Shoulder Pain Management

Weight Management

Prevalence of Chronic Pain in Obesity

Obese people (BMI 30-34.9) are twice as likely to experience chronic pain as people of normal weight. For the severely obese (BMI ≥35), the likelihood of having chronic pain is 4 times higher than normal weight people.¹ Obese people and severely obese people report a high prevalence of chronic pain, 64.8% and 80% respectively. They also have significantly more sites of pain, higher pain frequency and more severe pain.¹

Neck and shoulder chronic pain ranks third, behind the back and lower extremities, as a common site for chronic pain in the obese population.¹

The odds of having shoulder pain or stiffness are 1.5 times higher in obese people compared with people of normal weight.² Shoulder pain can reduce a person’s quality of life by limiting the ability to perform daily activities and work.² Over 50% of participants in one study reported shoulder pain at 3 years follow-up and 90% also reported disability that significantly influenced daily activities.²

Shoulder Pain and Work

The increased risk of chronic pain in the obese may contribute to increased work-related injuries. People with BMI 25-29 are 2.5 times more likely to report shoulder pain and those with BMI ≥30 are nearly 3 times more likely to report shoulder pain in jobs requiring:

• Lifting
• Working in awkward positions
• Repetitive motions
• Exposure to vibration³

Furthermore, research shows that a person with a BMI ≥30 who performs a job with a higher ergonomic posture rating and high hand repetition has a high likelihood of developing upper extremity tendonitis, a condition localized at the shoulder, elbow, wrist or hand. People with a BMI ≥30 are also more likely to report upper extremity tendonitis at baseline screening than those who do not develop upper extremity tendonitis.⁴

For those who experience shoulder pain, physical work may have long-term, irreversible effects.³ A 20 year follow-up of retired people whose jobs were physically demanding showed increased risk of shoulder pain even though the repetitive exposure to demanding physical work was absent.³

Disability

Obese people have reported 30% lower physical function compared with normal weight people. Obese people are more likely to have reduced activity and complete disability due to musculoskeletal pain compared with normal weight people.

• 49% of people with normal weight and 63% of obese people report that pain limits activity >3 days per week.
• 32% of people with normal weight and 49% of obese people report complete disability from pain >3 days per week.⁵

Furthermore, patients who present with chronic pain and are obese may require more intensive treatment for the symptoms of their disability.⁵

Summary

Obesity significantly increases the risk of chronic musculoskeletal pain. Compared with people of normal weight, obese people are much more likely to report chronic shoulder pain or stiffness as well as shoulder pain related to the physical demands of employment. In addition, obese people are more likely to report disability from shoulder pain compared with people of normal weight.

Shoulder pain and disability can lead to reduced quality of life. However, proactive treatment of shoulder pain and early referral to an orthopaedic shoulder specialist may provide earlier relief.

References