The Effect of Shoulder Pain on Sleep Quality

Year 2024, Volume: 6 Issue: 1, 56 - 62, 26.02.2024

Yasemin Tombak , Fatma Nazlı Ünkazan

https://doi.org/10.52827/hititmedj.1365643

Abstract

Objective: Shoulder pain, a common musculoskeletal issue, is most prevalent in patients aged 50-59. It can cause sleep problems, reducing sleep quality. We aimed to explore the relationship between sleep quality, pain, and disability in patients with shoulder pain, despite limited literature on this issue.
Material-Method: Study involved 91 patients aged 18-80 with persistent shoulder pain sought out at a physical medicine and rehabilitation outpatient clinic. Factors such as age, gender, education, symptom duration, body mass index (BMI), occupation, and pain severity were recorded. Severity of pain was assessed using the visual analogue scale (VAS), pain and disability using the Shoulder Pain and Disability Index (SPADI), and sleep quality using the Pittsburgh Sleep Quality Index (PSQI).
Results: Average age was 54.9. 63% of patients were female and 28% were male. 14% of them had heavy work above shoulder level. A positive correlation was detected between PSQI and VAS and SPADI (p value 0.004 and 0.003, respectively). No significant relationship was found between PSQI and BMI and symptom duration (p value 0.464 and 0.718, respectively). While there was a significant difference in SPADI values between two groups with and without heavy work above the shoulder level, no significant difference was detected in PSQI values (p value 0.021 and 0.36, respectively).
Conclusion: We found that the patient's VAS and SPADI values and sleep quality were negatively related to shoulder pain. Sleep disturbance due to pain at night can also affect daytime disability. Pain and sleep quality disorders can enter a vicious circle.

Keywords

Shoulder pain, sleep quality, musculoskeletal system, VAS, SPADI, PSQI

Ethical Statement

The study protocol received institutional review board approval (dated 16.05.2023; Protocol No. 05) and all participants provided informed consent in the format required by the clinical research ethics committee of the local institute., Kirklareli University, Faculty of Medicine.

Supporting Institution

None

Thanks

None

Omuz Ağrısının Uyku Kalitesine Etkisi

Abstract

Giriş-Amaç: Sık görülen bir kas-iskelet sistemi sorunu olan omuz ağrısı, en sık 50-59 yaş arası hastalarda görülür. Uyku sorunlarına yol açarak uyku kalitesini düşürebilir. Literatürde bu sorunla ilgili bilgi çok azdır. Omuz ağrılı hastalarda uyku kalitesi ve uykunun ağrı ve dizabilite ile ilişkisini incelemeyi amaçladık.
Gereç-Yöntem: Çalışmaya omuz ağrısı şikayetiyle fizik tedavi ve rehabilitasyon kliniğine başvuran 18-80 yaş arası 91 hasta dahil edildi. Yaş, cinsiyet, eğitim, semptom süresi, vücut kitle indeksi (VKİ), meslek ve ağrı şiddeti gibi faktörler kaydedildi. Ağrının şiddeti vizüel analog skala (VAS), ağrı ve disabilite Omuz Ağrısı ve Disabilite İndeksi (SPADI) ve uyku kalitesi Pittsburgh Uyku Kalitesi İndeksi (PUKİ) kullanılarak değerlendirildi.
Bulgular: Ortalama yaş 54,9 idi. Hastaların %63'ü kadın, %28'i erkekti. Bunların %14'ü omuz hizasının üzerinde ağır işlerde çalışıyordu. PUKİ ile VAS ve SPADI arasında pozitif bir korelasyon tespit edildi (sırasıyla p değeri 0,004 ve 0,003). PUKİ ile VKİ ve semptom süresi arasında anlamlı bir ilişki bulunamadı (sırasıyla p değeri 0,464 ve 0,718). Omuz üstü ağır iş yapılan ve yapılmayan iki grup arasında SPADI değerlerinde anlamlı fark bulunurken, PUKİ değerlerinde anlamlı fark saptanmadı (sırasıyla p değeri 0,021 ve 0,36).
Sonuç: Hastanın VAS ve SPADI değerleri ile uyku kalitesinin omuz ağrısı ile negatif ilişkili olduğunu bulduk. Gece ağrıya bağlı uyku bozukluğu gündüz sakatlığını da etkileyebilir. Ağrı ve uyku kalitesi bozuklukları bir kısır döngüye girebilmektedir.

Keywords

Omuz ağrısı, uyku kalitesi, kas-iskelet sistemi, VAS, SPADI, PUKİ

References

• Djade CD, Porgo TV, Zomahoun HTV, Perrault-Sullivan G, Dionne CE. Incidence of shoulder pain in 40 years old and over and associated factors: A systematic review. Eur J Pain. 2020; 24:39-50.
• Murphy RJ, Carr AJ. Shoulder pain. BMJ Clin Evid. 2010; 07:1107.
• Akalın E, El Ö, Bircan Ç, et al. Omuz Problemi Olan Hastaların Genel Özellikleri. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi. 2006; 20:75-78.
• Meislin RJ, Sperling JW, Stitik TP. Persistent shoulder pain: epidemiology, pathophysiology, and diagnosis. Am J Orthop. 2005; 34: 5-9.
• Hee-hyeon K, Dong-ho L. Comparative analysis of pain disorder factors and subjective pain reduction effect after functional adjustment procedure therapy for shoulder pain patients. J Korean Soc Phys Med. 2020; 15:87–99.
• Health Insurance Review & Assessment Service. Three major diseases that cause shoulder pain. 2020. [cited January 1, 2022]. Available at: https://www.korea.kr/news/healthView.do?newsId=148873773 [access date October 5, 2022].
• Laslett M, Steele M, Hing W, McNair P, Cadogan A. Shoulder pain patients in primary care--part 1: Clinical outcomes over 12 months following standardized diagnostic workup, corticosteroid injections, and community-based care. J Rehabil Med. 2014; 46:898-907.
• Khazzam MS, Mulligan EP, Brunette-Christiansen M, Shirley Z. Sleep Quality in Patients with Rotator Cuff Disease. J. Am Acad Orthop Surg. 2018; 26:215–222.
• Mollayeva T, Thurairajah P, Burton K, Mollayeva S, Shapiro CM, Colantonio A. The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis. Sleep Med. Rev. 2016; 25:52–73.
• Park SY, Choi TS, Kim DH, Ryu BH, Lee SB. Correlation between neck and shoulder pain, neck and shoulder disability, headache and smartphone addiction in adults with sleep disorders. J Korean Soc Phys Med. 2020; 15:43–50.
• Tekeoglu I, Ediz L, Hiz O, Toprak M, Yazmalar L, Karaaslan G. The relationship between shoulder impingement syndrome and sleep quality. Eur Rev Med Pharmacol Sci. 2013; 17:370-374.
• Canivet C, Ostergren PO, Choi B, et al. Sleeping problems as a risk factor for subsequent musculoskeletal pain and the role of job strain: results from a one-year follow-up of the Malmö Shoulder Neck Study Cohort. Int J Behav Med. 2008; 15:254-62.
• Longo UG, Facchinetti G, Marchetti A, et al. Sleep Disturbance and Rotator Cuff Tears: A Systematic Review. Medicina (Kaunas) 2019; 55:453.
• Benca RM, Ancoli-Israel S, Moldofsky H. Special considerations in insomnia diagnosis and management: depressed, elderly, and chronic pain populations. J Clin Psychiatry. 2004; 65:26-35.
• Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain. 2014; 155:2545–2550.
• Paul A, Lewis M, Shadforth MF, Croft PR, Van Der Windt DA, Hay EM. A comparison of four shoulder-specific questionnaires in primary care. Ann Rheum Dis. 2004; 63:1293–1299.
• Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991; 4:143-9.
• Bicer A, Ankaralı H. Shoulder pain and disability index: a validation study in Turkish woman. Singapore Mefd J. 2010; 51:865-870.
• Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric prac- tice and research. Psychiatry Res. 1989; 28:193-213.
• Agarguun MY, Kara H, Anlar OO. The validity and reliability of the Pittsburgh sleep quality index. Turk Psikiyatri Dergisi. 1996; 7:107- 115.
• van Doorn PF, de Schepper EIT, Rozendaal RM, et al. The incidence and management of shoulder complaints in general practice: a retrospective cohort study. Fam Pract. 2021; 38:582-588.
• van der Heijden G. Shoulder disorders: a state-of-the-art review. Bailliere’s Clin Rheum. 1999; 13:287-309.
• Hwang Y, Oh J. The relationship between shoulder pain and shoulder disability in women: The mediating role of sleep quality and psychological disorders. Medicine (Baltimore). 2022; 101: e31118.
• Mulligan EP, Brunette M, Shirley Z, Khazzam M. Sleep quality and nocturnal pain in patients with shoulder disorders. Journal of shoulder and elbow surgery, 2015; 24:1452–1457.
• Lee MK, Oh J. The relationship between sleep quality, neck pain, shoulder pain and disability, physical activity, and health perception among middle-aged women: a cross-sectional study. BMC Womens Health. 2022; 22:186.
• Irwin M. Effects of sleep and sleep loss on immunity and cytokines. Brain Behav Immun. 2002; 16:503–512.
• Meier-Ewert HK, Ridker PM, Rifai N, et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol. 2004; 43:678–683.
• Ranjit N, Diez-Roux AV, Shea S, Cushman M, Seeman T, Jackson SA, Ni H. Psychosocial factors and inflammation in the multi-ethnic study of atherosclerosis. Arch Intern Med. 2007; 167:174–181.
• Ferranti R, Marventano S, Castellano S, et al. Sleep quality and duration is related with diet and obesity in young adolescent living in Sicily, Southern Italy. Sleep Sci. 2016; 9:117- 122.
• Fatima Y, Doi SA, Mamun AA. Sleep quality and obesity in young subjects: a meta-analysis. Obes Rev. 2016; 17:1154-1166.
• Ural FG. Miyofasiyal ağrı sendromu olan hastalarda obezitenin uyku kalitesi ve günlük yaşam aktiviteleri üzerine etkisi. Cukurova Medical Journal. 2018; 43:600-604.
• Austin L, Pepe M, Tucker B, et al. Sleep disturbance associated with rotator cuff tear: correction with arthroscopic rotator cuff repair. The American journal of sports medicine 2015; 43: 1455-1459.
• Holdaway LA, Hegmann KT, Thiese MS, Kapellusch J. Is sleep position associated with glenohumeral shoulder pain and rotator cuff tendinopathy: A cross-sectional study. BMC Musculoskelet. Disord. 2018; 19:408.
• Longo UG, Candela V, De Salvatore S, et al. Arthroscopic Rotator Cuff Repair Improves Sleep Disturbance and Quality of Life: A Prospective Study. Int J Environ Res Public Health. 2021; 18:3797.
• Ansok CB, Khalil LS, Muh S. Objective assessment of sleep quality in patients with rotator cuff tears. Orthopaedics & traumatology, surgery & research: OTSR. 2020; 106:61–66.
• Ha E, Lho YM, Seo HJ, Cho CH. Melatonin plays a role as a mediator of nocturnal pain in patients with shoulder disorders. J Bone Joint Surg Am. 2014; 96:e108-131.
• Hamilton NA, Affleck G, Tennen H, et al. Fibromyalgia: the role of sleep in affect and in negative event reactivity and recovery. Health Psychol 2008; 27: 490-497.
• Belt NK, Kronholm E, Kauppi MJ. Sleep problems in fibromyalgia and rheumatoid arthritis compared with the general population. Clin Exp Rheumatol. 2009; 27: 35-41.
• Cho C, Song K, Hwang, et al. Does Rotator Cuff Repair Improve Psychologic Status and Quality of Life in Patients With Rotator Cuff Tear? Clin Orthop Relat Res. 2015; 473:3494-3500.
• Karatas G , Kutluk O, Akyuz M, Karaahmet OZ, Yalcin E. The effects of carpal tunnel syndrome on sleep quality. Ann Med Res 2020;27(1):381-7
• Muñoz-Muñoz S, Muñoz-García MT, Alburquerque-Sendín F, Arroyo-Morales M, Fernández-de-las-Peñas C. Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain. J Manipulative Physiol Ther. 2012; 35:608-613.
• Ruiz-Sáez M, Fernández-de-las-Peñas C, Blanco CR, Martí- nez-Segura R, García-León R. Changes in pressure pain sensitivity in latent myofascial trigger points in the upper trapezius muscle after a cervical spine manipulation in pain- free subjects. J Manipulative Physiol Ther. 2007; 30:578-583.
• Marin R, Cyhan T, Miklos W. Sleep disturbance in patients with chronic low back pain. Am J Phys Med Rehabil. 2006; 85:430-435.