Understanding biopsychosocial aspects related with pain mechanism-based phenotypes of shoulder pain.

Abstract

Shoulder pain is one of the most prevalent musculoskeletal diseases with a burden heath cost. Although conservative treatment is the first line option, the frequency of pain recurrence is still high. When understood as a multidimensional and biopsychosocial phenomenon, shoulder pain seems to have different clinical, sensory, and psychosocial components among individuals with similar complaints. The combination of different components in a clinical picture can characterize the predominant pain mechanism. So, the predominant pain mechanism classification system has been used in different chronic pain populations to guide clinicians towards a more assertive assessment. The purpose of the proposal is to classify the predominant pain mechanism of people with shoulder pain and to explore evident biopsychosocial aspects in each mechanism. Moreover, it intends to understand which combinations of clinical, sensory and/or psychosocial outcomes best explain each pain mechanism and functional and social limitations. Subjects will be classified according to the predominant pain mechanism into nociceptive, nociplastic or neuropathic pain, according to IASP recommendations. Data normality will be tested by Shapiro-Wilk test and histograms. ANOVA test will verify differences between the 3 pain mechanisms in the variables not used to classify the predominant mechanism. Multinomial logistic regression analysis will determine the outcomes that best explain each of the 3 mechanisms. Two multiple regressions analyzes will identify which aspects best explain functional and social limitations. (AU)