What is the incidence of musculoskeletal complaints in the elbow, shoulder, and neck after hand and forearm injuries?
Filed under Reviews
Winiarski, L. M., Livoni, J. D., Madsen, P. V., Rathleff, M. S., & Larsen, P. (2021). Concurrent musculoskeletal complaints in elbows, shoulders, and necks after common hand and forearm injuries or conditions: A cross-sectional study among 600 patients. Journal of hand therapy: official journal of the American Society of Hand Therapists, 34(4), 543–548. https://doi.org/10.1016/j.jht.2020.05.002
The Skinny:
The authors looked to determine what the incidence of shoulder elbow and neck pain after sustaining a typical hand and forearm injury. Isolated hand injuries account for 20-29% of hand and forearm injuries in emergency rooms and orthopedic departments. Oftentimes pain associated in the upper quadrant beyond the injury is neglected and ignored. The authors hoped to bring awareness to these concurrent musculoskeletal issues.
In the Weeds:
The authors used a cross-sectional study. The study used patients that were referred to the shoulder elbow hand therapy department for an isolated hand or forearm injury. The patients were asked two basic questions.
1.) do you currently have pain and/or stiffness in the elbow, shoulder, or neck?
If yes then,
2.) did the symptoms develop before or after their hand and forearm injury?
If the patient answered yes to question 1 and stated the symptoms developed after the hand or forearm injury they were included in the study.
Bringing it Home:
The study took place for 15 months and a total of 600 patients met the eligibility requirements. The average age of patients was 49.1 years with the largest diagnostic group being distal radius and ulna fractures, ligament lesions in fingers (16%), finger fractures (14%). The common areas of concurrent pain were the shoulder (62%), elbow (49%), and the neck (32%”). Thirty-eight percent of patient reports multiple areas of musculoskeletal or stiffness in two or three regions of the upper quadrant and neck.
Rating 4/5.
The study brings attention to the continued need to address the entire upper quadrant when a patient sustains a hand, wrist, or forearm injury. In the future, it would be helpful to publish outcomes after addressing the musculoskeletal impairments to help justify the need for occupational and physical therapy services to prevent long-term pathologies.
2 Comments
Leave a Comment
More To Read
Increasing Shoulder Range of Motion by improving Scapulohumeral Rhythm
Scapulohumeral rhythm is often the key component when treating shoulder conditions and the reason for the lack of total shoulder range of motion. This may also be a critical component in order to prevent shoulder conditions during rehabilitation of other upper extremity conditions such as distal radius fractures, tendon injuries, and elbow injuries. Scapulohumeral rhythm…
Read More
Pediatric & Adolescent Shoulder Instability
Lin, K.M, James, E.W., Spitze, E. & Fabricant, P.D. (2018). Pediatric and adolescent anterior shoulder instability: Clinical management of first-time dislocators. Current opinion in pediatrics, 30, 49-56. doi: 10.1097/MOP.0000000000000566. The Skinny: Shoulder instability for pediatric and adolescent patients is fairly common and is often complicated by a high re-dislocation rate. Shoulder instability typically occurs after…
Read More
Soft Tissue Healing in Pediatrics
By: Chelsea Gonzalez Why do pediatric clients often not require as much hand therapy for soft tissue injuries when compared to adults? The simple answer: Kids have very elastic soft tissue, which can return to its original shape and position after stretch. This elasticity is lost with time as collagen fibers expand and their internal…
Read More
Flexor tendon rehabilitation in the 21st century: A systematic review
Neiduski, R. L. & Powell, R. K. (2019). Flexor tendon rehabilitation in the 21st century: A systematic review. Journal of Hand Therapy, 32, 165-174. The Skinny The objective of the study was to determine if there was evidence to support 1 type of exercise regimen. Exercise regimens reviewed include place and holds, early passive or…
Read More
Sign-up to Get Updates Straight to Your Inbox!
Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.
Thank you for this article. Trying to justify therapy beyond the specific joint a patient is brought in for can be frustrating. We need more research like this.
Great, good article.
At times patients are not necessarily believed and areas of discomfort are neglected. We forget there is fascia, and dermatomes that connect all structures, and will affect above or below the injured site.