C. Maxwell1, K. Robinson1, K. McCreesh1
1University of Limerick, Health Research Institute, Limerick, Ireland
Background: Over a quarter of the general population experience musculoskeletal shoulder pain in their lifetime, with pain persisting beyond six months in 50% of individuals. It is a disabling condition that negatively impacts on quality of life, psychological wellbeing and ability to maintain employment. Reports of current practice reflect a lack of consistency in the implementation of research recommendations for the management of shoulder pain. Deepening our understanding of the individuals’ experiences of living with shoulder pain, and of receiving treatment, is likely to play a key role in improving engagement and stricter adherence with evidence-based interventions.
Purpose: The purpose of this study was to review and synthesize qualitative research studies exploring the experiences of individuals living with shoulder pain to enhance understanding of such experiences and facilitate healthcare developments.
Methods: A meta-ethnographic approach was adopted to review and synthesize eligible published qualitative research studies. The findings from each included study were translated into one another using Noblit and Hares’ seven-stage process. A systematic search of 11 electronic databases was conducted in March 2020. Methodological quality was assessed using the CASP Appraisal Tool.
Results: Nineteen studies were included in the meta-synthesis. The included articles explored both the lived and treatment-related experiences of the participants. All such articles were deemed of high methodological quality. Three themes were identified; 1) Negative emotional, social and activity impact: “It has been a big upheaval”, 2) Developing an understanding: “Why is it hurting so much?”, 3) Exercise: “Am I going to go through a lot of pain in moving it...?”. Across the range of included studies, the severe emotional and physical impact of shoulder pain was a core finding. Many sought a ‘permanent’ solution involving surgery. Openness to other treatment options was influenced by factors including; understanding of pain, prior experiences and treatment expectations.
Conclusion(s): This review provides valuable insight into the impact of shoulder pain on peoples’ lives, as well as providing novel insight into the experience of treatment. Enhanced awareness of people’s experiences of shoulder pain and its treatment is crucial for clinicians when planning and implementing evidence-based recommendations. Further qualitative research exploring treatment decision-making would provide valuable information, helping to bridge the gap between research and clinical practice.
Implications:
- This paper provides a valuable insight into the experiences of individuals with shoulder pain and, to the authors’ knowledge, is the first review to explore treatment-related experiences of individuals with shoulder pain.
- To enhance engagement and optimise treatment outcomes, it is recommended that clinicians identify and address any misconceptions early within the care pathway by thoroughly exploring past experiences, understanding, and expectations.
- To enhance engagement with first-line treatments, such as exercise therapy, clinicians must explore beliefs and perceptions on exercise and be mindful of how they present this intervention to individuals with shoulder pain, having due regard to recovery expectations and their level of self-efficacy.
Funding, acknowledgements: This work was supported by the Irish Research Council (IRC) - Postgraduate Scholarship awarded to Christina Maxwell in 2018.
Keywords: Musculoskeletal, Shoulder Pain, Qualitative Evidence Synthesis
Topic: Musculoskeletal: upper limb
Did this work require ethics approval? No
Institution: University of Limerick
Committee: University of Limerick Research Ethics Committee
Reason: This study is a review of published research, and therefore ethical approval was not required.
All authors, affiliations and abstracts have been published as submitted.
