Like lower back injuries and back pain, upper extremity disorders can cause significant economic and quality-of-life costs. Traditionally, the estimated prevalence rates of upper extremity disorders range from two percent to 53 percent. The 12-month range is almost equally as broad, ranging from two percent to 41 percent.
The need for a consistent use of terminologies and classifications is vital in order for the medical community to accurately assess the impact of complaints of arm, neck, and/or shoulder (CANS). This was done and a definition was issued: “musculoskeletal complaints of arm, neck and shoulder not caused by acute trauma or by any systematic disease.”
The authors of this article evaluated data in order to determine the prevalence of specific and nonspecific CANS, the patients’ contact with healthcare professionals, the relationship between the health and sickness absence characteristics and patient use of healthcare, and the overlap of pain locations visualized within CANS.
Using the results of a study done in the Netherlands, involving responses from 3664 people, researchers assessed the baseline data regarding symptoms in the neck, shoulder, elbow and wrist/hand. Patients who had symptoms caused by acute trauma or a systemic disease were excluded from the assessment.
the researchers found that, according to the CANS definition, 48 percent of the Dutch population who were over 25 years old reported upper extremity disorders (UEDs) within the previous year, and 36.8 percent reported CANS. Almost 37 percent of those with UEDs had them at the time of the survey. Of these patients, 27.2 percent met the criteria for chronic pain. for patients who reported CANS, 26.4 percent reported current CANS and 19 percent met the criteria for chronic pain.
Examining the demographics of the people with UEDs and CANs, the researchers noted that CANs were more prevalent in women and most common among those between the ages of 45 and 64 years. With chronic CANS, 58 percent said they had sought medical help; more women than men sought help. There was also a difference between working and nonworking populations – those who worked were more likely to seek medical help.
For the study, all subjects completed the Short Form 36, SF-36, which is questionnaire that assesses general health. The scores range from zero to 100; the higher the score, the better the health. People with chronic CANS scored higher on the SF-36 than did those with UEDs. subjects with UEDs were more likely to see a doctor if they were affected by a systemic disease or had sustained a trauma, which caused the UED. Among all subjects who used healthcare services more, there were more complaints of continuous and recurrent pain, more limitations on daily life, and more sickness absence because of CANS.
The authors point out some weaknesses in the study, which include the relatively low response rate of the original questionnaire. Out of 8000 questionnaires sent out, only 46.9 percent were returned. As well, much of the information was based on subject self-reporting and patient recall. However, despite the study drawbacks, the authors do state that their study showed that slightly fewer than 60 percent of subjects with CANS sought medical treatment and those are the ones who complained of more pain and disability. The prevalence of CANS was higher in the working population and among women. The area affected, the neck and shoulders were most commonly reported as being troublesome.