title: Intensity and distribution of shoulder pain in patients with different sized postero-superior rotator cuff tears.
abstract: BACKGROUND
  The vast majority of studies regarding rotator cuff tears (RCTs) are focused on etiopathogenesis and treatments, but information on shoulder pain characteristics needs further investigation. We analyzed the intensity and distribution of shoulder pain in patients with different sizes of RCTs.
  
  
  METHODS
  Two hundred eighty-five consecutive patients with postero-superior RCTs were enrolled for this study. Tear size was intraoperatively classified. Before surgery, all patients completed an upper limb pain map (dermatome map made by Keegan). Shoulder pain intensity was assessed with a visual analogue scale (VAS). Data were submitted to statistical analysis.
  
  
  RESULTS
  Shoulder pain intensity caused by a RCT was greater in females (P = .024); it did not vary with the side nor with age. Pain intensity was less in massive tears (P < .05) and in patients whose pain was distributed only to the shoulder (P = .035). Furthermore, patients whose pain persisted for more than 6 months maintained the same pain intensity. Pain was localized predominantly on dermatomes C5-C6, was more diffuse in massive tears (P < .05), and rarely extended beyond the elbow. In the presence of intense shoulder pain, its precise distribution was not well-delimited.
  
  
  CONCLUSIONS
  Shoulder pain characteristics in patients with RCTs may be influenced by gender and size of tear. Cuff tear pain distribution principally involves the antero-lateral aspect of the shoulder with extension down the lateral surface of the arm to the elbow. Information about pain intensity and distribution in patients with RCTs may contribute to a more accurate diagnosis.
  
  
  METHODS
  Level III, cross sectional study.
authors.affiliation: Shoulder and Elbow Unit, Department of Orthopaedics and Traumatology, University Sapienza, Rome, Italy. Electronic address: gumina@tiscali.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Gumina
authors.affiliation: Shoulder and Elbow Unit, Department of Orthopaedics and Traumatology, University Sapienza, Rome, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Candela
authors.affiliation: Shoulder and Elbow Unit, Department of Orthopaedics and Traumatology, University Sapienza, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Passaretti
authors.affiliation: Shoulder and Elbow Unit, Department of Orthopaedics and Traumatology, University Sapienza, Rome, Italy; Physical Medicine and Rehabilitation Unit, Department of Orthopaedics and Traumatology, University Sapienza, Rome, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Venditto
authors.affiliation: Shoulder and Elbow Unit, Department of Orthopaedics and Traumatology, University Sapienza, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Carbone
authors.affiliation: Shoulder and Elbow Unit, Department of Orthopaedics and Traumatology, University Sapienza, Rome, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Arceri
authors.affiliation: Shoulder and Elbow Unit, Department of Orthopaedics and Traumatology, University Sapienza, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giannicola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D000070636:Rotator Cuff Injuries; D020069:Shoulder Pain / Q000209:etiology
keywords: Rotator cuff tear; pain distribution; pain intensity; shoulder pain