Diabetes mellitus affects the prognosis of frozen shoulder.

INTRODUCTION: The aim of this study was to establish whether diabetes mellitus (DM) affects the prognosis for patients with a frozen shoulder. METHODS: In this prospective two-year follow-up study, we included 235 patients with newly diagnosed unilateral frozen shoulder. Among the 235 patients, 34 (14%) were diagnosed with DM prior to their inclusion in the study. Patients were asked to fill out a questionnaire at the time of diagnosis and at six-, 12- and 24-month follow-ups. The questionnaire included the Oxford Shoulder Score (OSS) and a visual analogue scale (VAS) for both maximum and average daily pain. DM status was recorded for all patients and glycated haemoglobin was measured for patients not diagnosed with DM. RESULTS: Overall, patients with and without DM had a similar OSS (p = 0.22) and VAS score for maximum (p = 0.46) and average (p = 0.46) daily pain at the time of diagnosis compared with patients without DM. Both groups improved their OSS and VAS score, but patients with DM had a poorer OSS at the six-month (p = 0.04) and 24-month follow-ups (p = 0.02); poorer VAS scores for maximum daily pain at the six-month (p = 0.04), 12-month (p = 0.03) and 24-month follow-ups (p = 0.03); and poorer VAS scores for average daily pain at the six-month (p = 0.02) and 12-month follow-ups (p = 0.01). CONCLUSIONS: This study shows that patients with frozen shoulder may expect a gradual improvement of both pain and movement during a two-year follow-up, but also that having DM is associated with a poorer prognosis. FUNDING: none. TRIAL REGISTRATION: NCT01978886.

Effect of Psychomotricity in Combination With 3 Months of Active Shoulder Exercises in Individuals With Chronic Shoulder Pain: Primary Results From an Investigator-Blinded, Randomized, Controlled Trial.

OBJECTIVE: To evaluate whether psychomotor therapy (PMT) in combination with usual care active exercise (AE) rehabilitation for the shoulder is superior to merely AE. DESIGN: The trial was a single-center, stratified (by corticosteroid injection [yes or no]), randomized, and controlled superiority trial. SETTING: Shoulder unit of the orthopedic department at Hospital Lillebaelt, Vejle Hospital. PARTICIPANTS: Eligible participants (N=87) were adults aged 18-75 years with shoulder complaints lasting for at least 3 months, in addition to a score equal to or below 3 on the Multidimensional Assessment of Interoceptive Awareness score. Furthermore, patients had at least a visual analog scale pain score of 2 at rest, 3 at night, and 5 in activity (range: 0-10). INTERVENTIONS: Patients were randomized to 12 weeks of AE (control group) or in combination with 5 PMT sessions (intervention group). MAIN OUTCOME MEASURE: The primary outcome was the patient-reported outcome score Disability of the Arm, Shoulder and Hand questionnaire. The primary endpoint was 12 weeks after baseline. RESULTS: There was no between-group difference in function between the intervention group and control group. CONCLUSIONS: Our results showed no additional benefit on patient-reported function and pain from PMT over usual care in patients with long-lasting shoulder pain and low body awareness. This finding suggests that PMT adds no additional benefit to patients' recovery in relation to pain and active function in comparison to standard care.

Prevalence of diabetes mellitus in patients with shoulder symptoms is low.

INTRODUCTION: Patients with diabetes mellitus have a high risk of developing symptoms from their shoulder. The generally accepted theory is that high blood glucose levels cause excessive glycosylation and that the delay in diagnosing diabetes mellitus may influence the risk of acquiring a musculoskeletal disorder. The aim of the study was to determine whether there was a large percentage of undiagnosed diabetes mellitus in a population of patients with shoulder symptoms. MATERIAL AND METHODS: The study population consisted of patients who were referred by their GP with shoulder symptoms. HbA1c level was measured, and height, weight, sex, age and diabetes status were registered. Patients with shoulder symptoms were compared to a group of patients who had been referred with knee symptoms and to the regional prevalence of unknown and diagnosed diabetes mellitus. RESULTS: A total of 221 patients with shoulder symptoms were included. There was no significant difference in the prevalence of unknown diabetes mellitus between the group of patients with shoulder symptoms and the group of patients with knee symptoms or the regional prevalence. There was a significantly higher prevalence of diagnosed diabetes mellitus in the group of patients with shoulder symptoms. CONCLUSION: The low prevalence of unknown diabetes mellitus we observed in this study may be owed to the fact that upper extremity disorder often occurs years after onset of diabetes, and for that reason patients have already been diagnosed when the extremity disorder is present. This study demonstrates a higher prevalence of diagnosed diabetes mellitus among patients with shoulder symptoms. It is important for physicians to be aware of this in the treatment of patients with shoulder symptoms.