Are respiratory disorders risk factors for troublesome neck/shoulder pain? A study of a general population cohort in Sweden

PURPOSE

The etiology of neck/shoulder pain is complex. Our purpose was to investigate if respiratory disorders are risk factors for troublesome neck/shoulder pain in people with no or occasional neck/shoulder pain.

METHODS

This prospective cohort study was based on the Stockholm Public Health Cohorts (SPHC) 2006/2010 and the SPHC 2010/2014. We included adults who at baseline reported no or occasional neck/shoulder pain in the last six months, from the two subsamples (SPHC 06/10 n = 15 155: and SPHC 2010/14 n = 25 273). Exposures were self-reported asthma at baseline in SPHC 06/10 and Chronic Obstructive Pulmonary Disease (COPD) at baseline in SPHC 10/14. The outcome was having experienced at least one period of troublesome neck/shoulder pain which restricted work capacity or hindered daily activities to some or to a high degree during the past six months, asked for four years later. Binomial regression analyses were used to calculate risk ratios (RR) with 95% confidence intervals (95% CI).

RESULTS

Adjusted results indicate that those reporting to suffer from asthma at baseline had a higher risk of troublesome neck/shoulder pain at follow-up four years later (RR 1.48, 95% CI 1.10-2.01) as did those reporting to suffer from COPD (RR 2.12 95%CI 1.54-2.93).

CONCLUSION

Our findings indicate that those with no or occasional neck/shoulder pain and reporting to suffer from asthma or COPD increase the risk for troublesome neck/shoulder pain over time. This highlights the importance of taking a multi-morbidity perspective into consideration in health care. Future longitudinal studies are needed to confirm our findings.

Are job strain and sleep disturbances prognostic factors for neck/shoulder/arm pain? A cohort study of a general population of working age in Sweden

OBJECTIVE

To study whether job strain, that is, psychological job demands and decision latitude, and sleep disturbances among persons with occasional neck/shoulder/arm pain (NSAP) are prognostic factors for having experienced at least one episode of troublesome NSAP, and to determine whether sleep disturbances modify the association between job strain and troublesome NSAP.

DESIGN

Prospective cohort study.

SETTING

Stockholm, Sweden.

PARTICIPANTS

A population-based cohort of individuals with occasional NSAP (n=6979) who answered surveys in 2006 and 2010.

OUTCOME MEASURES

Report of at least one episode of troublesome NSAP in 2010.

RESULTS

The ORs for troublesome NSAP at follow-up were in individuals exposed to passive jobs 1.2 (95% CI 0.9 to 1.4); to active jobs 1.3 (95% CI 1.1 to 1.5); to high strain 1.5 (95% CI 1.0 to 2.4); to mild sleep disturbances 1.4 (95% CI 1.3 to 1.6) and to severe sleep disturbances 2.2 (95% CI 1.6 to 3.0). High strain and active jobs were associated with having experienced at least one episode of troublesome NSAP during the previous 6 months in persons with sleep disturbances, but not in individuals without sleep disturbances.

CONCLUSIONS

Our results indicate that high strain, active jobs and sleep disturbances are prognostic factors that should be taken into account when implementing preventive measures to minimise the risk of troublesome NSAP among people of working age. We suggest that sleep disturbances may modify the association between high strain and troublesome NSAP.

Stabilizing training compared with manual treatment in sub-acute and chronic low-back pain

The present aim was to compare the effects of stabilizing training with those of manual treatment in patients with sub-acute or chronic low-back pain (LBP). Forty-seven patients were randomized to a stabilizing training group (ST group) or a manual treatment group (MT group). The patients underwent a 6-week treatment programme on a weekly basis. Pain, health and functional disability level at the start of treatment, after treatment, and at 3- and 12-month follow-ups were assessed. In the ST group all assessed variables improved significantly (P<0.05) after the treatment period and were maintained long term. After the treatment period there was a significant difference between the groups in assessed function (P<0.05). More individuals in the ST group had improved than in the MT group. At the 3-month follow-up significantly more improved individuals were evident in the ST group regarding pain, general health and functional disability levels. In the long term, significantly more (P<0.05) patients in the MT group reported recurrent treatment periods. The study did not indicate any clear short-term differences between the groups in the accessed outcome measures. In the long term, however, stabilizing training seemed to be more effective than manual treatment in terms of improvement of individuals and the reduced need for recurrent treatment periods.