Skip to content
2000
image of The Frequency of Musculoskeletal Disorders and Nerve Entrapment Syndromes Around the Shoulder in a Cohort of Egyptian Patients

Abstract

Background

Shoulder pain is a common musculoskeletal (MSK) disorder. However, proper diagnosis of shoulder dysfunction and causes of pain remains challenging.

Objective

The objective of this study is to identify the frequency of musculoskeletal and neurological disorders among a cohort of Egyptian patients with chronic shoulder pain.

Methods

A cross-sectional study was conducted on 120 patients with chronic shoulder pain. Clinical, imaging, and electrophysiology studies were conducted on each participant to assess the frequency of musculoskeletal and neurological causes of shoulder pain.

Results

The commonest causes of shoulder pain in the present study were musculoskeletal disorders, representing 94.2% of the whole cases, of which rotator cuff pathology was the commonest in 78.3%. Neurological disorders were found in 45.8%, of which suprascapular neuropathy was the commonest in 31.7%. At the same time, combined musculoskeletal and neurological disorders were found in 59.2% of cases. The frequency of musculoskeletal disorders was significantly associated with the duration of shoulder pain, as well as patients' occupation, specifically manual working. While the frequency of neurological disorders was significantly associated with shoulder pain duration, old age, sex, and patient's occupation (mainly manual working).

Conclusion

Musculoskeletal disorders are the most common causes of chronic shoulder pain, especially rotator cuff disorders. While suprascapular neuropathy is the most common neurological cause of chronic shoulder pain. The combination of musculoskeletal and neurological disorders together is also an important cause of shoulder pain in many cases, which may not be obvious and must be detected early to provide early and appropriate therapeutic intervention. Manual work is a risk factor for developing MSK and neuropathic shoulder disease.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/crr/10.2174/0115733971338169250327074446
2025-04-07
2025-12-06

  • From This Site

    /content/journals/crr/10.2174/0115733971338169250327074446
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. Pope D.P. Croft P.R. Pritchard C.M. Silman A.J. Prevalence of shoulder pain in the community: The influence of case definition. Ann. Rheum. Dis. 1997 56 5 308 312 10.1136/ard.56.5.308 9175931
    [Google Scholar]
  2. Burbank K.M. Stevenson J.H. Czarnecki G.R. Dorfman J. Chronic shoulder pain: Part I. Evaluation and diagnosis. Am. Fam. Physician 2008 77 4 453 460 18326164
    [Google Scholar]
  3. Coventry M.B. MB C Problem of painful shoulder. J. Am. Med. Assoc. 1953 151 3 177 185 12999532
    [Google Scholar]
  4. Gerber C. Galantay R.V. Hersche O. The pattern of pain produced by irritation of the acromioclavicular joint and the subacromial space. J. Shoulder Elbow Surg. 1998 7 4 352 355 10.1016/S1058‑2746(98)90022‑2 9752643
    [Google Scholar]
  5. Goetti P. Denard P.J. Collin P. Ibrahim M. Hoffmeyer P. Lädermann A. Shoulder biomechanics in normal and selected pathological conditions. EFORT Open Rev. 2020 5 8 508 518 10.1302/2058‑5241.5.200006 32953136
    [Google Scholar]
  6. Terry G.C. Chopp T.M. Functional anatomy of the shoulder. J. Athl. Train. 2000 35 3 248 255 16558636
    [Google Scholar]
  7. Nelson G.B. McMellen C.J. Kolaczko J.G. Millett P.J. Gillespie R.J. Su C.A. Immunologic contributions following rotator cuff injury and development of cuff tear arthropathy. JBJS Rev. 2021 9 11 10.2106/JBJS.RVW.21.00126 34757960
    [Google Scholar]
  8. Ibounig T. Simons T. Launonen A. Paavola M. Glenohumeral osteoarthritis: An overview of etiology and diagnostics. Scand. J. Surg. 2021 110 3 441 451 10.1177/1457496920935018 32662351
    [Google Scholar]
  9. Katsuura Y. Bruce J. Taylor S. Gullota L. Kim H.J. Overlapping, masquerading, and causative cervical spine and shoulder pathology: A systematic review. Global Spine J. 2020 10 2 195 208 10.1177/2192568218822536 32206519
    [Google Scholar]
  10. Cannon D.E. Dillingham T.R. Miao H. Andary M.T. Pezzin L.E. Musculoskeletal disorders in referrals for suspected cervical radiculopathy. Arch. Phys. Med. Rehabil. 2007 88 10 1256 1259 10.1016/j.apmr.2007.07.010 17908566
    [Google Scholar]
  11. Apaydin N. Tubbs R.S. Loukas M. Duparc F. Review of the surgical anatomy of the axillary nerve and the anatomic basis of its iatrogenic and traumatic injury. Surg. Radiol. Anat. 2010 32 3 193 201 10.1007/s00276‑009‑0594‑8 19916067
    [Google Scholar]
  12. Lopiz Y. Rodríguez-González A. Martín-Albarrán S. Herzog R. García-Fernández C. Marco F. Neuropathy of the suprascapular and axillary nerves in rotator cuff arthropathy: A prospective electrodiagnostic study. Int. Orthop. 2024 48 5 1285 1294 10.1007/s00264‑024‑06130‑7 38478022
    [Google Scholar]
  13. Moen T.C. Babatunde O.M. Hsu S.H. Ahmad C.S. Levine W.N. Suprascapular neuropathy: What does the literature show? J. Shoulder Elbow Surg. 2012 21 6 835 846 10.1016/j.jse.2011.11.033 22445163
    [Google Scholar]
  14. Bozzi F. Alabau-Rodriguez S. Barrera-Ochoa S. Ateschrang A. Schreiner A.J. Monllau J.C. Perelli S. Suprascapular neuropathy around the shoulder: A current concept review. J. Clin. Med. 2020 9 8 2331 10.3390/jcm9082331 32707860
    [Google Scholar]
  15. Jesus d.J.O. Parker L. Frangos A.J. Nazarian L.N. Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: A meta-analysis. AJR Am. J. Roentgenol. 2009 192 6 1701 1707 10.2214/AJR.08.1241 19457838
    [Google Scholar]
  16. Liu F. Dong J. Shen W.J. Kang Q. Zhou D. Xiong F. Detecting rotator cuff tears: A network meta-analysis of 144 diagnostic studies. Orthop. J. Sports Med. 2020 8 2 2325967119900356 10.1177/2325967119900356 32076627
    [Google Scholar]
  17. Shin H. Kim K.H. Song C. Lee I. Lee K. Kang J. Kang Y.K. Electrodiagnosis support system for localizing neural injury in an upper limb. J. Am. Med. Inform. Assoc. 2010 17 3 345 347 10.1136/jamia.2009.001594 20442155
    [Google Scholar]
  18. Preston D.C. Shapiro B.E. Electromyography And neuromuscular disorders e-book: Clinical-electrophysiologic correlations (Expert Consult-Online). New York Elsevier Health Sciences 2012
    [Google Scholar]
  19. Shafshak T.S. Abdelhamid M.M. Reda M.I. Amer M.A. A clinical, electrophysiological, And imaging study on the different causes of poststroke shoulder pain. J. Int. Soc. Phys. Rehabil. Med. 2019 2 1 35 41 10.4103/jisprm.jisprm_40_19
    [Google Scholar]
  20. Redebrandt H.N Christian Brandt Said Hawran Clinical evaluation versus magnetic resonance imaging findings in patients with radicular arm pain- A pragmatic study. Health Sci. Rep. 2022 5 3 e589
    [Google Scholar]
  21. Ubaid R.M. Al-Najjar S.A Magnetic resonance imaging findings of patients with neck pain in Erbil City. ZANco. J. Med. Sci. 2020 24 1 96 106
    [Google Scholar]
  22. Muhammad S.A. Zainab Mustapha Okedayo M. Cervical spine magnetic resonance imaging findings in patients presenting with neck pain and radiculopathy. Inter. Res. J. Basic Clin. Stud. 2014 2 2 20 26
    [Google Scholar]
  23. Östör A.J.K. Richards C.A. Prevost A.T. Speed C.A. Hazleman B.L. Diagnosis and relation to general health of shoulder disorders presenting to primary care. Rheumatology 2005 44 6 800 805 10.1093/rheumatology/keh598 15769790
    [Google Scholar]
  24. Gumina S. Passaretti D. Epidemiology and demographics of the rotator cuff tear. Rotator Cuff Tear: Pathogenesis, Evaluation And Treatment. Gumina S. Cham Springer International Publishing 2017 53 59
    [Google Scholar]
  25. Guerra-Soriano F. Encalada-Díaz M.I. Ruiz-Suárez M. Valero-González F.S. Prevalencia de artropatía por desgarro masivo del manguito de los rotadores. Acta Ortop. Mex. 2017 31 5 228 232 29518297
    [Google Scholar]
  26. Cadogan A. Laslett M. Hing W.A. McNair P.J. Coates M.H. A prospective study of shoulder pain in primary care: Prevalence of imaged pathology and response to guided diagnostic blocks. BMC Musculoskelet. Disord. 2011 12 1 119 10.1186/1471‑2474‑12‑119 21619663
    [Google Scholar]
  27. Gupta R. Lee T.Q. Positional-dependent changes in glenohumeral joint contact pressure and force: Possible biomechanical etiology of posterior glenoid wear. J. Shoulder Elbow Surg. 2005 14 1 Suppl. S S105 S110 10.1016/j.jse.2004.10.005 15726069
    [Google Scholar]
  28. Sanchez-Adams J. Leddy H.A. McNulty A.L. O’Conor C.J. Guilak F. The mechanobiology of articular cartilage: Bearing the burden of osteoarthritis. Curr. Rheumatol. Rep. 2014 16 10 451 10.1007/s11926‑014‑0451‑6 25182679
    [Google Scholar]
  29. Ecklund K.J. Lee T.Q. Tibone J. Gupta R. Rotator cuff tear arthropathy. J. Am. Acad. Orthop. Surg. 2007 15 6 340 349 10.5435/00124635‑200706000‑00003 17548883
    [Google Scholar]
  30. Vad V.B. Southern D. Warren R.F. Altchek D.W. Dines D. Prevalence of peripheral neurologic injuries in rotator cuff tears with atrophy. J. Shoulder Elbow Surg. 2003 12 4 333 336 10.1016/S1058‑2746(03)00040‑5 12934025
    [Google Scholar]
  31. Lopiz Y. Rodriguez-González A. Martín-Albarrán S. Marcelo H. García-Fernández C. Marco F. Injury to the axillary and suprascapular nerves in rotator cuff arthropathy and after reverse shoulder arthroplasty: A prospective electromyographic analysis. J. Shoulder Elbow Surg. 2018 27 7 1275 1282 10.1016/j.jse.2017.12.030 29475786
    [Google Scholar]
  32. Strauss E.J. Kingery M.T. Klein D. Manjunath A.K. The evaluation and management of suprascapular neuropathy. J. Am. Acad. Orthop. Surg. 2020 28 15 617 627 10.5435/JAAOS‑D‑19‑00526 32732653
    [Google Scholar]
  33. Ilfeld B.M. Finneran J.J. IV Gabriel R.A. Said E.T. Nguyen P.L. Abramson W.B. Khatibi B. Sztain J.F. Swisher M.W. Jaeger P. Covey D.C. Meunier M.J. Hentzen E.R. Robertson C.M. Ultrasound-guided percutaneous peripheral nerve stimulation: Neuromodulation of the suprascapular nerve and brachial plexus for postoperative analgesia following ambulatory rotator cuff repair. A proof-of-concept study. Reg. Anesth. Pain Med. 2019 44 3 310 318 10.1136/rapm‑2018‑100121 30770421
    [Google Scholar]
  34. Leider J.D. Derise O.C. Bourdreaux K.A. Dierks G.J. Lee C. Varrassi G. Sherman W.F. Kaye A.D. Treatment of suprascapular nerve entrapment syndrome. Orthop. Rev. 2021 13 2 25554 10.52965/001c.25554 34745481
    [Google Scholar]
  35. Sachinis N.P. Boutsiadis A. Papagiannopoulos S. Ditsios K. Christodoulou A. Papadopoulos P. Suprascapular neuropathy in the setting of rotator cuff tears: Study protocol for a double-blinded randomized controlled trial. Trials 2016 17 1 554 10.1186/s13063‑016‑1672‑y 27876086
    [Google Scholar]
  36. Neal S. Fields K.B. Peripheral nerve entrapment and injury in the upper extremity. Am. Fam. Physician 2010 81 2 147 155 20082510
    [Google Scholar]
  37. Borrelli J. Haslach H.W.J. Jr Experimental characterization of axillary/underarm interface pressure in swing-through crutch walking. J. Rehabil. Res. Dev. 2013 50 3 423 436 10.1682/JRRD.2012.01.0013 23881767
    [Google Scholar]
  38. Borrel F. Desmoineaux P. Delcourt T. Pujol N. Feasibility of arthroscopic decompression of the axillary nerve in the quadrilateral space: Cadaver study. Orthop. Traumatol. Surg. Res. 2021 107 1 102762 10.1016/j.otsr.2020.102762 33333278
    [Google Scholar]
  39. SteinmANn SP. Axillary nerve injury: Diagnosis And treatment. J. Amer. Acad. Orthop. Surg. 2001 9 5 328 335
    [Google Scholar]
  40. Date E.S. Gray L.A. Electrodiagnostic evidence for cervical radiculopathy and suprascapular neuropathy in shoulder pain. Electromyogr. Clin. Neurophysiol. 1996 36 6 333 339 8891472
    [Google Scholar]
/content/journals/crr/10.2174/0115733971338169250327074446
Loading
The Frequency of Musculoskeletal Disorders and Nerve Entrapment Syndromes Around the Shoulder in a Cohort of Egyptian Patients
Bentham Science Publishers ; https://doi.org/10.2174/0115733971338169250327074446
/content/journals/crr/10.2174/0115733971338169250327074446
/content/journals/crr/10.2174/0115733971338169250327074446
Loading

Data & Media loading...


  • Article Type:     Research Article
Keywords: musculoskeletal disorders ; suprascapular neuropathy ; electrodiagnosis ; rotator-cuff pathologies ; Chronic shoulder pain ; axillary neuropathy

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test