KaydedilenlerDerginizi ekleyin

Dergiler / The European Research Journal / 2025 / Volume: 11 Issue: 6

Subacromial injection failure in shoulder impingement: is somatic amplification the missing link?

Ömer Faruk Bucak(Department of Physical Medicine and Rehabilitation, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye)0000-0003-3995-8120
Emine Cengiz Çavuşoğlu(Department of Psychiatry, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye)0000-0001-9333-6715
Adil Öncel(Department of Physical Therapy and Rehabilitation, Nişantaşı University Faculty of Medicine, BHT Clinic İstanbul Tema Hospital, İstanbul, Türkiye)0000-0002-9792-217X
Eser Kalaoğlu(Department of Physical Therapy and Rehabilitation, İstanbul Physical Therapy Rehabilitation Training and Research Hospital, İstanbul, Türkiye)0000-0001-8959-6522
Sayfa
—
Yayın Tarihi
2025-11-04
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

These findings support the importance of including psychosomatic assessment in routine care to improve treatment outcomes and guide more personalized management.

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:Objectives: To investigate whether somatosensory amplification - a heightened sensitivity to normal bodily sensations - affects the clinical response to corticosteroid injection in shoulder impingement syndrome (SIS) patients who did not respond to conservative treatment.
📊
Temel Bulgular & Veri:Methods: This prospective observational study included 70 patients with SIS and persistent pain despite at least four weeks of physical therapy and non-steroidal anti-inflammatory drugs (NSAIDs).
💡
Sonuç & Katkı:These findings support the importance of including psychosomatic assessment in routine care to improve treatment outcomes and guide more personalized management.
🔬Tür:Uygulamalı Anket & Alan Araştırması
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Shoulder impingement · ultrasound · subacromial injection

Abstract

Objectives: To investigate whether somatosensory amplification - a heightened sensitivity to normal bodily sensations - affects the clinical response to corticosteroid injection in shoulder impingement syndrome (SIS) patients who did not respond to conservative treatment. Methods: This prospective observational study included 70 patients with SIS and persistent pain despite at least four weeks of physical therapy and non-steroidal anti-inflammatory drugs (NSAIDs). All patients received a standardized corticosteroid injection into the subacromial space under ultrasound guidance. Pain intensity was measured using the Visual Analog Scale (VAS) at rest (VAS-rest) and during movement (VAS-movement), while shoulder-related disability was assessed with the Shoulder Pain and Disability Index (SPADI) at baseline and one month after the injection. Somatosensory amplification - referring to increased sensitivity to normal bodily sensations—was evaluated using the Somatosensory Amplification Scale (SSAS), a brief self-report questionnaire administered at the one-month follow-up by a psychiatrist blinded to clinical outcomes. Treatment response was defined as a ≥30% reduction in VAS-movement, based on the minimal clinically important difference (MCID). Patients were categorized as responders or non-responders accordingly. Results: Thirty (42.9%) patients were classified as responders and 40 (57.1%) as non-responders. At 1-month, non-responders had significantly higher SSAS scores than responders (30.7 [27.4-32.6] vs. 21.5 [19.4-23.4], P<0.001). Compared to non-responders, the responder group demonstrated more significant improvements in VAS-rest, VAS-movement, and SPADI scores (P<0.001 for all). Spearman correlation analysis revealed strong positive correlations between SAS and VAS-rest (r=0.732), VAS-movement (r=0.748), and SPADI (r=0.734); P<0.001 for all. Conclusions: Higher levels of somatosensory amplification were linked to a lower likelihood of benefiting from subacromial injection in SIS. These findings support the importance of including psychosomatic assessment in routine care to improve treatment outcomes and guide more personalized management.

🔖

Bu Makaleye Atıf Yap

Bucak, Ö. F., Çavuşoğlu, E. C., Öncel, A., Kalaoğlu, E. (2025). Subacromial injection failure in shoulder impingement: is somatic amplification the missing link?. The European Research Journal, Volume: 11 Issue: 6. https://doi.org/10.18621/eurj.1668332

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (36)

  1. Luime JJ, Koes BW, Hendriksen IJ, et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol. 2004;33(2):73-81. doi: 10.1080/03009740310004667.
  2. Garving C, Jakob S, Bauer I, Nadjar R, Brunner UH. Impingement Syndrome of the Shoulder. Dtsch Arztebl Int. 2017;114(45):765-776. doi: 10.3238/arztebl.2017.0765.
  3. Linaker CH, Walker-Bone K. Shoulder disorders and occupation. Best Pract Res Clin Rheumatol. 2015;29(3):405-423. doi: 10.1016/j.berh.2015.04.001.
  4. de la Serna D, Navarro-Ledesma S, Alayon F, Lopez E, Pruimboom L. A Comprehensive View of Frozen Shoulder: A Mystery Syndrome. Front Med (Lausanne). 2021;8:663703. doi: 10.3389/fmed.2021.663703.
  5. Park HB, Yokota A, Gill HS, El Rassi G, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am. 2005;87(7):1446-1455. doi: 10.2106/JBJS.D.02335.
  6. Metin Terzibaşıoğlu A, Çınar Ç, Soluk Özdemir Y, Doran M, Bagatır N, Öneş K. Ultrasound-guided subacromial corticosteroid injections in comparison to anatomic landmark guided injections in subacromial impingement syndrome. Arch Health Sci Res. 2022;9(3):180-185. doi: 10.5152/ArcHealthSciRes.2022.22055.
  7. Khan KM, Cook JL, Taunton JE, Bonar F. Overuse tendinosis, not tendinitis part 1: a new paradigm for a difficult clinical problem. Phys Sportsmed. 2000;28(5):38-48. doi: 10.3810/psm.2000.05.890.
  8. Karjalainen TV, Jain NB, Page CM, et al. Subacromial decompression surgery for rotator cuff disease. Cochrane Database Syst Rev. 2019 Jan 17;1(1):CD005619. doi: 10.1002/14651858.CD005619.pub3.
  9. Coronado RA, Simon CB, Valencia C, George SZ. Experimental pain responses support peripheral and central sensitization in patients with unilateral shoulder pain. Clin J Pain. 2014;30(2):143-151. doi: 10.1097/AJP.0b013e318287a2a4.
  10. Sheikhzadeh A, Wertli MM, Weiner SS, Rasmussen-Barr E, Weiser S. Do psychological factors affect outcomes in musculoskeletal shoulder disorders? A systematic review. BMC Musculoskelet Disord. 2021;22(1):560. doi: 10.1186/s12891-021-04359-6.
  11. Martinez-Calderon J, Meeus M, Struyf F, Miguel Morales-Asencio J, Gijon-Nogueron G, Luque-Suarez A. The role of psychological factors in the perpetuation of pain intensity and disability in people with chronic shoulder pain: a systematic review. BMJ Open. 2018;8(4):e020703. doi: 10.1136/bmjopen-2017-020703.
  12. Barsky AJ, Wyshak G, Klerman GL. The somatosensory amplification scale and its relationship to hypochondriasis. J Psychiatr Res. 1990;24(4):323-34. doi: 10.1016/0022-3956(90)90004-a.
  13. Güleç H, Sayar K. Reliability and validity of the Turkish form of the Somatosensory Amplification Scale. Psychiatry Clin Neurosci. 2007;61(1):25-30. doi: 10.1111/j.1440-1819.2007.01606.x.
  14. Nijs J, Leysen L, Vanlauwe J, et al. Treatment of central sensitization in patients with chronic pain: time for change? Expert Opin Pharmacother. 2019;20(16):1961-1970. doi: 10.1080/14656566.2019.1647166.
  15. Linton SJ, Shaw WS. Impact of psychological factors in the experience of pain. Phys Ther. 2011;91(5):700-11. doi: 10.2522/ptj.20100330.
  16. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S240-52. doi: 10.1002/acr.20543.
  17. Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991;4(4):143-149.
  18. Bumin G, Tüzün EH, Tonga E. The Shoulder Pain and Disability Index (SPADI): Cross-cultural adaptation, reliability, and validity of the Turkish version. J Back and Musculoskelet Rehabil. 2008;21(1):57-62. doi:10.3233/BMR-2008-21108.
  19. Dworkin RH, Turk DC, Wyrwich KW, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain. 2008;9(2):105-121. doi: 10.1016/j.jpain.2007.09.005.
  20. Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehabil. 2011;92(12):2041-2056. doi: 10.1016/j.apmr.2011.07.198.
  21. Wolfe F, Hauser W. Fibromyalgia diagnosis and diagnostic criteria. Ann Med. 2011;43(7):495-502. doi: 10.3109/07853890.2011.595734.
  22. Meeus M, Nijs J. Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome. Clin Rheumatol. 2007;26(4):465-473. doi: 10.1007/s10067-006-0433-9.
  23. Giesecke T, Gracely RH, Williams DA, et al. The relationship between depression, clinical pain, and experimental pain in a chronic pain cohort. Arthritis Rheum. 2005;52(5):1577-1584. doi: 10.1002/art.21008.
  24. Akay E, Şenormancı Ö, Eröksüz R, Şenormancı G, Demirci OO. The effect of psychopathology on quality of life and disability in patients with fibromyalgia. Eur Res J. 2022;8(1):103-110. doi:10.18621/eurj.854956.
  25. Fallon N, Li X, Chiu Y, Nurmikko T, Stancak A. Altered cortical processing of observed pain in patients with fibromyalgia syndrome. J Pain. 2015;16(8):717-726. doi: 10.1016/j.jpain.2015.04.008.
  26. Barsky AJ, Wyshak G, Klerman GL. The somatosensory amplification scale and its relationship to hypochondriasis. J Psychiatr Res. 1990;24(4):323-334. doi: 10.1016/0022-3956(90)90004-a.
  27. Meeus M, Nijs J, Huybrechts S, Truijen S. Evidence for generalized hyperalgesia in chronic fatigue syndrome: a case control study. Clin Rheumatol. 2010;29(4):393-398. doi: 10.1007/s10067-009-1339-0.
  28. Chiarotto A, Deyo RA, Terwee CB, et al. Core outcome domains for clinical trials in non-specific low back pain. Eur Spine J. 2015;24(6):1127-1142. doi: 10.1007/s00586-015-3892-3.
  29. Lumley MA, Schubiner H, Lockhart NA, et al. Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia: a cluster-randomized controlled trial. Pain. 2017;158(12):2354-2363. doi: 10.1097/j.pain.0000000000001036.
  30. Lepri B, Romani D, Storari L, Barbari V. Effectiveness of Pain Neuroscience Education in Patients with Chronic Musculoskeletal Pain and Central Sensitization: A Systematic Review. Int J Environ Res Public Health. 2023;20(5):4098. doi: 10.3390/ijerph20054098.
  31. Williams ACC, Fisher E, Hearn L, Eccleston C. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev. 2020;8(8):CD007407. doi: 10.1002/14651858.CD007407.pub4.
  32. Shin S, Kim H. Carryover Effects of Pain Neuroscience Education on Patients with Chronic Lower Back Pain: A Systematic Review and Meta-Analysis. Medicina (Kaunas). 2023;59(7):1268. doi: 10.3390/medicina59071268.
  33. Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007;133(4):581-624. doi: 10.1037/0033-2909.133.4.581.
  34. Nijs J, Meeus M, Cagnie B, et al. A modern neuroscience approach to chronic spinal pain: combining pain neuroscience education with cognition-targeted motor control training. Phys Ther. 2014;94(5):730-738. doi: 10.2522/ptj.20130258.
  35. Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152(3 Suppl):S2-S15. doi: 10.1016/j.pain.2010.09.030.
  36. Neblett R, Cohen H, Choi Y, et al. The Central Sensitization Inventory (CSI): establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample. J Pain. 2013;14(5):438-445. doi: 10.1016/j.jpain.2012.11.012.