Shoulder pain, disability and psychosocial dimensions across diagnostic categories: Profile of patients attending shoulder physiotherapy clinics

Abstract

Patient-reported shoulder pain, function and psychosocial status inform physiotherapy intervention. Central nervous system sensitisation may also need to be considered. The aim of this retrospective chart review was to establish and compare patient-reported outcome measures and psychosocial factors across diagnostic categories for people with should symptoms attending two shoulder physiotherapy specialist clinics. We analysed data of 445 patients including demographics, duration of pain and patient-reported outcome measures for shoulder pain and disability, central sensitivity and psychosocial factors. The physiotherapists defined diagnostic groups following the clinical assessment. The Instability group had lower pain scores (Shoulder Pain and Disability Index) compared to the Subacromial Pain (p < 0.001) and the Stiff Shoulder (p < 0.001) groups. The Stiff Shoulder group had worse disability scores than all other groups (Subacromial Pain group, p < 0.001; Instability group, p < 0.001; Acromioclavicular group, p < 0.001; Other group, p = 0.044). The Stiff Shoulder group had higher ‘Optimal Screening for Prediction of Outcome’ scores (pain associated psychological distress) than the Instability group (p = 0.040). The two-item ‘Pain Self-efficacy Questionnaire’ scores were lower for the Other group than for the Subacromial Pain group (p = 0.035). Physiotherapists should screen psychosocial factors as part of their assessment of patients with shoulder pain, regardless of diagnostic category.