scholarly journals Shoulder Pain — Where Are We Now?

2021 ◽  
Author(s):  
Karen Walker-Bone ◽  
Danielle AWM van der Windt
Keyword(s):  
Shoulder Pain ◽  
Musculoskeletal Pain ◽  
Imaging Techniques ◽  
Rotator Cuff Tears ◽  
Past Century ◽  
Pain Processing ◽  
Low Back ◽  
Limited Evidence ◽  
The Past ◽  
Peripheral Pain

Abstract Purpose of Review Shoulder pain is common and costly. For the past century, diagnosis and management has been based upon presumed patho-anatomical abnormalities. With the evolution of imaging techniques and new insight about the causes of musculoskeletal pain, this review evaluates the evidence that a patho-anatomical approach remains justified. Recent Findings Imaging modalities have developed considerably but, so far, have only proven value in evaluating full thickness rotator cuff tears prior to surgery. Correlation between imaging findings and symptoms is otherwise poor, with limited evidence of the value and impact of imaging for decision-making. Much of shoulder pain is chronic and few people have single-site musculoskeletal pain. Pain studies suggest that chronic shoulder pain is associated with both central and peripheral pain sensitisation. Moreover, functional MRI points to an effect of cognitive affective pain processing rather than nociception. Few of the established therapies, medical or surgical, that treat the presumed patho-anatomical cause have been shown to have lasting benefit. Summary Much of the evidence suggests that shoulder pain is more similar than different from mechanical low back pain. For most people with shoulder pain, the best approach might well be de-medicalisation, support to (self)manage pain, emphasis on retaining movement and identifying adverse beliefs and risk factors for disability and chronicity. Approaches like this are currently being evaluated and more research is desperately required.

scholarly journals Physical Activity Level and Sport Participation in Relation to Musculoskeletal Pain in a Population-Based Study of Adolescents

2017 ◽  
Vol 5 (1) ◽  
pp. 232596711668554 ◽  
Author(s):  
Maren Hjelle Guddal ◽  
Synne Øien Stensland ◽  
Milada Cvancarova Småstuen ◽  
Marianne Bakke Johnsen ◽  
John-Anker Zwart ◽  
...  
Keyword(s):  
Physical Activity ◽  
Low Back Pain ◽  
Back Pain ◽  
Shoulder Pain ◽  
Musculoskeletal Pain ◽  
Physical Activity Level ◽  
Sport Participation ◽  
Activity Level ◽  
Low Back ◽  
Neck And Shoulder Pain

Background: Prevalence of musculoskeletal pain among adolescents is high, and pain in adolescence increases the risk of chronic pain in adulthood. Studies have shown conflicting evidence regarding associations between physical activity and musculoskeletal pain, and few have evaluated the potential impact of sport participation on musculoskeletal pain in adolescent population samples. Purpose: To examine the associations between physical activity level, sport participation, and musculoskeletal pain in the neck and shoulders, low back, and lower extremities in a population-based sample of adolescents. Study Design: Cross-sectional study; Level of evidence 4. Methods: Data from the Nord-Trøndelag Health Study (Young-HUNT3) were used. All 10,464 adolescents in the Nord-Trøndelag county of Norway were invited, of whom 74% participated. Participants were asked how often they had experienced pain, unrelated to any known disease or acute injury, in the neck and shoulders, low back, and lower extremities in the past 3 months. The associations between (1) physical activity level (low [reference], medium or high) or (2) sport participation (weekly compared with no/infrequent participation) and pain were evaluated using logistic regression analyses, stratified by sex, and adjusted for age, socioeconomic status, and psychological distress. Results: The analyses included 7596 adolescents (mean age, 15.8 years; SD, 1.7). Neck and shoulder pain was most prevalent (17%). A moderate level of physical activity was associated with reduced odds of neck and shoulder pain (OR = 0.79 [95% CI, 0.66-0.94]) and low back pain (OR = 0.75 [95% CI, 0.62-0.91]), whereas a high level of activity increased the odds of lower extremity pain (OR = 1.60 [95% CI, 1.29-1.99]). Participation in endurance sports was associated with lower odds of neck and shoulder pain (OR = 0.79 [95% CI, 0.68-0.92]) and low back pain (OR = 0.77 [95% CI, 0.65-0.92]), especially among girls. Participation in technical sports was associated with increased odds of low back pain, whereas team sports were associated with increased odds of lower extremity pain. Strength and extreme sports were related to pain in all regions. Conclusion: We found that a moderate physical activity level was associated with less neck and shoulder pain and low back pain, and that participation in endurance sports may be particularly beneficial. Our findings highlight the need for health care professionals to consider the types of sports adolescents participate in when evaluating their musculoskeletal pain.

scholarly journals Associations of sickness absence for pain in the low back, neck and shoulders with wider propensity to pain

2020 ◽  
Vol 77 (5) ◽  
pp. 301-308
Author(s):  
David Coggon ◽  
Georgia Ntani ◽  
Karen Walker-Bone ◽  
Vanda E Felli ◽  
Raul Harari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sickness Absence ◽  
Musculoskeletal Pain ◽  
Low Back ◽  
Occupational Groups ◽  
The Past ◽  
Potential Risk Factors ◽  
Psychosocial Influences ◽  
Absence From Work

ObjectivesTo explore the association of sickness absence ascribed to pain at specific anatomical sites with wider propensity to musculoskeletal pain.MethodsAs part of the CUPID (Cultural and Psychosocial Influences on Disability) study, potential risk factors for sickness absence from musculoskeletal pain were determined for 11 922 participants from 45 occupational groups in 18 countries. After approximately 14 months, 9119 (78%) provided follow-up information about sickness in the past month because of musculoskeletal pain, including 8610 who were still in the same job. Associations with absence for pain at specific anatomical sites were assessed by logistic regression and summarised by ORs with 95% CIs.Results861 participants (10%) reported absence from work because of musculoskeletal pain during the month before follow-up. After allowance for potential confounders, risk of absence ascribed entirely to low back pain (n=235) increased with the number of anatomical sites other than low back that had been reported as painful in the year before baseline (ORs 1.6 to 1.7 for ≥4 vs 0 painful sites). Similarly, associations with wider propensity to pain were observed for absence attributed entirely to pain in the neck (ORs up to 2.0) and shoulders (ORs up to 3.4).ConclusionsSickness absence for pain at specific anatomical sites is importantly associated with wider propensity to pain, the determinants of which extend beyond established risk factors such as somatising tendency and low mood. Better understanding of why some individuals are generally more prone to musculoskeletal pain might point to useful opportunities for prevention.

scholarly journals Association of musculoskeletal pain in other body parts with new-onset shoulder pain: a longitudinal study among survivors of the Great East Japan Earthquake

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041804
Author(s):  
Yoshihiro Hagiwara ◽  
Yutaka Yabe ◽  
Takuya Sekiguchi ◽  
Yumi Sugawara ◽  
Masahiro Tsuchiya ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Shoulder Pain ◽  
Musculoskeletal Pain ◽  
Body Part ◽  
Great East Japan Earthquake ◽  
Low Back ◽  
Body Parts ◽  
Public Health Policies ◽  
Shoulder And Neck Pain ◽  
New Onset

ObjectiveShoulder pain is a common health problem coexisting with other musculoskeletal pain. However, the effects of pre-existing musculoskeletal pain on the development of shoulder pain are not clear. The present study aimed to elucidate the association between coexisting musculoskeletal pain at other body sites and new-onset shoulder pain among survivors of the Great East Japan Earthquake (GEJE).DesignThis is a longitudinal study.SettingThe study was conducted at the severely damaged coastal areas in Ishinomaki and Sendai cities.ParticipantsThe survivors who did not have shoulder pain at 3 years after the GEJE were followed up 1 year later (n=2131).InterventionsMusculoskeletal pain (low back, hand and/or foot, knee, shoulder and neck pain) was assessed using self-reported questionnaires.Main outcome measuresThe outcome of interest was new-onset shoulder pain, which was defined as shoulder pain absent at 3 years but present at 4 years after the disaster. The main predictive factor for new-onset shoulder pain was musculoskeletal pain in other body parts at 3 years after the GEJE; this was categorised according to the number of pain sites (0, 1, ≥2). Multiple regression analyses were conducted to calculate the odds ratio (OR) and 95% confidence interval (CI) for new-onset shoulder pain due to musculoskeletal pain in other body parts.ResultsThe incidence of new-onset shoulder pain was 6.7% (143/2131). Musculoskeletal pain in other body parts was significantly associated with new-onset shoulder pain. Using the survivors without other musculoskeletal pain as reference, the adjusted OR and 95% CI for new-onset shoulder pain were 1.86 (1.18 to 2.94) for those with one body part and 3.22 (2.08 to 4.98) for those with ≥2 body parts presenting with musculoskeletal pain (p<0.001).ConclusionsPre-existing musculoskeletal pain in other body parts was significantly associated with new-onset shoulder pain among survivors; this provides useful information for clinical and public health policies.

scholarly journals Investigation of Central Pain Processing in Shoulder Pain: Converging Results From 2 Musculoskeletal Pain Models

2012 ◽  
Vol 13 (1) ◽  
pp. 81-89 ◽  
Author(s):  
Carolina Valencia ◽  
Lindsay L. Kindler ◽  
Roger B. Fillingim ◽  
Steven Z. George
Keyword(s):  
Shoulder Pain ◽  
Musculoskeletal Pain ◽  
Pain Processing ◽  
Central Pain ◽  
Pain Models ◽  
Central Pain Processing

Mitochondrial Reconstructions Based on Serial Thick Sections and HVEM

1975 ◽  
Vol 33 ◽  
pp. 286-287
Author(s):  
Jerome J. Paulin
Keyword(s):  
Imaging Techniques ◽  
Three Dimensional ◽  
Posterior Pole ◽  
Dimensional Structure ◽  
Stereo Imaging ◽  
Thin Sections ◽  
Anatomical Features ◽  
The Past ◽  
Cellular Components ◽  
Mitochondrial Reticulum

Within the past decade it has become apparent that HVEM offers the biologist a means to explore the three-dimensional structure of cells and/or organelles. Stereo-imaging of thick sections (e.g. 0.25-10 μm) not only reveals anatomical features of cellular components, but also reduces errors of interpretation associated with overlap of structures seen in thick sections. Concomitant with stereo-imaging techniques conventional serial Sectioning methods developed with thin sections have been adopted to serial thick sections (≥ 0.25 μm). Three-dimensional reconstructions of the chondriome of several species of trypanosomatid flagellates have been made from tracings of mitochondrial profiles on cellulose acetate sheets. The sheets are flooded with acetone, gluing them together, and the model sawed from the composite and redrawn.The extensive mitochondrial reticulum can be seen in consecutive thick sections of (0.25 μm thick) Crithidia fasciculata (Figs. 1-2). Profiles of the mitochondrion are distinguishable from the anterior apex of the cell (small arrow, Fig. 1) to the posterior pole (small arrow, Fig. 2).

The zoonotic potential of bat-borne coronaviruses

2020 ◽  
Vol 4 (4) ◽  
pp. 365-381
Author(s):  
Ny Anjara Fifi Ravelomanantsoa ◽  
Sarah Guth ◽  
Angelo Andrianiaina ◽  
Santino Andry ◽  
Anecia Gentles ◽  
...  
Keyword(s):  
Genetic Material ◽  
Field Research ◽  
Sympatric Species ◽  
Animal Origin ◽  
Mammalian Host ◽  
Past Century ◽  
The Past ◽  
Novel Host ◽  
Horseshoe Bat ◽  
Human Infections

Seven zoonoses — human infections of animal origin — have emerged from the Coronaviridae family in the past century, including three viruses responsible for significant human mortality (SARS-CoV, MERS-CoV, and SARS-CoV-2) in the past twenty years alone. These three viruses, in addition to two older CoV zoonoses (HCoV-229E and HCoV-NL63) are believed to be originally derived from wild bat reservoir species. We review the molecular biology of the bat-derived Alpha- and Betacoronavirus genera, highlighting features that contribute to their potential for cross-species emergence, including the use of well-conserved mammalian host cell machinery for cell entry and a unique capacity for adaptation to novel host environments after host switching. The adaptive capacity of coronaviruses largely results from their large genomes, which reduce the risk of deleterious mutational errors and facilitate range-expanding recombination events by offering heightened redundancy in essential genetic material. Large CoV genomes are made possible by the unique proofreading capacity encoded for their RNA-dependent polymerase. We find that bat-borne SARS-related coronaviruses in the subgenus Sarbecovirus, the source clade for SARS-CoV and SARS-CoV-2, present a particularly poignant pandemic threat, due to the extraordinary viral genetic diversity represented among several sympatric species of their horseshoe bat hosts. To date, Sarbecovirus surveillance has been almost entirely restricted to China. More vigorous field research efforts tracking the circulation of Sarbecoviruses specifically and Betacoronaviruses more generally is needed across a broader global range if we are to avoid future repeats of the COVID-19 pandemic.

PCSK9 inhibition for LDL lowering and beyond – implications for patients with peripheral artery disease

VASA ◽  
2018 ◽  
Vol 47 (3) ◽  
pp. 165-176 ◽  
Author(s):  
Katrin Gebauer ◽  
Holger Reinecke
Keyword(s):  
Cardiovascular Risk ◽  
Risk Reduction ◽  
Ldl Receptor ◽  
Density Lipoprotein ◽  
Past Century ◽  
Pcsk9 Inhibitors ◽  
Cardiovascular Risk Reduction ◽  
Simultaneous Application ◽  
The Past ◽  
Pcsk9 Inhibition

Abstract. Low-density lipoprotein cholesterol (LDL-C) has been proven to be a causal factor of atherosclerosis and, along with other triggers like inflammation, the most frequent reason for peripheral arterial disease. Moreover, a linear correlation between LDL-C concentration and cardiovascular outcome in high-risk patients could be established during the past century. After the development of statins, numerous randomized trials have shown the superiority for LDL-C reduction and hence the decrease in cardiovascular outcomes including mortality. Over the past decades it became evident that more intense LDL-C lowering, by either the use of highly potent statin supplements or by additional cholesterol absorption inhibitor application, accounted for an even more profound cardiovascular risk reduction. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a serin protease with effect on the LDL receptor cycle leading to its degradation and therefore preventing continuing LDL-C clearance from the blood, is the target of a newly developed monoclonal antibody facilitating astounding LDL-C reduction far below to what has been set as target level by recent ESC/EAS guidelines in management of dyslipidaemias. Large randomized outcome trials including subjects with PAD so far have been able to prove significant and even more intense cardiovascular risk reduction via further LDL-C debasement on top of high-intensity statin medication. Another approach for LDL-C reduction is a silencing interfering RNA muting the translation of PCSK9 intracellularly. Moreover, PCSK9 concentrations are elevated in cells involved in plaque composition, so the potency of intracellular PCSK9 inhibition and therefore prevention or reversal of plaques may provide this mechanism of action on PCSK9 with additional beneficial effects on cells involved in plaque formation. Thus, simultaneous application of statins and PCSK9 inhibitors promise to reduce cardiovascular event burden by both LDL-C reduction and pleiotropic effects of both agents.

Archaeology in the Past Century

1901 ◽  
Vol 51 (1309supp) ◽  
pp. 20976-20977
Author(s):  
W. M. Flinders Petrje
Keyword(s):  
Past Century ◽  
The Past

Catholicism and Cosmopolitanism: the Confluence of Three Catholic Scholars and the Cosmopolitan Democrats on State Sovereignty and the Future of Global Governance

2016 ◽  
Vol 3 (2) ◽  
pp. 37-51
Author(s):  
Matthew Bagot
Keyword(s):  
Global Governance ◽  
State Sovereignty ◽  
Current Debate ◽  
Past Century ◽  
Jacques Maritain ◽  
The Past ◽  
Technological Advances ◽  
The Future ◽  
Cosmopolitan Democracy ◽  
Catholic Tradition

One of the central questions in international relations today is how we should conceive of state sovereignty. The notion of sovereignty—’supreme authority within a territory’, as Daniel Philpott defines it—emerged after the Treaty of Westphalia in 1648 as a result of which the late medieval crisis of pluralism was settled. But recent changes in the international order, such as technological advances that have spurred globalization and the emerging norm of the Responsibility to Protect, have cast the notion of sovereignty into an unclear light. The purpose of this paper is to contribute to the current debate regarding sovereignty by exploring two schools of thought on the matter: first, three Catholic scholars from the past century—Luigi Sturzo, Jacques Maritain, and John Courtney Murray, S.J.—taken as representative of Catholic tradition; second, a number of contemporary political theorists of cosmopolitan democracy. The paper argues that there is a confluence between the Catholic thinkers and the cosmopolitan democrats regarding their understanding of state sovereignty and that, taken together, the two schools have much to contribute not only to our current understanding of sovereignty, but also to the future of global governance.

Aftershocks

2017 ◽  
Author(s):  
Seva Gunitsky
Keyword(s):  
Twentieth Century ◽  
Regime Change ◽  
International System ◽  
Political Legitimacy ◽  
Great Powers ◽  
Past Century ◽  
The Past ◽  
Sudden Rise ◽  
The World ◽  
National Borders

Over the past century, democracy spread around the world in turbulent bursts of change, sweeping across national borders in dramatic cascades of revolution and reform. This book offers a new global-oriented explanation for this wavelike spread and retreat—not only of democracy but also of its twentieth-century rivals, fascism, and communism. The book argues that waves of regime change are driven by the aftermath of cataclysmic disruptions to the international system. These hegemonic shocks, marked by the sudden rise and fall of great powers, have been essential and often-neglected drivers of domestic transformations. Though rare and fleeting, they not only repeatedly alter the global hierarchy of powerful states but also create unique and powerful opportunities for sweeping national reforms—by triggering military impositions, swiftly changing the incentives of domestic actors, or transforming the basis of political legitimacy itself. As a result, the evolution of modern regimes cannot be fully understood without examining the consequences of clashes between great powers, which repeatedly—and often unsuccessfully—sought to cajole, inspire, and intimidate other states into joining their camps.

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