The Spatial Extent of Pain Is Associated with Pain Intensity, Catastrophizing and Some Measures of Central Sensitization in People with Frozen Shoulder

Abstract

The aim of this cross-sectional study was to explore the spatial extent of pain and its association with clinical symptoms, psychological features, and pain sensitization in people with frozen shoulder (FS). Forty-eight individuals with FS completed pain drawings (PDs) and reported their clinical symptoms including pain intensity (Visual Analogue Scale) and shoulder disability (Shoulder Pain and Disability Index). Moreover, pain sensitization measurements (pressure pain thresholds, temporal summation, conditioned pain modulation, and Central Sensitization Inventory (CSI)) were assessed. Psychological features were assessed by Pain Catastrophizing Scale (PCS) and Pain Vigilance and Awareness Questionnaire. Pain frequency maps were generated, Margolis rating scale was used for pain location, and Spearman correlation coefficients were computed. The mean (SD) pain extent was 12.5% (6.7%) and the most common painful area was the anterolateral shoulder region (100%). Women presented a more widespread pain distribution compared with men. Significant positive associations were obtained between pain extent and current pain intensity (rs = 0.421, p < 0.01), PCS (rs = 0.307, p < 0.05) and CSI (rs = 0.358, p < 0.05). The anterolateral region of the shoulder was the most common painful area in people with FS. Women with FS presented more extended areas of pain; and a more widespread distribution of pain was correlated with higher levels of pain, pain catastrophizing and pain sensitization.

Deficits in the thalamocortical pathway associated with hypersensitivity to pain in patients with frozen shoulder

“…Previous studies have reported that the pain of FS is recurrent and frequently progresses to the chronic stage. Pain catastrophizing is considered a negative mental set during anticipated or actual painful experiences and has been shown to be increased in FS patients ( 9 ). As for pain vigilance, the PVAQ has been demonstrated to be a reliable instrument for the evaluation of vigilance and attention to pain ( 32 – 34 ).…”

“…Recent research, however, suggests that the pathophysiology of FS is complex, and central pain mechanisms have a crucial role in patients with FS ( 8 – 12 ). According to Mercè et al FS patients experience more extended areas of pain, which is associated with higher levels of pain, pain catastrophizing, and pain sensitization ( 9 ). Furthermore, Michel et al also observed greater allodynia, hyperalgesia, catastrophizing, and hypervigilance in FS patients compared to healthy participants, indicating potential central sensitization for pain in FS ( 11 ).…”

Structural and functional abnormalities in the medial prefrontal cortex were associated with pain and depressive symptoms in patients with adhesive capsulitis

“…8 However, recent research has shown that central pain mechanisms also have a crucial role in patients with AC. 4,24,25 Furthermore, patients with AC are at an increased risk of poor mental health due to persistent Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. J. Li, R. Zhao, C. Wang, and J.…”

“… 8 However, recent research has shown that central pain mechanisms also have a crucial role in patients with AC. 4 , 24 , 25 Furthermore, patients with AC are at an increased risk of poor mental health due to persistent pain. 5 Research indicated that individuals enduring prolonged pain frequently manifest symptoms of depression, with as many as 85% of those grappling with chronic pain being affected by severe depressive symptoms.…”

Relación entre catastrofización, kinesiofobia, discapacidad e intensidad de dolor en pacientes con síndrome de hombro doloroso (Relationship between catastrophizing, kinesiophobia, disability and pain intensity in patients with painful shoulder syndrome)

“…Tiene alta prevalencia en la sociedad, con un impacto significativo en la calidad de vida de las personas (Bilbeny et al, 2018). Adquiriendo importancia en las evaluaciones de salud, como medida de bienestar centrada en la percepción personal respecto a metas, expectativas, normas y preocupaciones según el estado de salud físico-mental, grado de independencia y relación socio-ambiental de la persona (Martínez & Calvo, 2014); debido a que el dolor crónico puede producir alteración en la funcionalidad de la vida diaria, kinesiofobia, catastrofización, deterioro en las relaciones interpersonales, aislamiento, complicaciones a nivel laboral, discapacidad e incluso invalidez (Bilbeny, 2019;Balasch et al, 2021).…”