Impact of Neck and Shoulder Pain on Health-Related Quality of Life in Adults in Saudi Arabia.

BACKGROUND: Musculoskeletal pain is widely recognized as a prevalent public health issue that affects individuals of various genders and age groups. This study aimed to assess the influence of neck and shoulder pain on the quality of life (QoL) of adult individuals living in Saudi Arabia. METHOD: This is a cross-sectional study using an online-administered questionnaire that was distributed via online platforms in Saudi Arabia for the duration between January and June 2023. The 36-Item Short Form Health Survey (SF-36) questionnaire was used to estimate participants QoL. Binary logistic regression analysis was used to identify predictors of better QoL. RESULTS: A total of 6601 participants were involved in this study. The majority of the participants (76.8%, n = 4610) reported that they had muscle tension, stiffness, pressure, or dull pain in the neck and shoulder area. The mean pain score for the study participants was 4.0 (SD: 2.9), which indicates mild degree of pain. When the participants were asked about their health today, the mean score was 5.9 (SD: 3.9), which indicates moderate health status. The mean SF-36 score for the study participants was 58.16 (17.4), which demonstrates moderate quality of life. Binary logistic regression analysis showed that male gender, younger age, being married or divorced, and having lower BMI (less than 25.3 kg/cm2) were predictors of better QoL (p < 0.05). CONCLUSION: Notwithstanding the participants' moderate evaluations of their current health and quality of life, certain demographic attributes - such as being male, being younger in age, being married, and having a lower body mass index - showed a favorable association with quality of life. Strict interventions and preventative measures are essential for addressing musculoskeletal issues in the neck and shoulder region, as indicated by these findings. Further research should be dedicated to developing tailored interventions that specifically target different demographic cohorts, with the ultimate goal of improving the quality of life for all.

Impact of Musculoskeletal Pain on Health-Related Quality of Life Among Adults in Saudi Arabia.

Background Musculoskeletal pain (MSP) is widely recognized as a prevalent public health issue that affects individuals of various genders and age groups. The aim of this study is to assess the influence of musculoskeletal pain on the quality of life (QoL) of adult individuals living in Saudi Arabia. Method This is a cross-sectional study using an online-administered questionnaire that was distributed via online platforms in Saudi Arabia for the duration between January and August 2023. Three questionnaire instruments were used in this study. The 36-item Short Form Health Survey questionnaire (SF-36), The 5-level EQ-5D version (EQ-5D-5L), and Roland-Morris Disability Questionnaire. Binary logistic regression analysis was used to identify predictors of better QoL and having mild to moderate disability. Results A total of 8359 participants were involved in this study. The most commonly reported sites of musculoskeletal pain were the lower back, neck, and shoulder, accounting for 36.8% (n= 3072), 30.5% (n= 2549), and 30.1% (n= 2514), respectively. The mean pain score for the study participants was 4.3 (SD: 2.3), which indicates mild degree of pain. The median EQ-5D-5L index value for the study participants was 0.827 (0.756-1.00), which demonstrates a high quality of life. The mean SF-36 score for the study participants was 63.11 (17.4), which demonstrates moderate quality of life. The median Roland-Morris Disability score for the study participants was 1.00 (0.00-7.00), which demonstrates a low level of pain-related disability. Male gender, younger age (30-39 years), having higher education attainment, having higher monthly income (more than SAR 20000), and having lower BMI (less than 25.8 kg/cm2) were predictors of better QoL (p<0.05). Conclusion Musculoskeletal pain is a multifactorial condition influenced by structural, physical, psychological, social, lifestyle, and comorbid health elements. It ranges from acute to chronic pain and, despite rarely being fatal, has a significant impact on QoL. Musculoskeletal discomfort varies in terms of intensity, affected regions, and demographic and lifestyle factors. This study sheds light on the multifaceted nature of MSP, its impact on QoL, and the significance of early intervention and individualized management strategies to improve the QoL of those affected.

Prevalence, Awareness, and Management of Carpal Tunnel Syndrome Among Diabetic Patients.

BACKGROUND: Carpal tunnel syndrome (CTS) is a common condition that can significantly affect the quality of life for individuals, particularly those with diabetes. This study aims to examine the severity of CTS symptoms among diabetic patients and explore the associations between demographic factors, diabetic characteristics, knowledge, and management approaches. METHODOLOGY: A cross-sectional study was conducted among diabetic patients, and data were collected using standardized questionnaires. The incidence and severity of CTS were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ). Demographic information, diabetic characteristics, knowledge of CTS, and management approaches were also recorded. Descriptive statistics and inferential analysis were performed to analyze the data. RESULTS: The study included 303 participants. The majority of the participants were aged 50 or older (44.9%) (N=136), followed by those aged 39-49 (24.4%) (N=74). In terms of gender, there were more female participants (61.4%) (N=186) than male participants (38.6%) (N=117). Older age groups exhibited higher mean BCTQ scores, suggesting increased severity. Females had significantly higher severity scores compared to males (mean BCTQ score of 17.52 vs 15.56). Regarding diabetic characteristics, complications in the eye and pain/numbness in the legs or feet were significantly associated with higher severity scores of CTS (P=0.0001). The study revealed a knowledge gap among diabetic patients about CTS, with inadequate knowledge about its causes, symptoms, consequences, and treatment options among 68.6% of the patients. The use of medical interventions such as splints, injections, and surgery was associated with higher severity scores. CONCLUSION: This study highlights the incidence and severity of CTS symptoms among diabetic patients and its associations with demographic factors, diabetic characteristics, knowledge, and management approaches. Older age, female gender, widowed, diabetic complications in the eye, and pain/numbness in the legs or feet were found to be related to increased severity of CTS. Additionally, inadequate knowledge about CTS was observed among diabetic patients.

Clinical and Radiological Outcomes of Halo Vest Application for Type II and III Odontoid Fractures.

Objective: To assess halo vest applications for type II and III odontoid fractures and to ascertain the radiological and clinical outcomes of this approach. Methods: A cross-sectional retrospective study was conducted by reviewing the medical charts of selected patients having type II and III odontoid fractures who underwent halo vest treatment at the King Saud Medical City Orthopaedic Department. Radiographic evaluations for the cervical spine (anterior-posterior, lateral, and open-mouth views) were used. Computed tomography scans were used to delineate the extent of the fracture and to measure the magnitude of displacement, the degree of the angulation, the vertebrae involved, and the fracture type. Results: A total of 45 patients with odontoid fractures (55.6% of the patients with type II odontoid fractures and 44.4% of patients with type III) received halo vest treatment. In the present study, in type II odontoid fractures, union was achieved in 15.6% of patients, 28.9% of patients had malunion and 11.1% had nonunion. In type III odontoid fractures, union cases comprised 15.6% of patients, while malunion cases accounted for 28.9% of patients and nonunion cases were found in 4.4% of the patients. Conclusion: The halo vest management for type II and III odontoid fracture requires a prolonged course of cervical immobilisation. Multiple factors contribute to the alteration of the management protocol, patient adherence, and difficulties related to HV, and a significant rate of reduction loss ultimately results in malunion or nonunion.

Knowledge and Attitude of Sciatica Pain and Treatment Methods among Adults in Saudi Arabia.

Background: Sciatica is a relatively common condition, with a lifetime incidence varying from 13% to 40%. The corresponding annual incidence of an episode of sciatica ranges from 1% to 5%. The exact cause of sciatica is unknown to this day; treatment methods and practices differ between individuals based on their cultural background, socioeconomic status, and religious beliefs. This study aimed to assess the knowledge and attitude toward sciatica pain among adults in Saudi Arabia. Methods: A cross-sectional study was conducted among the adult population in Saudi Arabia. A self-administered questionnaire was distributed among the study population using an online survey. Questions were divided into four groups, each containing multiple questions covering the following aspects: demographic data, past medical history, and the assessment of knowledge and attitudes regarding sciatica. Results: A total of 3,764 respondents were involved in this study, with an age range of 18-65 years old (females 59.8%). The mean knowledge score was 3.8 (SD 2.1), with the majority having poor knowledge (60.1%). The most common source of sciatica information was an orthopedic or a neurosurgeon, while the most common self-treatment used was painkiller medications (30.8%). The mean attitude score was 35.8 (SD 5.3), with most respondents having a neutral attitude (80.3%). The factors correlated with an increase in knowledge and attitude were having a bachelor's or higher degree and living in an urban area. Conclusion: While the attitude of the adult population toward sciatica pain seems adequate, their knowledge was shown to be deficient. Furthermore, when comparing diagnosed individuals living in cities with those in rural areas, both knowledge and attitudes were shown to be better in individuals living in cities. Awareness programs by health institutions and healthcare professionals are needed to enhance patients knowledge. Various media can be utilized to enhance patients knowledge including social media platforms.

Simultaneous Fractures of Distal and Proximal Ends of Radius and Ulna: Four Fractures in One Forearm.

A few cases reported simultaneous ipsilateral distal and proximal forearm fractures. This case report highlights a rare mechanism of injury that occurred due to extended forearm undergoing forced hyper-supination without the presence of ligamentous injury and the use of flexible fixation. A 49-year-old male truck driver presented to the emergency department as a motor vehicle accident (MVA) patient. A radiographic examination revealed a right forearm fracture with proximal and distal bone fractures. The distal radius was stabilized with three Kirschner wires (K-wires), and the radial neck fracture was stabilized with a single intramedullary K-wire. The olecranon and distal ulna fractures were also fixed with two intramedullary wires. On the eighth week after surgery, all K-wires were removed, and the fiberglass splint was reapplied for another two weeks. After the cast was removed, physical rehabilitation began. During the fourth month, a follow-up radiograph revealed complete healing and full wrist range of motion (ROM) with good hand grip.

Fixator-Assisted Nailing for Femur Neck Fracture Nonunion: A Case Series Study.

Background: Femoral neck fractures in young adults tend to be a result of high-energy trauma with a common pattern of Pauwels type III fracture, and they require timely and meticulous diagnosis and management. The objective of this study was to assess the clinical and radiological outcomes of the fixator-assisted nailing technique for managing femur neck fracture nonunion. Methods. This was a case series study of 16 patients with nonunion femoral neck fractures treated via a fixator-assisted nailing technique. Our inclusion criteria comprised the inclusion of any patient between the ages of 14 and 60 years old with a neglected neck of femur fracture or nonunion of the femur neck. In addition, we only included patients without further posttreatment trauma and without known metabolic diseases. The conditions that were excluded from this study included hip joints with preexisting osteoarthritis, radiographic evidence of avascular necrosis of the femoral head, and associated ipsilateral acetabulum fracture or fracture-dislocation. The fracture characteristics that were selected for the fixator-assisted nailing (FAN) technique were clear signs of pseudoarthrosis (such as sclerosis, clear fracture line defects, and failure of implants), in addition to evidence of varus malalignment. All fractures were Pauwels type III. Radiographs of the pelvis with both hips and a posteroanterior (PA) view of the injured hip were taken. Full weight bearing was allowed in all the patients from the first day postoperatively. Physical therapy was started for pain reduction modalities, stretching, and abductor strengthening. Results: Union of the femur neck fracture and osteotomy site was achieved in all patients. An excellent functional status after four months of follow-up was found based on a modified Harris hip score questionnaire. At follow-up, no patient was suffering from pain or flexion contracture. Preoperative limb length discrepancy (LLD) (cm) was 1.8 ± 0.8 cm and postoperative was 0 ± 0.1 cm, p < 0.001. Preoperative neck-shaft angle (NSA) (o) was 85.6 ± 4.4 and postoperative was 126.9 ± 2.5, p < 0.001. Preoperative Pauwels angle (o) was an average of 50.4 ± 5.9 and postoperative was 31.3 ± 2.5, p < 0.001. Conclusion: Our study indicates that FAN has a high success rate in young patients with nonunited femoral neck fractures.

Fixator-Assisted Nailing for Managing Slipped Capital Femoral Epiphysis Sequelae: A Novel Technique: A Case Report.

CASE: An 18-year-old man with a slipped capital femoral epiphysis treated within in situ screw fixation 5 years earlier presented to our clinic with hip pain, limping, and limited range of motion (ROM) of the left hip. Fixator-assisted nailing (FAN) accompanied by double femoral osteotomies was performed to treat the proximal femoral deformity. At follow-up, the patient had regained full ROM and acceptable alignment of the left lower limb. CONCLUSION: The FAN approach effectively manages proximal femoral deformities in select patients. It requires careful analysis of the deformity, meticulous preoperative planning, and surgeons familiar with both intramedullary nailing and external fixation techniques.

Hypertrophied reversed palmaris longus muscle (pseudotumor) of the forearm causing median nerve compression: a case report.

BACKGROUND: The palmaris longus muscle is considered one of the most anatomically variable muscles in the human body. Localized swelling of the forearm due to hypertrophy of the palmaris longus muscle is rare. CASE PRESENTATION: Here, we report a rare case of a 24-year-old Arab man who presented with a painful mass on his forearm with symptoms of median nerve compression. A full radiological assessment was performed, and he was treated conservatively. CONCLUSION: This case confirmed that a hypertrophied palmaris longus muscle can be the cause of swelling on the forearm and should always be considered in the differential diagnosis. With this report, we aimed to increase awareness regarding the unusual variations of palmaris longus muscle and the importance of using radiological investigations to establish a diagnosis.