Doctoral Thesis
Shouldering the Load: An Investigation of Prevalence, Psychosocial Correlates, and Patterns of Shoulder Pain
Doctor of Philosophy (PhD), Murdoch University
DOI:
https://doi.org/10.60867/00000043
Abstract
Shoulder pain (SP) is prevalent, debilitating, and costly. Research into patients’ pain experiences is limited. My thesis examines SP prevalence across adult generations, its association with occupational, physical, and psychological factors, and compares pain experiences of individuals receiving surgical or conservative treatment.
I systematically reviewed studies reporting SP prevalence or incidence in occupational groups, stratified by age. From 20 studies, SP prevalence increased with age among physically demanding occupations. Lower post-retirement estimates, indicated in previous literature, may reflect reduced occupational exposure.
In two large community cohorts spanning early adulthood (20-24 years; n = 1128) and mid-tolate adulthood (40-80 years; n = 1098), I analysed SP rates and associations with physical work, general activity, depression, and anxiety. Young females had higher SP rates and four times the rate of bilateral SP compared to males. Adults over 65 reported less SP, but physically demanding occupations increased rates. Depression and anxiety were associated with higher SP prevalence in both groups, while general physical activity was not.
In a longitudinal cohort of 176 patients with shoulder pain, tracked over 12 months using SMSbased monitoring, I analysed guideline adherence, attrition bias, pain persistence, and recovery/trajectory patterns, comparing surgical and conservative treatments. Surgical participants initially experienced more persistent pain; however, both groups improved over 12 months. Persistent pain was rare, though the surgery group (n=36) had more participants (29/36, 80%) with at least one persistent pain fortnight than the conservative group (n=140) (25/140, 18%). Many participants (40%) did not reach sustained recovery, with most experiencing fluctuating or episodic pain. Recovery patterns and pain trajectories did not significantly differ between treatments.
My thesis demonstrates that SP prevalence is associated with occupational and psychological factors, not general physical activity. Pain experiences vary, with many SP patients displaying episodic or fluctuating pain regardless of treatment. These findings support reframing patient education and future research to focus on dynamic pain patterns.
Details
- Title
- Shouldering the Load: An Investigation of Prevalence, Psychosocial Correlates, and Patterns of Shoulder Pain
- Authors/Creators
- Christopher J Hodgetts
- Contributors
- Yvonne C Learmonth (Supervisor) - Murdoch University, School of Allied HealthLee Daffin (Supervisor) - Murdoch University, School of Allied HealthOlivier Gagey (Supervisor)
- Awarding Institution
- Murdoch University; Doctor of Philosophy (PhD)
- Identifiers
- 991005845963107891
- Murdoch Affiliation
- School of Allied Health
- Resource Type
- Doctoral Thesis
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