What is the incidence of musculoskeletal complaints in the elbow, shoulder, and neck after hand and forearm injuries?

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 Therapists34(4), 543–548. https://doi.org/10.1016/j.jht.2020.05.002

shoulder elbow hand therapy

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

  1. Stacey Yohner on December 6, 2021 at 10:44 am

    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.

  2. Rosenda on December 6, 2021 at 6:39 pm

    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.

Leave a Comment






More To Read

Stretching Alone Can Change P1 Bone Shape in Patients with Camptodactyly

May 20, 2019

Woo Hong, S. Kim, J., Sang Kwon, O., Ho Lee, M., Sik Gong, H., Hyun Baek, G., (2019). Radiographic Remodeling of the Proximal Phalangeal Head Using a Stretching Exercise in Patients With Camptodactyly. J Hand Surg Am, 1.e1-1.e10 The Skinny – Camptodactyly is a congenital, nontraumatic flexion contracture of the PIP in fingers other than…

Dorsal Wrist Pain?

August 16, 2020

Incorporating Emerging Evidence into Clinical Practice for Patients Experiencing Dorsal Wrist Pain During Weight-Bearing Activities By: Brittany Day Supporting Evidence A randomized control study recently published in the Journal of Hand Therapy found rigid carpal stabilizing taping (CST) to significantly increase passive range of motion, active range of motion, and decrease pain in patients experiencing…

Do you know the secret ingredient to recovering from an injury?

July 14, 2019

Do you know the secret ingredient to recovering from an injury? I will give you a hint it is 5 letters and begins with the letter S.     SLEEP Have you ever asked yourself a question – does sleep help injuries heal? This is for you to share with your patients but also serve as a…

Functional Home Exercises for Patients with Wrist Instability

June 29, 2024

Functional Home Exercises for Patients with Wrist Instability Ever wondered what brushing your teeth, dressing, making a U-turn, and playing sports have in common? They all rely on a stable wrist. Wrist stability is crucial for everyday activities, supporting wrist proprioception, coordination, motor control, stability, and mobility (Wietlisbach, 2019). For patients recovering from a wrist…

Envelope_1

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.