Non-adherence to pain medication increases risk of postoperative frozen shoulder
Background: Postoperative frozen shoulder (FS) or adhesive capsulitis is a relatively frequent complication (5-20%), even after simple arthroscopic shoulder surgeries. The pathophysiology is still unclear, but psychological factors may play a pivotal role. From clinical experience, we hypothesized t...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | International Journal of Preventive Medicine |
| Subjects: | |
| Online Access: | http://www.ijpvmjournal.net/article.asp?issn=2008-7802;year=2021;volume=12;issue=1;spage=115;epage=115;aulast=Niehaus |
| _version_ | 1818722202785153024 |
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| author | Richard Niehaus Lukas Urbanschitz Jakob Schumann Christopher G Lenz Florian A Frank Stefan Ehrendorfer Karim Eid |
| author_facet | Richard Niehaus Lukas Urbanschitz Jakob Schumann Christopher G Lenz Florian A Frank Stefan Ehrendorfer Karim Eid |
| author_sort | Richard Niehaus |
| collection | DOAJ |
| description | Background: Postoperative frozen shoulder (FS) or adhesive capsulitis is a relatively frequent complication (5-20%), even after simple arthroscopic shoulder surgeries. The pathophysiology is still unclear, but psychological factors may play a pivotal role. From clinical experience, we hypothesized that patients, who are reluctant to take medications, particularly “pain-killers,” have an increased incidence of postoperative FS. Methods: We identified twenty patients who underwent limited arthroscopic operations of the shoulder and developed postoperative FS. Twenty patients with matching type of surgery, age, and gender served as control group (n = 20). All patients were at least one year postoperative and asymptomatic at the time of examination. Demographic data, the patient's adherence to self-medication (including self-medicating scale, SMS), development the Quality of life (QoL), and depression scale (PHQ-4-questionnaire) were assessed. Results: Patients with FS had a 2-fold longer rehabilitation and 3-fold longer work inability compared to the patients without FS (P < 0.009 and P < 0.003, respectively). Subjective shoulder value SSV (P = 0.075) and post-operative improvement of QoL (P = 0.292) did not differ among the groups. There was a trend—but not significant—toward less coherence to self-medication in the FS-group (26.50 vs. 29.50; P = 0.094). Patients with postoperative FS significantly more often stated not to have “taken pain-killers as prescribed” (P = 0.003). Conclusions: Patients reporting unwillingness to take the prescribed pain medications had a significantly higher incidence of postoperative FS. It remains unclear whether the increased risk of developing FS is due to reduced postoperative analgesia or a critical attitude toward taking medication. However, patients who are reluctant to take painkillers should strongly be encouraged to take medications as prescribed. |
| first_indexed | 2024-12-17T20:50:53Z |
| format | Article |
| id | doaj.art-02f282cd9cda4974b4670d544674527d |
| institution | Directory Open Access Journal |
| issn | 2008-7802 2008-8213 |
| language | English |
| last_indexed | 2024-12-17T20:50:53Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | International Journal of Preventive Medicine |
| spelling | doaj.art-02f282cd9cda4974b4670d544674527d2022-12-21T21:33:02ZengWolters Kluwer Medknow PublicationsInternational Journal of Preventive Medicine2008-78022008-82132021-01-0112111511510.4103/ijpvm.IJPVM_499_20Non-adherence to pain medication increases risk of postoperative frozen shoulderRichard NiehausLukas UrbanschitzJakob SchumannChristopher G LenzFlorian A FrankStefan EhrendorferKarim EidBackground: Postoperative frozen shoulder (FS) or adhesive capsulitis is a relatively frequent complication (5-20%), even after simple arthroscopic shoulder surgeries. The pathophysiology is still unclear, but psychological factors may play a pivotal role. From clinical experience, we hypothesized that patients, who are reluctant to take medications, particularly “pain-killers,” have an increased incidence of postoperative FS. Methods: We identified twenty patients who underwent limited arthroscopic operations of the shoulder and developed postoperative FS. Twenty patients with matching type of surgery, age, and gender served as control group (n = 20). All patients were at least one year postoperative and asymptomatic at the time of examination. Demographic data, the patient's adherence to self-medication (including self-medicating scale, SMS), development the Quality of life (QoL), and depression scale (PHQ-4-questionnaire) were assessed. Results: Patients with FS had a 2-fold longer rehabilitation and 3-fold longer work inability compared to the patients without FS (P < 0.009 and P < 0.003, respectively). Subjective shoulder value SSV (P = 0.075) and post-operative improvement of QoL (P = 0.292) did not differ among the groups. There was a trend—but not significant—toward less coherence to self-medication in the FS-group (26.50 vs. 29.50; P = 0.094). Patients with postoperative FS significantly more often stated not to have “taken pain-killers as prescribed” (P = 0.003). Conclusions: Patients reporting unwillingness to take the prescribed pain medications had a significantly higher incidence of postoperative FS. It remains unclear whether the increased risk of developing FS is due to reduced postoperative analgesia or a critical attitude toward taking medication. However, patients who are reluctant to take painkillers should strongly be encouraged to take medications as prescribed.http://www.ijpvmjournal.net/article.asp?issn=2008-7802;year=2021;volume=12;issue=1;spage=115;epage=115;aulast=Niehausadhesive capsulitisfrozen shoulderpainkillerspost-operative adherenceshoulder arthroscopy |
| spellingShingle | Richard Niehaus Lukas Urbanschitz Jakob Schumann Christopher G Lenz Florian A Frank Stefan Ehrendorfer Karim Eid Non-adherence to pain medication increases risk of postoperative frozen shoulder International Journal of Preventive Medicine adhesive capsulitis frozen shoulder painkillers post-operative adherence shoulder arthroscopy |
| title | Non-adherence to pain medication increases risk of postoperative frozen shoulder |
| title_full | Non-adherence to pain medication increases risk of postoperative frozen shoulder |
| title_fullStr | Non-adherence to pain medication increases risk of postoperative frozen shoulder |
| title_full_unstemmed | Non-adherence to pain medication increases risk of postoperative frozen shoulder |
| title_short | Non-adherence to pain medication increases risk of postoperative frozen shoulder |
| title_sort | non adherence to pain medication increases risk of postoperative frozen shoulder |
| topic | adhesive capsulitis frozen shoulder painkillers post-operative adherence shoulder arthroscopy |
| url | http://www.ijpvmjournal.net/article.asp?issn=2008-7802;year=2021;volume=12;issue=1;spage=115;epage=115;aulast=Niehaus |
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