Prevalence of symptoms and signs of shoulder problems in people with diabetes mellitus

Department of Trauma and Orthopaedic Surgery, Glasgow Royal Infirmary, Glasgow, Scotland.
Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] (Impact Factor: 2.29). 11/2007; 16(6):748-51. DOI: 10.1016/j.jse.2007.02.133
Source: PubMed


Diabetes mellitus is a known risk factor for frozen shoulder. This study was performed to quantify this association and test any relationship with other risk factors for diabetic complications. Patients attending diabetic (n = 865) and general medical (n = 202) clinics were interviewed and examined. External rotation was measured in both shoulders. Glycated hemoglobin A(1c) was measured in all diabetic patients. Frozen shoulder was defined as pain for more than 3 months and external rotation of less than 50% of the unaffected shoulder. Bilateral frozen shoulder was defined as external rotation of less than 30 degrees in both shoulders. Shoulder pain was present in 25.7% of diabetic patients compared with 5.0% of general medical patients. The criteria for frozen shoulder were fulfilled in 4.3% of diabetic patients and in 0.5% of the general medical patients. Only duration of diabetes had a positive association. The prevalence of painful or stiff shoulder was greater in diabetic patients than general medical patients. The prevalence of frozen shoulder is less than previously reported but still greater in diabetic patients.

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Available from: Miles Fisher, Oct 17, 2014
    • "Studies have been done on the relationship between shoulder ROM and function [32, 33, 37]. The results showed that people with loss of shoulder ROM have difficulty in completing their activities of daily living [32, 33, 37] . Overall, the condition affects work, leisure , and general quality of life [14]. "
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    ABSTRACT: Physiotherapy treatment of frozen shoulder is varied, but most lack specific focus on the underlying disorder, which is the adhered shoulder capsule. Although positive effects were found after physiotherapy, the recurrence and prolonged disability of a frozen shoulder are major factors to focus on to provide the appropriate treatment. We wished to study the effectiveness of a shoulder countertraction apparatus on ROM, pain, and function in patients with a frozen shoulder and compare their results with those of control subjects who received conventional physiotherapy. A total of 100 participants were randomly assigned to an experimental group and a control group, with each group having 50 participants. The control group received physiotherapy and the experimental group received countertraction and physiotherapy. The total treatment time was 20 minutes a day for 5 days per week for 2 weeks. The outcome measures used were goniometer measurements, VAS, and the Oxford Shoulder Score. Improvements were seen in the scores for shoulder flexion (94.1° ± 19.79° at baseline increased to 161.9° ± 13.05° after intervention), abduction ROM (90.4° ± 21.18° at baseline increased to 154.8° ± 13.21° after intervention), and pain (8.00 ± 0.78 at baseline decreased to 3.48 ± 0.71 after intervention) in the experimental group. Sixty percent of the participants (n = 30) were improved to the fourth stage of satisfactory joint function according to the Oxford Shoulder Score in the experimental group compared with 18% (n = 9) in the control group (p < 0.001). Incorporating shoulder countertraction along with physiotherapy improves shoulder function compared with physiotherapy alone for the treatment of a frozen shoulder. Additional studies are needed focusing on this concept to increase the generalizability of the counter-traction apparatus in various groups. Level II, prospective comparative study. See the Instructions for Authors for a complete description of levels of evidence.
    No preview · Article · Mar 2014 · Clinical Orthopaedics and Related Research
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    • "Lundbaek (1957) first described the association between shoulder pain and diabetes mellitus. It was noted that the incidence of adhesive capsulitis was two to four times higher in patients with diabetes than in the general population, and it has been described as the most disabling of the common musculoskeletal manifestations of this disease, affecting up to 58% of people within this population (Thomas et al, 2007; Laslett et al, 2008). In addition, older female patients with diabetes were more likely to report shoulder pain or disability (Laslett et al, 2008). "

    Full-text · Chapter · Apr 2012
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    • "The presence and severity of adhesive capsulitis in diabetic patients are reportedly correlated with age, the duration of diabetes mellitus (DM), existing neuropathies and hand problems (Arkkila et al. 1996; Balci et al. 1999). A large population survey found that 25.7% of diabetic patients had shoulder pain, but only 4.3% of diabetic patients fulfilled the criteria of a frozen shoulder (Thomas et al. 2007). It is reasonable to propose that a significant proportion of diabetic patients with shoulder pain may suffer from other shoulder pathologies. "
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    ABSTRACT: It is still unclear whether diabetic mellitus (DM) is associated with rotator cuff lesions. The object of this retrospective study was to compare the ultrasonographic (US) findings of rotator cuffs in diabetic patients with those of nondiabetic patients with chronic shoulder pain. In total, 419 patients (80 diabetic, 339 nondiabetic) who had chronic shoulder pain and had been referred to receive US examination between January 2005 and January 2008 in a medical center were included in this study. The US findings of rotator cuff lesions were classified into two main categories: rotator cuff tears (RCTs) and calcifying tendinopathy (CT). In total, 114 (25.2%) shoulders with CT of the rotator cuff and 160 (35.3%), 15 (3.3%) and 5 (1.1%) shoulders with supraspinatus, infraspinatus and subscapularis tears, respectively, were noted. No difference in the ratio of tears of RCTs was found on US examinations between two groups. The crude odds ratio (OR) for CT of diabetic patients was 1.85 (p = 0.014); however, the adjusted OR for CT in diabetic patients became insignificant after controlling for the other variables (OR = 1.59, p = 0.08). To our knowledge, this is the first study to explore US findings among diabetic and nondiabetic patients with chronic shoulder pain. Further study is advised to confirm our findings.
    Full-text · Article · Nov 2010 · Ultrasound in medicine & biology
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