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The Unhappy Shoulder: A Conceptual Review of the Psychosomatics of Shoulder Pain

Introduction: Chronic pain is a multifaceted disorder genuinely entangled with psychic and psychosomatic symptoms, which are typically involved in the processes of chronification. The impingement syndrome of the shoulder is no exception to this rule, but several studies have shown respective peculia...

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Autores principales: Vogel, Matthias, Binneböse, Marius, Wallis, Hannah, Lohmann, Christoph H., Junne, Florian, Berth, Alexander, Riediger, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9504378/
https://www.ncbi.nlm.nih.gov/pubmed/36143137
http://dx.doi.org/10.3390/jcm11185490
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author Vogel, Matthias
Binneböse, Marius
Wallis, Hannah
Lohmann, Christoph H.
Junne, Florian
Berth, Alexander
Riediger, Christian
author_facet Vogel, Matthias
Binneböse, Marius
Wallis, Hannah
Lohmann, Christoph H.
Junne, Florian
Berth, Alexander
Riediger, Christian
author_sort Vogel, Matthias
collection PubMed
description Introduction: Chronic pain is a multifaceted disorder genuinely entangled with psychic and psychosomatic symptoms, which are typically involved in the processes of chronification. The impingement syndrome of the shoulder is no exception to this rule, but several studies have shown respective peculiarities among those with pain and impingement of the shoulder. Notably, chronic pain is a lateralized experience, and, similarly, its psychosomatic correlates may be attached to the hemispheres functionally. Aim: The present review therefore gives an overview of the respective findings, with regard not only to psychopathology, but also to personality factors and psychologic trauma, since the latter are reportedly associated with chronic pain. Moreover, we acknowledge symmetry as a possible pathogenic factor. Methods: This narrative review followed the current standards for conducting narrative studies. Based on prior findings, our research strategy included the relevance of psychotraumatologic and symmetrical aspects, as well as comorbidity. We retrieved the relevant literature reporting on the impact of psychopathology as well as personality features on shoulder pain, as published up to January 2022 from the Medline database (1966–2022). Study selecton: We included numerous studies, and considered the contextual relevance of studies referring to the neuropsychosomatics of chronic pain. Results: Pain-specific fears, depression, and anxiety are important predictors of shoulder pain, and the latter is generally overrepresented in those with trauma and PTSD. Moreover, associations of shoulder pain with psychological variables are stronger as regards surgical therapies as compared to conservative ones. This may point to a specific and possibly trauma-related vulnerability for perioperative maladaptation. Additionally, functional hemispheric lateralization may explain some of those results given that limb pain is a naturally lateralized experience. Not least, psychosocial risk factors are shared between shoulder pain and its physical comorbidities (e.g., hypertension), and the incapacitated state of the shoulder is a massive threat to the function of the human body as a whole. Conclusions: This review suggests the involvement of psychosomatic and psychotraumatologic factors in shoulder impingement-related chronic pain, but the inconclusiveness and heterogeneity of the literature in the field is possibly suggestive of other determinants such as laterality.
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spelling pubmed-95043782022-09-24 The Unhappy Shoulder: A Conceptual Review of the Psychosomatics of Shoulder Pain Vogel, Matthias Binneböse, Marius Wallis, Hannah Lohmann, Christoph H. Junne, Florian Berth, Alexander Riediger, Christian J Clin Med Review Introduction: Chronic pain is a multifaceted disorder genuinely entangled with psychic and psychosomatic symptoms, which are typically involved in the processes of chronification. The impingement syndrome of the shoulder is no exception to this rule, but several studies have shown respective peculiarities among those with pain and impingement of the shoulder. Notably, chronic pain is a lateralized experience, and, similarly, its psychosomatic correlates may be attached to the hemispheres functionally. Aim: The present review therefore gives an overview of the respective findings, with regard not only to psychopathology, but also to personality factors and psychologic trauma, since the latter are reportedly associated with chronic pain. Moreover, we acknowledge symmetry as a possible pathogenic factor. Methods: This narrative review followed the current standards for conducting narrative studies. Based on prior findings, our research strategy included the relevance of psychotraumatologic and symmetrical aspects, as well as comorbidity. We retrieved the relevant literature reporting on the impact of psychopathology as well as personality features on shoulder pain, as published up to January 2022 from the Medline database (1966–2022). Study selecton: We included numerous studies, and considered the contextual relevance of studies referring to the neuropsychosomatics of chronic pain. Results: Pain-specific fears, depression, and anxiety are important predictors of shoulder pain, and the latter is generally overrepresented in those with trauma and PTSD. Moreover, associations of shoulder pain with psychological variables are stronger as regards surgical therapies as compared to conservative ones. This may point to a specific and possibly trauma-related vulnerability for perioperative maladaptation. Additionally, functional hemispheric lateralization may explain some of those results given that limb pain is a naturally lateralized experience. Not least, psychosocial risk factors are shared between shoulder pain and its physical comorbidities (e.g., hypertension), and the incapacitated state of the shoulder is a massive threat to the function of the human body as a whole. Conclusions: This review suggests the involvement of psychosomatic and psychotraumatologic factors in shoulder impingement-related chronic pain, but the inconclusiveness and heterogeneity of the literature in the field is possibly suggestive of other determinants such as laterality. MDPI 2022-09-19 /pmc/articles/PMC9504378/ /pubmed/36143137 http://dx.doi.org/10.3390/jcm11185490 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Vogel, Matthias
Binneböse, Marius
Wallis, Hannah
Lohmann, Christoph H.
Junne, Florian
Berth, Alexander
Riediger, Christian
The Unhappy Shoulder: A Conceptual Review of the Psychosomatics of Shoulder Pain
title The Unhappy Shoulder: A Conceptual Review of the Psychosomatics of Shoulder Pain
title_full The Unhappy Shoulder: A Conceptual Review of the Psychosomatics of Shoulder Pain
title_fullStr The Unhappy Shoulder: A Conceptual Review of the Psychosomatics of Shoulder Pain
title_full_unstemmed The Unhappy Shoulder: A Conceptual Review of the Psychosomatics of Shoulder Pain
title_short The Unhappy Shoulder: A Conceptual Review of the Psychosomatics of Shoulder Pain
title_sort unhappy shoulder: a conceptual review of the psychosomatics of shoulder pain
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9504378/
https://www.ncbi.nlm.nih.gov/pubmed/36143137
http://dx.doi.org/10.3390/jcm11185490
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