AI Article Synopsis
- The study investigates the effects of altered central pain processing (CPP) and dysautonomia on the clinical course of frozen shoulder, also highlighting the impact of psychological factors like pain catastrophizing and hypervigilance.
- Participants were tracked over 9 months, using various questionnaires and pain assessments to analyze changes in shoulder pain, disability, and psychological factors.
- Results showed initial improvement in pain and psychological variables, but with a more gradual change in autonomic symptoms, indicating that psychological aspects played a more immediate role while autonomic improvements were slower to develop.
Article Abstract
Background: Altered central pain processing (CPP) and dysautonomia might play a role in the clinical course of frozen shoulder and psychological factors, like pain catastrophizing and hypervigilance, might influence clinical variables in frozen shoulder.
Objectives: To explore the clinical course of frozen shoulder regarding CPP, dysautonomia, pain catastrophizing, and hypervigilance and to explore whether longitudinal correlations between these outcomes and pain intensity were present.
Design: prospective longitudinal observational study.
Method: Participants with frozen shoulder were recruited at hospitals and general practitioner practices and followed for 9 months. They completed six questionnaires (about demographics, shoulder pain and disability, pain intensity, pain catastrophizing, pain hypervigilance, and autonomic symptoms) and underwent tactile sensitivity (allodynia), pressure pain thresholds (hyperalgesia), temporal summation, and conditioned pain modulation during four timeframes (3-month intervals).
Results: Initially, 149 participants with frozen shoulder were recruited and 88 completed all the measurements. An improvement from baseline to at least one follow-up measurement was found for shoulder pain and disability, pain intensity, pain catastrophizing, hypervigilance, and dysautonomia. A fair longitudinal correlation was found between pain intensity and catastrophizing and hypervigilance (r = 0.301-0.397). Poor longitudinal correlations were found between pain intensity and allodynia and hyperalgesia (r = -0.180-0.193), between pain catastrophizing and dysautonomia (r = 0.209) and between hypervigilance and hyperalgesia (r = -0.159).
Conclusion: Patients with frozen shoulder showed an early improvement that flattened with time in several pain and psychological variables over the course of 9 months. However, autonomic symptoms rather showed a late improvement over 9 months.
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Source |
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| http://dx.doi.org/10.1016/j.msksp.2023.102857 | DOI Listing |
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