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Smoking, Obesity Connection to Shoulder Health
For a variety of reasons, shoulder pain and loss of shoulder function is a problem reported by many patients. Certain age groups, particularly people who are older, have a high number of shoulder problems because of injuries. But, many people with sore or limited use of their shoulders don't seem to have a predisposing factor that would be the cause. For this reason, the authors of this article suggest that in these cases, "shoulder pain and loss of function are directly proportional to lifestyle choices, including smoking and obesity." To back up this hypothesis, the authors conducted an on-line survey of 166 people.
Researchers evaluated the respondents by using a shoulder questionnaire that combined three well-known patient-response surveys: the Oxford Shoulder Questionnaire
, the Shoulder Rating Questionnaire
, and the Subjective Shoulder Rating System
. They also asked the respondents how they felt about their range of motion at the shoulder, demographic data, work and sports activities, current medical conditions, and whether they drank alcohol (and how much) or smoked (and how much). The shoulder's range of motion was determined by showing the respondents 20 photographs of a man moving his arm in various directions. The subjects were to click off the ones that they were able to perform. The study was done online and by volunteers who chose to complete it.
The results of the questionnaire seem to back up the authors' suggestions regarding lifestyle and shoulder pain and function. From the self-reported shoulder rating system, there was a marked relationship between smoking, high cholesterol, and shoulder problems. The numbers don't all add up to 166 because of variations in answers. Of the respondents, 37 complained of problems with both shoulders, 37 with just the left, and 63 with just the right. Thirty respondents reported smoking, 19 less than one pack per day and 11 from one to three packs per day. One hundred seven of the respondents did not have an injury that caused their shoulder problem, 56 did report an injury. Of these, 15 had undergone shoulder surgery. Ninety respondents said that they do not drink alcohol, 73 said that they did. Of those who did consume alcohol, 31 drank one or two bottles of beer per week and 26 drank more than two per week. Twenty six of those who drank alcohol drank one or two mixed drinks per week, and 10 drank more than two per week. Twenty six drank one or two glasses of wine per week and 16 drank more than 2 glasses per week.
In evaluating medical issues, the researchers found that 39 respondents reported having high blood pressure, 32 had reported high cholesterol, and 18 reported being obese.
While the numbers of the health and lifestyle issues may not be high, it was the number of injuries and problems that were significant. When evaluating shoulder function according to the Shoulder Objective Rating System, it is done on a scale of one to 100, with the higher the number the better. The respondents who smoked reported a mean of 68.43 (plus or minus 20.68), while the non-smokers rated themselves at 78.70 (plus or minus 17.38). Among those who smoked less than a pack a day, they reported a rating of 73.32 (plus or minus 21.37), but the ones who smoked more than a pack a day weighed in at only 60.00 (plus or minus 17.19).
Taking alcohol into account, people who drank alcohol reported a score of 78.84 (plus or minus) compared with non-drinkers who reported 74.75 (plus or minus). However, the numbers were lower among the people who drank more alcohol. Those who drank two or fewer bottles of beer, mixed drinks, or wine reported a score of 80.80 (plus or minus 13.93), 83.54 (plus or minus 12.64), and 77.27 (plus or minus 16,37), respectively. Those who drank more beer, mixed drinks, or wine scored 75.00 (plus or minus 17.25), 61,70 (plus or minus 22.32), and 68.13 (plus or minus 20.33). In other words, the more alcohol consumed, the lower the score.
Finally, when looking at medical conditions, those with high blood pressure scored only 69.077 (plus or minus 22.509), while those who did not report high blood pressure scored 79.242 (plus or minus 16.266). People with high cholesterol scored 71.063 (plus or minus 22.509) compared with those with normal cholesterol levels who scored 78.214 (plus or minus 17.560). The lowest score was found among people who were obese, at 66.556 (plus or minus 20.004), compared with those within accepted weight guidelines with scores of 78.083 (plus or minus 17.860).
Similar scores were found in the other two types of tests that were completed by the respondents. The authors noted that this study did have drawbacks, including that the respondents were not part of any particular group and were self-chosen
, only people who had access to the Internet could participate, and there was no control group with which to compare the results. It was interesting, they wrote, that there was such a significant connection between reported smoking and shoulder function. The link between high cholesterol and shoulder pain is particularly interesting. Steven Kane, MD, et al. A Shoulder Health Survey: Correlating Behaviors and Comorbidities with Shoulder Problems. In Sports Health. March/April 2010. Vol. 2. No. 2. Pp. 119-134.
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