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
Carpal Tunnel Syndrome: How does traditional hand therapy compare with neurodynamic therapy?
Hamzeh, H., Mohammad, M., Alghwiri, A., & Hawamdeh, Z. (2021). The long-term effect of neurodynamics vs. exercise therapy on pain and function in people with carpal tunnel syndrome: A randomized parallel-group clinical trial. Journal of Hand Therapy, 34, 521-530. The Skinny: Carpal tunnel is the most common peripheral nerve compression problem. There is now some…
Read More
CMC Arthritis Orthosis in the Hand: Mechanics and Purpose
One of the most common diagnoses we see in hand therapy is osteoarthritis of the 1st carpo-metacarpal joint where the metacarpal articulates with the trapezium. Also known as basal joint arthritis (CMC arthritis), this causes pain, joint deformity, loss of strength and loss of function. Patients come to us looking for relief of symptoms and…
Read More
Article Review: Relative Motion for Extensor Tendon Repair zone V-VI? Is a night-time resting hand orthosis beneficial?
Hirth, M. J., Hunt, I., Briody, K., Milner, Z., Sleep, K., Chu, A., Donovan, E. & O’Brien, L. (2021). Comparison of two relative motion extension orthotic programs following surgical repair of finger extensor tendons in zones V-VI: A randomized equivalence trial. Journal of Hand Therapy-to be published. The Skinny: Following a zone V-VI tendon repair,…
Read More
EDS 101: Understanding Hypermobility in the Hand Therapy Setting
EDS in the Hand Therapy Setting General Overview:Ehlers Danlos Syndrome (EDS) is a group of heritable connective tissue disorders caused bygenetic changes that affect collagen production, the protein responsible for strength and elasticityin skin, ligaments and tendons (The Ehlers Danlos Society, 2016). There are thirteen forms of EDS that each have their own set of…
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.