Factors Associated with Pain, Disability and Quality of Life in Patients Suffering from Frozen Shoulder

Document Type : RESEARCH PAPER

Authors

1 Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

2 Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

 Background:
Frozen shoulder is resulting in limb disability and reduction of quality of life but the factors associated with patients’ disability and quality of life is not clear. To assess pain, disability, the quality of life and factors associated with them in patients suffering from frozen shoulder. 
 
Methods:
We enrolled 120 patients (37 men and 83 women) with phase-II idiopathic frozen shoulder in our cross-sectional study. Demographic data were collected and shoulder range of motion was measured in four different directions (elevation, abduction, external and internal rotation) in both upper limbs. Patients were asked to fill out Visual Analog Scale for pain (VAS) and, Short-Form Health Survey questionnaire (SF-36) as well as Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires. We asked the patients to fill out the Hamilton anxiety and depression questionnaires.
Results:
The mean of VAS pain, DASH, PCS, and MCS scores were 69(18), 53(17), 35(8.0), and 42(10) respectively. All the domains of SF36 questionnaires where below the normal population except physical function. VAS pain score was correlated to Hamilton depression scores in both bivariate and mulivarilable analysis. DASH score were correlated to sex, age, ROM, and both Hamilton anxiety and depression scores; However, DASH score only impact with Hamilton anxiety and ROM independently. PCS is correlated to age and MCS to Hamilton depression.

Conclusion:
Patient with frozen shoulder are more suffering from pain and disability secondary to psychiatric parameters such as depression and anxiety than demographic features or even restriction of range of motion.

Keywords

Main Subjects

References

1. Carette S. Adhesive capsulitis--research advances
frozen in time? J Rheumatol. 2000; 27(6):1329-31.
2. Constant CR, Murley AH. A clinical method of
functional assessment of the shoulder. Clin Orthop
Relat Resh. 1987; 214:160-4.
3. Bunker TD. Frozen shoulder: unravelling the enigma.
Ann R Coll Surg Engl. 1997; 79(3):210-3.
4. Goldberg BA, Scarlat MM, Harryman Li DT.
Management of the stiff shoulder. J orthop sci. 1999;
4(6):462-71.
5. Vastamäki H, Kettunen J, Vastamäki M. The natural
history of idiopathic frozen shoulder: a 2-to 27-
year followup study. Clin Orthop Relat Res. 2012;
470(4):1133-43.
6. Ebrahimzadeh MH, Moradi A, Pour MK, Moghadam
MH, Kachooei AR. Clinical outcomes after
arthroscopic release for recalcitrant frozen shoulder.
Arch Bone Jt Surg. 2014; 2(3):220-4.
7. Lundberg BJ. The frozen shoulder. Clinical
and radiographical observations. The effect of
manipulation under general anesthesia. Structure
and glycosaminoglycan content of the joint capsule.
Local bone metabolism. Acta orthop Scand Suppl.
1969; 119:1-59.
8. Wolf JM, Green A. Influence of comorbidity on selfassessment
instrument scores of patients with
idiopathic adhesive capsulitis. J Bone Joint Surg Ame.
2002; 84-A(7):1167-73.
9. Hazleman BL. The painful stiff shoulder. Rheumatol
Phys Med. 1972; 11(8):413-21.
10. Harris AH, Youd J, Buchbinder R. A comparison of
directly elicited and pre-scored preference-based
measures of quality of life: the case of adhesive
capsulitis. Qual Life Res. 2013; 22(10):2963-71.
11. Alizadehkhaiyat O, Fisher AC, Kemp GJ, Frostick SP.
Pain, functional disability, and psychologic status in
tennis elbow. Clin J Pain. 2007; 23(6):482-9.
12. Cho CH, Seo HJ, Bae KC, Lee KJ, Hwang I, Warner
JJ. The impact of depression and anxiety on selfassessed
pain, disability, and quality of life in patients
scheduled for rotator cuff repair. J Shoulder Elbow
Surg. 2013; 22(9):1160-6.
13. Ding H, Tang Y, Xue Y, Yang Z, Li Z, He D, et al. A report
on the prevalence of depression and anxiety in
patients with frozen shoulder and their relations to
disease status. Psychol Health Med. 2014; 19(6):730-
7.
14. Hodkinson B, Maheu E, Michon M, Carrat F,
Berenbaum F. Assessment and determinants of
aesthetic discomfort in hand osteoarthritis. Ann
Rheum Diss. 2012; 71(1):45-9.
15. Ring D, Kadzielski J, Fabian L, Zurakowski D, Malhotra
LR, Jupiter JB. Self-reported upper extremity health
status correlates with depression. J Bone Joint Surg
Am. 2006; 88(9):1983-8.
16. Bair MJ, Wu J, Damush TM, Sutherland JM, Kroenke
K. Association of depression and anxiety alone and
in combination with chronic musculoskeletal pain
in primary care patients. Psychosom Med. 2008;
70(8):890-7.
17. Wolkind SN. Psychiatric aspects of low back pain.
Physiotherapy. 1974; 60(3):75-7.
18. Ebrahimzadeh MH, Moradi A, Vahedi E, Kachooei AR,
Birjandinejad A. Validity and reliability of the Persian
version of shortened disabilities of the arm, shoulder
and hand questionnaire (quick-DASH). Int J Prev
Med. 2015; 6:59.
19. Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S.
The hospital anxiety and depression scale (HADS):
translation and validation study of the Iranian
version. Health Qual Life Outcomes. 2003; 1(1):14.
20. Griggs SM, Ahn A, Green A. Idiopathic adhesive
capsulitis. A prospective functional outcome study of
nonoperative treatment. J Bone Joint Surg Am. 2000;
82-A(10):1398-407.
21. Buchbinder R, Hoving JL, Green S, Hall S, Forbes
A, Nash P. Short course prednisolone for adhesive
capsulitis (frozen shoulder or stiff painful shoulder):
a randomised, double blind, placebo controlled trial.
Ann Rheum Dis. 2004; 63(11):1460-9.
 
The Archives of Bone and Joint Surgery
Volume 4, Issue 3
July 2016
Pages 243-247

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History

  • Receive Date: 24 January 2016
  • Revise Date: 13 June 2016
  • Accept Date: 13 June 2016

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