. Achilles tendinopathy was the preferred term by 86/103 (83.5%) for the Achilles. FCPs were more likely to advise NSAIDs for both shoulder (p = 0.006) and Achilles (p = 0.046) scenarios than OCs. Amended duties were more likely to be advised for manual workers for the shoulder scenario compared to Achilles (p = <0.0001). Conclusion There were similarities in the management of recent onset tendon‐related pain; the majority of respondents recommended against further investigations, steroid injections, and recommended exercise. Understanding whether these approaches are clinically effective requires further investigation.

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Subacromial impingement syndrome – what does this mean to and for the patient: a qualitative study

Cited by 8 publications

References 0 publications

Physiotherapists’ recommendations for examination and treatment of rotator cuff related shoulder pain: A consensus exercise

Physiotherapists’ recommendations for examination and treatment of rotator cuff related shoulder pain: A consensus exercise

Shoulder patients in primary and specialist health care. A cross-sectional study

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

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