Shoulder pain in the Swiss spinal cord injury community: prevalence and associated factors

Abstract

Purpose: To determine the prevalence of shoulder pain and to identify factors associated with shoulder pain in a nationwide survey of individuals living with spinal cord injury (SCI) in Switzerland.

Methods: Data was collected through the 2012 community survey of the Swiss SCI Cohort Study (SwiSCI) (N = 1549; age 52.3 ± 14.8; 29% female). Sociodemographic and socioeconomic circumstances, SCI characteristics, health conditions as well as mobility independence and sporting activities were evaluated as predictor variables. Analyses were adjusted for item non-response (using multiple imputation) and unit-nonresponse (using inverse probability weighting).

Results: The adjusted prevalence of shoulder pain was 35.8% (95% CI: 33.4–38.3). Multivariable regression analysis revealed higher odds of shoulder pain in females as compared to males (odds ratio: 1.89; 95% CI: 1.44–2.47), and when spasticity (1.36; 1.00–1.85) and contractures (2.47; 1.91–3.19) were apparent. Individuals with complete paraplegia (1.62; 1.13–2.32) or any tetraplegia (complete: 1.63; 1.01–2.62; incomplete: 1.82; 1.30–2.56) showed higher odds of shoulder pain compared to those with incomplete paraplegia.

Conclusions: This survey revealed a high prevalence of shoulder pain. Sex, SCI severity, and specific health conditions were associated with having shoulder pain.

Implications for rehabilitation

• Individuals with spinal cord injury have a high prevalence of shoulder pain.

• Females, individuals with complete paraplegia or any tetraplegia and individuals with contractures and spasticity should receive considerable attention in rehabilitation programmes due to their increased odds of having shoulder pain.

Keywords:

• Spinal cord injuries
• disabled persons
• musculoskeletal pain
• health surveys
• mobility limitations

Acknowledgements

The members of the Swiss Spinal Cord Injury Cohort Study (SwiSCI, www.swisci.ch) Steering Committee are: Xavier Jordan, Bertrand Léger (Clinique Romande de Réadaptation, Sion); Michael Baumberger, Hans Peter Gmünder (Swiss Paraplegic Center, Nottwil); Armin Curt, Martin Schubert (University Clinic Balgrist, Zürich); Margret Hund-Georgiadis, Kerstin Hug (REHAB Basel, Basel); Hans Georg Koch, (Swiss Paraplegic Association, Nottwil); Hardy Landolt (Representative of persons with SCI, Glarus); Nadja Münzel (Parahelp, Nottwil); Mirjam Brach, Gerold Stucki (Swiss Paraplegic Research, Nottwil); Martin Brinkhof, Christine Thyrian (SwiSCI Study Center at Swiss Paraplegic Research, Nottwil).

Disclosure statement

All authors declare that they have no conflicts of interest.

Additional information

Funding

This study has been financed in the framework of SwiSCI supported by the Swiss Paraplegic Foundation.