Models of care for musculoskeletal shoulder pain in spinal cord injury: A scoping review

The Journal of Spinal Cord Medicine, 2024 · DOI: 10.1080/10790268.2023.2183335 · Published: January 1, 2024

Simple Explanation

Spinal cord injury (SCI) can lead to secondary musculoskeletal shoulder pain, impacting lifestyle, health, and well-being. This review examines research on diagnosis and management of shoulder pain in SCI to identify gaps and inform future research. The review found inconsistencies in methodologies and the literature sometimes values procedures inconsistent with best practice.

Study Duration

Not specified

Participants

Majority people with any kind of SCI

Evidence Level

Scoping Review

Key Findings

1
The most common diagnostic technique was clinical examination, but there was significant heterogeneity in reporting.
2
Exercise was the most commonly reported management strategy, followed by electrophysical agents and surgical interventions.
3
The Wheelchair User’s Shoulder Pain Index was identified as the preferred outcome measure for quantifying shoulder pain in SCI.

Research Summary

This scoping review mapped literature on the diagnosis and management of musculoskeletal shoulder pain in SCI. The review identified inconsistencies in the literature and highlighted gaps in research, particularly the need for more randomized controlled trials. The study encourages collaborative and integrated approaches, combining best practice for musculoskeletal shoulder pain with clinical expertise in SCI management.

Practical Implications

Clinical Practice

Highlights the need for collaboration between musculoskeletal and neurological experts in managing shoulder pain in SCI.

Future Research

Provides a foundation for constructing robust studies to develop a quality model of care for musculoskeletal shoulder pain in the SCI population.

Clinical Tools

May inform the development of clinical tools, such as decision-making algorithms, to assist clinicians in their clinical practice.

Study Limitations

1
Exclusion of articles with SCI population samples below 80% may have excluded relevant articles from the wider wheelchair-using population.
2
Exclusion of articles suggesting direct relationships between pathology and pain may have omitted relevant diagnostic utility factors.
3
The decision not to include studies related to prevention of shoulder pain in SCI limits the scope of the review.

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