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Abstract

Objective

Irritability utilises pain behaviour during movement to inform examination and treatment intensity. Standardised measures of movement-evoked pain have not previously been applied to irritability. This study examined whether shoulder pain during standard movements differed by irritability category and level.

Design

Observational study

Setting

Research laboratory

Participants

Participants with shoulder pain (n=40)

Intervention

Irritability was assessed followed by psychological questionnaires (Fear of Pain Questionnaire, Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Center for Epidemiologic Studies-Depression, State-Trait Anger Expression Inventory, Pain Anxiety Symptoms Scale, Pain Self-Efficacy Questionnaire), quantitative sensory testing (pressure pain threshold, heat pain threshold, conditioned pain modulation, temporal summation), and movement-evoked pain (lifting, functional movements, repetitive movements, self-selected task).

Main measures

Shoulder pain intensity was assessed before, during, and after each task. A t-test and ANOVA examined differences in each movement task by irritability.

Results

Pain during the standardised lifting task was significantly higher in individuals categorised as irritable (p=0.03) than not irritable, as well as high irritability compared to moderate (p<0.01). Pain during functional movements was significantly higher in individuals categorised as irritable (p<0.01) compared to not, as well as high compared to low irritability (p<0.01). Performance on repetitive tasks did not significantly differ by irritability category (p=0.63) or level (p=0.44). Change in pain ratings during the self-selected task did not differ by irritability category (p=0.67) or level (p=0.95).

Conclusions

Pain during standardised, functional movements may differentiate irritability. Clinicians may want to consider functional testing in which pain is assessed during movement for patients with irritable shoulder pain.

Keywords

Irritability Maitland movement-evoked pain shoulder pain

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Shoulder irritability differs by standardised measures of movement-evoked pain