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ORIJINAL ARAŞTIRMA

Uyku Pozisyonu Omuz Ağrısını Etkiliyor mu? Klinik ve Sonografik Bir Çalışma
Does the Sleeping Position Affect Shoulder Pain? A Clinical and Sonographic Study
Received Date : 28 Jan 2020
Accepted Date : 21 Apr 2020
Available Online : 28 Sep 2020
Doi: 10.31609/jpmrs.2020-73821 - Makale Dili: EN
J PMR Sci. 2020;23(3):174-82
ÖZET
Amaç: Bu çalışmada, omuz ağrısı olan hastaları, uyku pozisyonlarına göre klinik ve sonografik bulgularla değerlendirmeyi ve omuz ağrısını etkileyen olası faktörleri ortaya koymayı amaçladık. Gereç ve Yöntemler: Çalışmaya, 41 hasta alındı. Omuz ağrısının (hareketle oluşan/ istirahat) şiddeti, vizüel analog skala (VAS); omuz dizabilitesi, Omuz Ağrı ve Dizabilite İndeksi [Shoulder Pain and Disability Index (SPADI)] ve uyku kalitesi, Pittsburgh Uyku Kalite İndeksi kullanılarak değerlendirildi. Biseps tendonu, rotator kaf (RK), subakromiyal-subdeltoid bursa, glenohumeral eklem (GHE) ve akromiyoklavikular eklem (AKE) sonografik görüntüleme ile değerlendirildi. Bulgular: Tüm hastalarda kötü olan uyku kalitesinin, kadınlarda daha fazla olduğu (p=0,020) ve gece ağrısı olanlarda SPADI skorlarının daha yüksek olduğu (p=0,004) tespit edildi. “Asker” pozisyonunda uyuyan hastalarda, daha yüksek oranda biseps tenosinoviti olduğu; “fetüs” şeklinde yatanlarda hareketle oluşan ağrı, subakromiyal sıkışma sendromu ve parsiyel supraspinatus tendon rüptürü bakımından anlamlı oranda artış olduğu; “kütük” şeklinde uyuyanlarda da supraspinatus tendinitinin daha yüksek oranlarda görüldüğü belirlendi. Yaş ile supraspinatus tendon rüptürü ve tendiniti riskinin yükseldiği, AKE kapsülündeki genişlemeyle GHE’de dejenerasyon gelişme olasılığının arttığı kaydedildi. Sonuç: Farklı uyku pozisyonları, farklı omuz patolojilerine ve omuz ağrısına yatkınlık gösterebilir. Özellikle ileri yaştaki hastalar, RK patolojileri bakımından risk altında bulunmaktadır. Dolayısıyla doğru ve uygun uyku pozisyonlarını önermek; ağrının, dizabilitenin azalması ile uyku kalitesinin artması konusunda yardımcı bir tedavi yöntemi olabilir.
ABSTRACT
Objective: In this study, we aimed to evaluate patients with shoulder pain according to their sleep positions with clinical and sonographic findings and to reveal possible factors affecting shoulder pain. Material and Methods: A total of 41 patients were included in this study. The severity of shoulder pain (movement/at rest) was evaluated by the visual analog scale, shoulder disability by the Shoulder Pain and Disability Index (SPADI), and sleep quality by the Pittsburgh Sleep Quality Index. Biceps tendon, rotator cuff (RC), subacromial-subdeltoid bursa, glenohumeral (GH), and acromioclavicular (AC) joints were evaluated by sonographic imaging. Results: Poor sleep quality available in all patients was higher in women (p=0.020) and SPADI scores were higher in patients with night pain (p=0.004). It was determined that biceps tenosynovitis was observed at higher rates in patients sleeping in the “soldier” position, pain during movement, subacromial impingement syndrome, and partial supraspinatus tendon rupture in those lying in the form of "fetus", and supraspinatus tendinitis in those who slept in the form of a "log". It was noted that the risk of supraspinatus tendon rupture and tendinitis increased with age, and the possibility of degeneration in the GH joint increases with enlargement of the AC joint capsule. Conclusion: Different sleeping positions may predispose to different shoulder pathologies and shoulder pain. Especially older patients are at risk for RC pathologies. Therefore, recommending correct and appropriate sleep positions might be a helpful treatment method for decreasing pain and disability and increasing sleep quality.
REFERENCES
  1. Matsen FA III, Arntz CT. Subacromial impingement. In: Rockwood CD Jr, Matsen FA III, eds. The Shoulder. 2nd ed. Philadelphia: WB Saunders; 1990. p.623-45.
  2. Bhattacharyya R, Edwards K, Wallace AW. Does arthroscopic sub-acromial decompression really work for sub-acromial impingement syndrome: a cohort study. BMC Musculoskelet Disord. 2014;15:324. [Crossref]  [PubMed]  [PMC] 
  3. Dalton SE. The shoulder. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt M, Weisman MH, eds: Rheumatology. 3rd ed. Mosby London; 2003. p. 615-30.
  4. Werner CML, Blumenthal S, Curt A, Gerber C. Subacromial pressures in vivo and effects of selective experimental suprascapular nerve block. J Shoulder Elbow Surg. 2006;15(3):319-23. [Crossref]  [PubMed] 
  5. Bigliani LU, Levine WN. Subacromial impingement syndrome. J Bone Joint Surg Am. 1997;79(12):1854-68. [Crossref]  [PubMed] 
  6. Neer CS. Impingement lesions. Clin Orthop Relat Res. 1983;173:70-7. [Crossref]  [PubMed] 
  7. Consigliere P, Haddo O, Levy O, Sforza G. Subacromial impingement syndrome: management challenges. Orthop Res Rev. 2018;10:83-91. [Crossref]  [PubMed]  [PMC] 
  8. Zenian J. Sleep position and shoulder pain. Med Hypotheses. 2010;74(4):639-43. [Crossref]  [PubMed] 
  9. Belzer JP, Durkin RC. Common disorders of the shoulder. Prim Care. 1996;23(2):365-88. [Crossref]  [PubMed] 
  10. Wehby CT, Wehby JH. Sleep shoulder syndrome. Ohio State Med J. 1980;76(11):691-2. [PubMed] 
  11. Longo UG, Facchinetti G, Marchetti A, Candela V, Ambrogioni LR, Faldetta A, et al. Sleep disturbance and rotator cuff tears: a systematic review. Medicina (Kaunas). 2019;55(8):453. [Crossref]  [PubMed]  [PMC] 
  12. Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991;4(4):143-9. [Crossref]  [PubMed] 
  13. Bicer A, Ankaralı H. Shoulder pain and disability index: a validation study in Turkish woman. Singapore Med J. 2010;51(11):865-70. [PubMed] 
  14. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. [Crossref]  [PubMed] 
  15. Ağargün MY, Kara H, Anlar Ö. [The validity and reliability of the Pittsburgh sleep quality index]. Türk Psikiyatri Dergisi. 1996;7(2):107-15.
  16. Ptasznik R. Sonography of the shoulder. In: van Holsbeeck MT, Introcaso JH eds. Musculoskeletal ultrasound. 2nd ed. ST Louis: Mosby; 2001. p.463-516.
  17. Mack LA, Nyberg DA, Matsen FA. Sonographic evaluation of the rotator cuff. Radiol Clin North Am. 1988;26(1):161-77. [PubMed] 
  18. Middleton WD. Ultrasonography of the shoulder. Radiol Clin North Am. 1992;30(5):927-40. [PubMed] 
  19. Holdaway LA, Hegmann KT, Thiese MS, Kapellusch J. Is sleep position associated with glenohumeral shoulder pain and rotator cuff tendinopathy: a cross-sectional study. BMC Musculoskelet Disord. 2018;19(1):408. [Crossref]  [PubMed]  [PMC] 
  20. Seiler WO, Allen S, Stähelin BH. Influence of the 30 laterally inclined position and the ''super-soft" 3-piece mattress on skin oxygen tension on areas of maximum pressure--implications for pressure sore prevention. Gerontology. 1986;32(3):158-66. [Crossref]  [PubMed] 
  21. Neer CS. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;54(1):41-50. [Crossref]  [PubMed] 
  22. Neer CS, Kirby RM. Revision of humeral head and total shoulder arthroplasties. Clin Orthop Relat Res. 1982;(170)189-95. [Crossref]  [PubMed] 
  23. Applegate KA, Thiese MS, Merryweather AS, Kapellusch J, Drury DL, Wood E, et al. Association between cardiovascular disease risk factors and rotator cuff tendinopathy: a cross-sectional study. J Occup Environ Med. 2017;59(2):154-60. [Crossref]  [PubMed] 
  24. Umul A, Demirtaş H, Çelik AO, Kara M, Yılmaz Ö, Değirmenci B, et al. [Relationship of rotator cuff tendon pathology with obesity, chronic diseases and steroid use]. Cukurova Med J. 2016;41(4):648-52. [Crossref] 
  25. Austin L, Pepe M, Tucker B, Ong A, Nugent R, Eck B, et al. Sleep disturbance associated with rotator cuff tear: correction with arthroscopic rotator cuff repair. Am J Sports Med. 2015;43(6):1455-9. [Crossref]  [PubMed] 
  26. Horneff JG, Tjoumakaris F, Wowkanech C, Pepe M, Tucker B, Austin L. Long-term correction in sleep disturbance is sustained after arthroscopic rotator cuff repair. Am J Sports Med. 2017;45(7):1670-5. [Crossref]  [PubMed] 
  27. Tekeoglu I, Ediz L, Hiz O, Toprak M, Yazmalar L, Karaaslan G. The relationship between shoulder impingement syndrome and sleep quality. Eur Rev Med Pharmacol Sci. 2013;17(3):370-4. [PubMed] 
  28. Bal A, Ekşioğlu E, Gürçay E, Karaahmet Ö, Küçük S, Çakcı A. [Assessment of factors affecting shoulder disability in patients with subacromial impingement syndrome]. Turkiye Klinikleri J Med Sci. 2008;28(4):468-72.