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Is Diabetes Associated with Shoulder Pain or Stiffness? Results from a Population Based Study ANTONIA COLE, TIFFANY K. GILL, E. MICHAEL SHANAHAN, PATRICK PHILLIPS, ANNE W. TAYLOR, and CATHERINE L. HILL
ABSTRACT. Methods. Participants were randomly recruited from the North West Adelaide Health Study, a longitudinal, population based study. In the second stage, 3128 participants were assessed for diabetes mellitus and shoulder complaints via questionnaires, the Shoulder Pain and Disability Index (SPADI), physical assessment, blood sampling for fasting plasma glucose, and HbA1c levels. Results. Overall, 682 (21.8%) participants experienced shoulder pain and/or stiffness and 221 participants (7.1%) fulfilled criteria for diabetes mellitus. Those with diabetes had a higher prevalence of shoulder pain and/or stiffness (27.9% vs 21.3%; p = 0.025), and poorer SPADI disability subscore (p = 0.01) and total SPADI score (p = 0.02). After controlling for age, sex, obesity, and current smoking, the prevalence of shoulder pain and/or stiffness did not differ significantly between those with diabetes and those without (OR 1.05, 95% CI 0.76-1.45), nor were there significant differences in the SPADI disability subscore (p = 0.39) or total SPADI score (p = 0.32) between the 2 groups. After adjustment for covariates, there was no association between higher levels of HbA1c and shoulder pain and/or stiffness (p > 0.8). Range of shoulder movement was significantly reduced in those with diabetes (p < 0.05). Conclusions. There is a higher prevalence of shoulder pain and/or stiffness in people with diabetes mellitus. The differences observed between those with diabetes and those without can largely be explained by the confounding factors of age, sex, obesity, and current smoking. (J Rheumatol First Release Nov 15 2008; doi:10.3899/jrheum.080349) Key Indexing Terms:
SHOULDER PAIN From the Department of Rheumatology, The Queen Elizabeth Hospital, Woodville; Population Research and Outcome Studies Unit, SA Department of Health, Adelaide, South Australia; Rheumatology Unit, Repatriation General Hospital, Daw Park; and Endocrinology Unit, The Queen Elizabeth Hospital, Woodville, South Australia, Australia. Funded by the Health Services Improvement Research Program (HSIRP), SA Department of Health. A. Cole, MBChB, Rheumatology Registrar, The Queen Elizabeth Hospital; T.K. Gill, PhD, Senior Epidemiologist, Population Research and Outcome Studies Unit, SA Department of Health; E.M. Shanahan, PhD, Senior Lecturer, Flinders University of South Australia; P. Phillips, MBBS, Senior Director, Endocrinology Unit, The Queen Elizabeth Hospital; A.W. Taylor, PhD, Manager, Population Research and Outcome Studies Unit, SA Department of Health; C.L. Hill, MBBS, Staff Specialist, Rheumatology Unit, The Queen Elizabeth Hospital. Address reprint requests to Dr. C. Hill, Department of Rheumatology, The Queen Elizabeth Hospital, 28 Woodville St., Woodville, South Adelaide, South Australia 5006, Australia. Accepted for publication September 5, 2008.
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