The researchers were interested in exploring new models of care to help identify patients who may benefit from different care pathways.

The study consisted of 119 participants who had experienced shoulder pain for more than three months and had attended a public hospital orthopaedic department.

The control group included 44 participants without shoulder pain. All subjects underwent a range of standardised quantitative sensory testing protocols measuring pressure pain threshold, temporal summation and conditioned pain modulation.

The primary objective was to compare sensory processing measures in people attending specialist orthopaedic consultation for
management of persistent shoulder pain with control participants.

The secondary objective was to compare the groups’ sociodemographic, clinical and general health, lifestyle and psychological characteristics.

For the primary objective, statistically significant results were found for pressure pain threshold and conditioned pain modulation, but not for temporal summation.

Compared to the control group, the shoulder pain group produced higher Shoulder Pain and Disability Index scores, reduced shoulder AROM for abduction and external rotation.

For the secondary objective, the shoulder pain group had statistically higher BMI, waist circumferences and waist-hip ratios, as well as comorbidities across mental health, respiratory, bone/joint issues and cardiovascular categories.

They were also more likely to take medication for health issues, smoke, get fewer hours of sleep and engage only in light-intensity exercise.

Compared with controls, the shoulder pain group’s results indicated altered sensory function, including local and widespread mechanical hyperalgesia (lower pressure pain thresholds at all sites) and decreased descending inhibition of nociception (lower conditioned pain modulation).

The researchers recommend a multidisciplinary approach to managing people with persistent shoulder pain, focusing on improving an individual’s physical and psychological wellbeing alongside relevant biomechanical or medical interventions.

Hollis et al. Altered Sensory Processing in People Attending Specialist Orthopaedic Consultation for Management of Persistent Shoulder Pain: An Observational Cross-Sectional Study. Journal of Orthopaedic & Sports Physical Therapy. 2024(54:10) doi: 10.2519/jospt.2024.12512