title: Musculoskeletal pain and overuse syndromes in adult acquired major upper-limb amputees.
abstract: OBJECTIVE
  (1) To compare the prevalence of self-reported musculoskeletal pain in upper-limb amputees (ULAs) in Norway with that of a control group drawn from the Norwegian general population; (2) to describe musculoskeletal pain bothersomeness in ULAs; (3) to estimate the association between prosthesis wear and self-reported musculoskeletal pain in ULAs; and (4) to describe the occurrence of musculoskeletal overuse syndromes in a sample of ULAs.
  
  
  METHODS
  Cross-sectional study: postal questionnaires and clinical examinations.
  
  
  METHODS
  Norwegian ULA population. Clinical examinations performed at 3 clinics.
  
  
  METHODS
  Questionnaires: population-based amputee sample (n=224; 57.4% response rate). Random control sample (n=318; 33.1% response rate). Clinical examinations: combined referred sample and convenience sample (n=70; 83.3% of those invited). Survey inclusion criteria: adult, resident in Norway and mastering Norwegian (amputees and controls), acquired major upper-limb amputation (amputees only).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Self-reported musculoskeletal pain and pain bothersomeness. Self-reported pain in prosthesis wearers and nonwearers. Clinically assessed diagnoses of musculoskeletal overuse syndromes.
  
  
  RESULTS
  Self-reported musculoskeletal pain was more frequent in ULAs than in the control group except for lower back pain. In ULAs, 57.0% reported neck/upper back pain (odds ratio [OR]=2.56; 95% confidence interval [CI], 1.64-3.98), and 58.9% reported shoulder pain (OR=4.00; 95% CI, 2.51-6.36). The percentage difference for arm pain was 24.8% (P<.001). All pain was reported as bothersome. We found no difference in pain prevalence between prosthesis wearers and nonwearers. Musculoskeletal overuse syndromes were found in 6.1% to 24.2% of ULAs, depending on diagnosis and case-definition criteria.
  
  
  CONCLUSIONS
  Upper-limb loss increases the risk of self-reported musculoskeletal pain in the neck/upper back, shoulders, and in the remaining arm. Prosthesis wear does not prevent musculoskeletal pain. Further studies should be conducted to investigate the effects of prosthesis wear and possible preventive measures, and to ascertain our preliminary prevalence estimates of overuse syndromes.
authors: Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Ottestad, Norway. kristin.ostlie@sykehuset-innlandet.no
authors: Kristin
authors: K
authors: Ostlie
authors: Rosemary J
authors: RJ
authors: Franklin
authors: Ola H
authors: OH
authors: Skjeldal
authors: Anders
authors: A
authors: Skrondal
authors: Per
authors: P
authors: Magnus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000674:Amputees / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D012090:Cumulative Trauma Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology; D009408:Nerve Compression Syndromes / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology*; D010147:Pain Measurement; D015995:Prevalence; D019534:Shoulder Impingement Syndrome / Q000453:epidemiology / Q000503:physiopathology; D055815:Young Adult