Öz
ÖZET
Amaç: Omuz ağrısı sık görülen kas-iskelet sistemi ağrılarından biridir ve en sık nedeni de rotator manşet hastalıklarıdır (RCD). Omuz ağrısı olan hastalarda gece ağrısı sık görülür ve doktor başvurusunun önemli nedenlerinden biridir. Bu çalışmanın amacı omuz ağrısı olan hastalarda omuz fonksiyonu ve gece ağrısının uyku kalitesine etkisini değerlendirmektir.
Gereç ve yöntem: Ekim 2024 ve Aralık 2024 tarihleri arasında omuz ağrısı ile polikliniğe başvuran ve RCD tanısı alan 93 hasta çalışmaya dahil edilmiştir. Omuz fonksiyonu Penn Omuz Skoru (PSS) ve uyku kalitesi Pittsburgh Uyku Kalitesi İndeksi (PSQI) kullanılarak değerlendirilmiştir. Hastaların ilgili omuzlarından gerçekleştirilen manyetik rezonans görüntüleme (MRI) bulguları kaydedilmiştir.
Bulgular: Katılımcıların ortalama PSQI skoru 6,7±2,7 olarak hesaplandı ve %63,4’ünün PSQI skoru 5’in üzerindeydi. Uyku kalitesi iyi olan grupta PSS daha yüksek, Penn Ağrı alt skorunun daha düşük olduğu saptandı (p<0,001). Gece ağrısı varlığı uyku kalitesinde 0,25 kat azalmaya neden olurken, PSS’de bir birimlik artış ise uyku kalitesinde 1,06 kat düzelmeye neden olduğu görüldü (p değeri sırasıyla 0.019 ve 0.001). PSS’nin fonksiyon alt ölçeğinin gece ağrısı için risk faktörü olduğu ve fonksiyon skorunda bir birimlik artmanın gece ağrısında 0,25 kat azalmaya neden olduğu saptandı (p<0.001).
Sonuç: Bozulmuş omuz fonksiyonu ve gece ağrısı varlığı RCD nedenli omuz ağrısı olan hastalarda uyku kalitesini bozan risk faktörleridir. Omuz ağrılı hastaların uyku kalitesinin ve gece ağrısı varlığının değerlendirilmesi, bu hastaların tedavi ve takibinde önem arz eden bir durumdur.
Anahtar Kelimeler
rotator manşet yaralanmaları omuz ağrısı uyku bozuklukları uyku kalitesi
Kaynakça
- 1. Djade CD, Porgo TV, Zomahoun HTV, Perrault-Sullivan G, Dionne CE. Incidence of shoulder pain in 40 years old and over and associated factors: A systematic review. Eur J Pain. 2020 Jan;24(1):39-50. doi: 10.1002/ejp.1482. Epub 2019 Oct 13. PMID: 31514243.
- 2. Murphy RJ, Carr AJ. Shoulder pain. BMJ Clin Evid. 2010 Jul;22;2010:1107. PMID: 21418673; PMCID: PMC3217726.
- 3. Smythe A, Rathi S, Pavlova N, Littlewood C, Connell D, Haines T, et al. Self-reported management among people with rotator cuff related shoulder pain: An observational study. Musculoskelet Sci Pract. 2021 Feb;51:102305. doi: 10.1016/j.msksp.2020.102305. Epub 2020 Nov 20. PMID: 33249362.
- 4. Minns Lowe CJ, Moser J, Barker K. Living with a symptomatic rotator cuff tear 'bad days, bad nights': a qualitative study. BMC Musculoskelet Disord. 2014 Jul 9;15:228. doi: 10.1186/1471-2474-15-228. PMID: 25008095; PMCID: PMC4105791.
- 5. Bishay V, Gallo RA. The evaluation and treatment of rotator cuff pathology. Prim Care. 2013 Dec;40(4):889-910, viii. doi: 10.1016/j.pop.2013.08.006. PMID: 24209724.
- 6. Mengi A, Akif Guler M. Nocturnal pain in patients with rotator cuff related shoulder pain: A prospective study. Musculoskelet Sci Pract. 2022 Jun;59:102536. doi: 10.1016/j.msksp.2022.102536. Epub 2022 Feb 22. PMID: 35220021.
- 7. Khazzam MS, Mulligan EP, Brunette-Christiansen M, Shirley Z. Sleep Quality in Patients With Rotator Cuff Disease. J Am Acad Orthop Surg. 2018 Mar 15;26(6):215-222. doi: 10.5435/JAAOS-D-16-00547. PMID: 29517624.
- 8. Vergili O, Oktas B, Canbeyli IDD, Arikan H, Aktas Arslan FC. Comparison of sleep quality, shoulder function, and quality of life in patients with different-sized rotator cuff tears. Asian J Med Sci. 2021;12(8).
- 9. Reyes BA, Hull BR, Kurth AB, Kukowski NR, Mulligan EP, Khazzam MS. Do Magnetic Resonance Imaging Characteristics of Full-Thickness Rotator Cuff Tears Correlate With Sleep Disturbance? Orthop J Sports Med. 2017 Nov 1;5(11):2325967117735319. doi: 10.1177/2325967117735319. PMID: 29147668; PMCID: PMC5669319.
- 10. Gumina S, Candela V, Passaretti D, Venditto T, Mariani L, Giannicola G. Sleep quality and disturbances in patients with different-sized rotator cuff tear. Musculoskelet Surg. 2016 Dec;100(Suppl 1):33-38. doi: 10.1007/s12306-016-0405-4. Epub 2016 Nov 30. PMID: 27900705.
- 11. Shahabpour M, Kichouh M, Laridon E, Gielen JL, De Mey J. The effectiveness of diagnostic imaging methods for the assessment of soft tissue and articular disorders of the shoulder and elbow. Eur J Radiol. 2008 Feb;65(2):194-200. doi: 10.1016/j.ejrad.2007.11.012. PMID: 18312783.
- 12. Kvalvaag E, Anvar M, Karlberg AC, Brox JI, Engebretsen KB, Soberg HL, et al. Shoulder MRI features with clinical correlations in subacromial pain syndrome: a cross-sectional and prognostic study. BMC Musculoskelet Disord. 2017 Nov 21;18(1):469. doi: 10.1186/s12891-017-1827-3. PMID: 29157224; PMCID: PMC5696760.
- 13. Benca RM, Ancoli-Israel S, Moldofsky H. Special considerations in insomnia diagnosis and management: depressed, elderly, and chronic pain populations. J Clin Psychiatry. 2004;65 Suppl 8:26-35. PMID: 15153065.
- 14. Onen SH, Onen F, Courpron P, Dubray C. How pain and analgesics disturb sleep. Clin J Pain. 2005 Sep-Oct;21(5):422-31. doi: 10.1097/01.ajp.0000129757.31856.f7. PMID: 16093748.
- 15. Mulligan EP, Brunette M, Shirley Z, Khazzam M. Sleep quality and nocturnal pain in patients with shoulder disorders. J Shoulder Elbow Surg. 2015 Sep;24(9):1452-7. doi: 10.1016/j.jse.2015.02.013. Epub 2015 Apr 1. PMID: 25842028.
- 16. Kempf B, Kongsted A. Association between the side of unilateral shoulder pain and preferred sleeping position: a cross-sectional study of 83 Danish patients. J Manipulative Physiol Ther. 2012 Jun;35(5):407-12. doi: 10.1016/j.jmpt.2012.04.015. Epub 2012 May 17. PMID: 22608285.
- 17. Ha E, Lho YM, Seo HJ, Cho CH. Melatonin Plays a Role as a Mediator of Nocturnal Pain in Patients with Shoulder Disorders. J Bone Joint Surg Am. 2014 Jul 2;96(13):e108. doi: 10.2106/JBJS.M.01011. Epub 2014 Jul 2. PMID: 24990982.
- 18. Terabayashi N, Watanabe T, Matsumoto K, Takigami I, Ito Y, Fukuta M, et al. Increased blood flow in the anterior humeral circumflex artery correlates with night pain in patients with rotator cuff tears. J Orthop Sci. 2014 Sep;19(5):744-9. doi: 10.1007/s00776-014-0604-5. Epub 2014 Jul 29. PMID: 25069807.
- 19. Hazar Kanik Z, Gunaydin G, Pala OO, Sozlu U, Alkan ZB, Citaker S, et al. Translation, cultural adaptation, reliability, and validity of the Turkish version of the Penn Shoulder Score. Disabil Rehabil. 2018 May;40(10):1214-1219. doi: 10.1080/09638288.2017.1284905. Epub 2017 Feb 7. PMID: 28637131.
- 20. Leggin BG, Michener LA, Shaffer MA, Brenneman SK, Iannotti JP, Williams GR Jr. The Penn shoulder score: reliability and validity. J Orthop Sports Phys Ther. 2006 Mar;36(3):138-51. doi: 10.2519/jospt.2006.36.3.138. PMID: 16596890.
- 21. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4. PMID: 2748771.
- 22. Ağargün MY, Kara H, Anlar Ö. Pittsburgh Uyku Kalitesi İndeksi’nin Geçerliği ve Güvenirliği. Türk Psikiyatri Dergisi. 1996;7(2).
- 23. Berquist TH. Shoulder and arm. In: Berquist TH, Peterson JJ, editors. MRI of the Musculoskeletal System. Philadelphia: Lippincott Williams and Wilkins; 2012. p. 597-706.
- 24. Tekeoglu I, Ediz L, Hiz O, Toprak M, Yazmalar L, Karaaslan G. The relationship between shoulder impingement syndrome and sleep quality. Eur Rev Med Pharmacol Sci. 2013 Feb;17(3):370-4. PMID: 23426540.
- 25. Tombak Y, Nazlı Ünkazan F. The Effect of Shoulder Pain on Sleep Quality. Hitit Medical Journal. Feb; 2024;6(1):56-62. doi:10.52827/hititmedj.1365643.
- 26. Abeler K, Bergvik S, Sand T, Friborg O. Daily associations between sleep and pain in patients with chronic musculoskeletal pain. J Sleep Res. 2021 Aug;30(4):e13237. doi: 10.1111/jsr.13237. Epub 2021 Feb 2. PMID: 33529464.
- 27. Castro-Contreras E, Valdez-Pardo ME. Rotator cuff injuries with nighttime pain and sleep quality before and after treatment. Acta Ortop Mex. 2022 Jan-Feb;36(1):33-38. Spanish. PMID: 36099571.
- 28. Krief OP, Huguet D. Shoulder pain and disability: comparison with MR findings. AJR Am J Roentgenol. 2006 May;186(5):1234-9. doi: 10.2214/AJR.04.1766. PMID: 16632711.
- 29. Teunis T, Lubberts B, Reilly BT, Ring D. A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age. J Shoulder Elbow Surg. 2014 Dec;23(12):1913-1921. doi: 10.1016/j.jse.2014.08.001. PMID: 25441568.
Öz
ABSTRACT
Objectives: The most common cause of shoulder pain is rotator cuff disease (RCD). Nocturnal pain is common in patients and is one of the main reasons for visiting a doctor. The aim of this study is to evaluate the effect of shoulder function and nocturnal pain on sleep quality in patients with RCD.
Material and Methods: Ninety-three patients who presented to the outpatient clinic with RCD-related shoulder pain between October 2024 and December 2024 were included in the study. Shoulder function was assessed by the Penn Shoulder Score (PSS) and sleep quality by the Pittsburgh Sleep Quality Index (PSQI). Patients' magnetic resonance imaging (MRI) findings were recorded.
Results: The mean PSQI score was 6.7±2.7. In the group with better sleep quality, the PSS was higher and the Penn Pain subscore was lower (p<0.001). While the presence of nocturnal pain was associated with a 0.25-fold decrease in sleep quality, a one-unit increase in PSS was associated with a 1.06-fold improvement in sleep quality (p values are 0.019 and 0.001, respectively). The function subscale of the PSS was found to be a risk factor for nocturnal pain, and a one-unit increase in the function subscore was associated with a 0.25-fold decrease in nocturnal pain (p<0.001).
Conclusion: Impaired shoulder function and the presence of nocturnal pain are risk factors for poor sleep quality. Assessment of sleep quality and nocturnal pain is important for management and follow-up of these patients.
Anahtar Kelimeler
rotator cuff injuries shoulder pain sleep disorders sleep quality
Kaynakça
- 1. Djade CD, Porgo TV, Zomahoun HTV, Perrault-Sullivan G, Dionne CE. Incidence of shoulder pain in 40 years old and over and associated factors: A systematic review. Eur J Pain. 2020 Jan;24(1):39-50. doi: 10.1002/ejp.1482. Epub 2019 Oct 13. PMID: 31514243.
- 2. Murphy RJ, Carr AJ. Shoulder pain. BMJ Clin Evid. 2010 Jul;22;2010:1107. PMID: 21418673; PMCID: PMC3217726.
- 3. Smythe A, Rathi S, Pavlova N, Littlewood C, Connell D, Haines T, et al. Self-reported management among people with rotator cuff related shoulder pain: An observational study. Musculoskelet Sci Pract. 2021 Feb;51:102305. doi: 10.1016/j.msksp.2020.102305. Epub 2020 Nov 20. PMID: 33249362.
- 4. Minns Lowe CJ, Moser J, Barker K. Living with a symptomatic rotator cuff tear 'bad days, bad nights': a qualitative study. BMC Musculoskelet Disord. 2014 Jul 9;15:228. doi: 10.1186/1471-2474-15-228. PMID: 25008095; PMCID: PMC4105791.
- 5. Bishay V, Gallo RA. The evaluation and treatment of rotator cuff pathology. Prim Care. 2013 Dec;40(4):889-910, viii. doi: 10.1016/j.pop.2013.08.006. PMID: 24209724.
- 6. Mengi A, Akif Guler M. Nocturnal pain in patients with rotator cuff related shoulder pain: A prospective study. Musculoskelet Sci Pract. 2022 Jun;59:102536. doi: 10.1016/j.msksp.2022.102536. Epub 2022 Feb 22. PMID: 35220021.
- 7. Khazzam MS, Mulligan EP, Brunette-Christiansen M, Shirley Z. Sleep Quality in Patients With Rotator Cuff Disease. J Am Acad Orthop Surg. 2018 Mar 15;26(6):215-222. doi: 10.5435/JAAOS-D-16-00547. PMID: 29517624.
- 8. Vergili O, Oktas B, Canbeyli IDD, Arikan H, Aktas Arslan FC. Comparison of sleep quality, shoulder function, and quality of life in patients with different-sized rotator cuff tears. Asian J Med Sci. 2021;12(8).
- 9. Reyes BA, Hull BR, Kurth AB, Kukowski NR, Mulligan EP, Khazzam MS. Do Magnetic Resonance Imaging Characteristics of Full-Thickness Rotator Cuff Tears Correlate With Sleep Disturbance? Orthop J Sports Med. 2017 Nov 1;5(11):2325967117735319. doi: 10.1177/2325967117735319. PMID: 29147668; PMCID: PMC5669319.
- 10. Gumina S, Candela V, Passaretti D, Venditto T, Mariani L, Giannicola G. Sleep quality and disturbances in patients with different-sized rotator cuff tear. Musculoskelet Surg. 2016 Dec;100(Suppl 1):33-38. doi: 10.1007/s12306-016-0405-4. Epub 2016 Nov 30. PMID: 27900705.
- 11. Shahabpour M, Kichouh M, Laridon E, Gielen JL, De Mey J. The effectiveness of diagnostic imaging methods for the assessment of soft tissue and articular disorders of the shoulder and elbow. Eur J Radiol. 2008 Feb;65(2):194-200. doi: 10.1016/j.ejrad.2007.11.012. PMID: 18312783.
- 12. Kvalvaag E, Anvar M, Karlberg AC, Brox JI, Engebretsen KB, Soberg HL, et al. Shoulder MRI features with clinical correlations in subacromial pain syndrome: a cross-sectional and prognostic study. BMC Musculoskelet Disord. 2017 Nov 21;18(1):469. doi: 10.1186/s12891-017-1827-3. PMID: 29157224; PMCID: PMC5696760.
- 13. Benca RM, Ancoli-Israel S, Moldofsky H. Special considerations in insomnia diagnosis and management: depressed, elderly, and chronic pain populations. J Clin Psychiatry. 2004;65 Suppl 8:26-35. PMID: 15153065.
- 14. Onen SH, Onen F, Courpron P, Dubray C. How pain and analgesics disturb sleep. Clin J Pain. 2005 Sep-Oct;21(5):422-31. doi: 10.1097/01.ajp.0000129757.31856.f7. PMID: 16093748.
- 15. Mulligan EP, Brunette M, Shirley Z, Khazzam M. Sleep quality and nocturnal pain in patients with shoulder disorders. J Shoulder Elbow Surg. 2015 Sep;24(9):1452-7. doi: 10.1016/j.jse.2015.02.013. Epub 2015 Apr 1. PMID: 25842028.
- 16. Kempf B, Kongsted A. Association between the side of unilateral shoulder pain and preferred sleeping position: a cross-sectional study of 83 Danish patients. J Manipulative Physiol Ther. 2012 Jun;35(5):407-12. doi: 10.1016/j.jmpt.2012.04.015. Epub 2012 May 17. PMID: 22608285.
- 17. Ha E, Lho YM, Seo HJ, Cho CH. Melatonin Plays a Role as a Mediator of Nocturnal Pain in Patients with Shoulder Disorders. J Bone Joint Surg Am. 2014 Jul 2;96(13):e108. doi: 10.2106/JBJS.M.01011. Epub 2014 Jul 2. PMID: 24990982.
- 18. Terabayashi N, Watanabe T, Matsumoto K, Takigami I, Ito Y, Fukuta M, et al. Increased blood flow in the anterior humeral circumflex artery correlates with night pain in patients with rotator cuff tears. J Orthop Sci. 2014 Sep;19(5):744-9. doi: 10.1007/s00776-014-0604-5. Epub 2014 Jul 29. PMID: 25069807.
- 19. Hazar Kanik Z, Gunaydin G, Pala OO, Sozlu U, Alkan ZB, Citaker S, et al. Translation, cultural adaptation, reliability, and validity of the Turkish version of the Penn Shoulder Score. Disabil Rehabil. 2018 May;40(10):1214-1219. doi: 10.1080/09638288.2017.1284905. Epub 2017 Feb 7. PMID: 28637131.
- 20. Leggin BG, Michener LA, Shaffer MA, Brenneman SK, Iannotti JP, Williams GR Jr. The Penn shoulder score: reliability and validity. J Orthop Sports Phys Ther. 2006 Mar;36(3):138-51. doi: 10.2519/jospt.2006.36.3.138. PMID: 16596890.
- 21. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4. PMID: 2748771.
- 22. Ağargün MY, Kara H, Anlar Ö. Pittsburgh Uyku Kalitesi İndeksi’nin Geçerliği ve Güvenirliği. Türk Psikiyatri Dergisi. 1996;7(2).
- 23. Berquist TH. Shoulder and arm. In: Berquist TH, Peterson JJ, editors. MRI of the Musculoskeletal System. Philadelphia: Lippincott Williams and Wilkins; 2012. p. 597-706.
- 24. Tekeoglu I, Ediz L, Hiz O, Toprak M, Yazmalar L, Karaaslan G. The relationship between shoulder impingement syndrome and sleep quality. Eur Rev Med Pharmacol Sci. 2013 Feb;17(3):370-4. PMID: 23426540.
- 25. Tombak Y, Nazlı Ünkazan F. The Effect of Shoulder Pain on Sleep Quality. Hitit Medical Journal. Feb; 2024;6(1):56-62. doi:10.52827/hititmedj.1365643.
- 26. Abeler K, Bergvik S, Sand T, Friborg O. Daily associations between sleep and pain in patients with chronic musculoskeletal pain. J Sleep Res. 2021 Aug;30(4):e13237. doi: 10.1111/jsr.13237. Epub 2021 Feb 2. PMID: 33529464.
- 27. Castro-Contreras E, Valdez-Pardo ME. Rotator cuff injuries with nighttime pain and sleep quality before and after treatment. Acta Ortop Mex. 2022 Jan-Feb;36(1):33-38. Spanish. PMID: 36099571.
- 28. Krief OP, Huguet D. Shoulder pain and disability: comparison with MR findings. AJR Am J Roentgenol. 2006 May;186(5):1234-9. doi: 10.2214/AJR.04.1766. PMID: 16632711.
- 29. Teunis T, Lubberts B, Reilly BT, Ring D. A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age. J Shoulder Elbow Surg. 2014 Dec;23(12):1913-1921. doi: 10.1016/j.jse.2014.08.001. PMID: 25441568.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Ağrı, Ortopedi, Romatoloji ve Artrit |
| Bölüm | Original Article |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2025 |
| Gönderilme Tarihi | 20 Aralık 2024 |
| Kabul Tarihi | 9 Mayıs 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 35 Sayı: 3 |
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