Neuropathic pain in patients with rotator cuff tears.
Recent studies have confirmed the existence of neuropathic pain (NeP) components in patients with musculoskeletal disorders. However, the presence of NeP in patients with rotator cuff tears has not been investigated thus far. Therefore, we studied the prevalence of NeP and the prognostic factors for NeP in patients with rotator cuff tears.



Data were collected from 110 patients with rotator cuff tears, diagnosed by physical examination and magnetic resonance imaging, who attended an outpatient clinic between August 2013 and August 2014. The measured parameters included visual analog scale (VAS) pain scores, painDETECT questionnaire (PDQ) responses, a physical examination, and magnetic resonance imaging. To evaluate the factors associated with NeP, we performed a two-stage analysis. For univariate analysis, we used the Mann-Whitney U test. For multivariate analysis, forward stepwise regression was performed using factors that demonstrated statistical significance in the univariate analysis.



Patients were classified into three groups according to their PDQ score: an NeP group (n = 12; 10.9 %), possible NeP group (n = 33; 30.0 %), and a nociceptive pain (NoP) group (n = 65; 59.1 %). In the univariate analysis between the NeP group and NoP group, NeP was affected by sex (p = 0.034), VAS score (average pain during the past 4 weeks; p = 0.013), and positive Neer and Hawkins impingement signs (p = 0.039). In the multivariate analysis, VAS score (p = 0.031) was an independent prognostic factor for NeP.



Using the PDQ, we found that 10.9 % of patients with rotator cuff tears may have NeP. The VAS score (average pain during the past 4 weeks) was a prognostic factor for NeP. Clinicians should remain vigilant for heterogeneous etiologies of pain in patients with rotator cuff tears.
Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Central Ward, Kumamoto City, 860-8556, Japan.
Tatsuki
T
Karasugi
Department of Advanced Joint Reconstructive Surgery, Kumamoto University Hospital, Kumamoto University, 1-1-1, Honjo, Central Ward, Kumamoto City, 860-8556, Japan. ide@kumamoto-u.ac.jp.
Junji
J
Ide
Kumamoto Orthopaedic Hospital, 1-15-7, Kuhonji, Central Ward, Kumamoto City, 862-0976, Japan.
Toshio
T
Kitamura
Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Central Ward, Kumamoto City, 860-8556, Japan.
Nobukazu
N
Okamoto
Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Central Ward, Kumamoto City, 860-8556, Japan.
Takuya
T
Tokunaga
Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Central Ward, Kumamoto City, 860-8556, Japan.
Hiroshi
H
Mizuta
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009437:Neuralgia / Q000453:epidemiology* / Q000209:etiology; D059226:Nociceptive Pain / Q000453:epidemiology* / Q000209:etiology; D010147:Pain Measurement; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries / Q000150:complications* / Q000000981:diagnostic imaging; D020069:Shoulder Pain / Q000453:epidemiology / Q000209:etiology*
Neuropathic pain; Nociceptive pain; Rotator cuff tear; painDETECT questionnaire