Shoulder pain following tetraplegia: a follow-up study 2-4 years after injury.

Objectives: To investigate (1) the characteristics of shoulder pain following discharge from rehabilitation for tetraplegia, (2) the relationship between pain and any associated risk factors and (3) the relationship between pain and functional activities, and pain and quality of life.
Design: Longitudinal study.
Setting: Spinal Injuries Unit, Australia.
Methods: Participants (n=27) were surveyed between 2 and 4 years postinjury. Prospective data on shoulder pain during rehabilitation had been collected previously and allowed comparison with the follow-up data. Data collected included pain intensity and quality, the Wheelchair User's Shoulder Pain Index (WUSPI) and perceived effect of pain on quality of life.
Results: Shoulder pain prevalence was 70%. Pain was associated with discharge motor level of C6-T1 (P=0.003). Pain was most commonly located in the shoulder joint. Pain was primarily aggravated by movement and cold weather and relieved by rest. The most painful activity was lifting an object from overhead. Quality of life was affected by pain in 68.4% of participants.
Conclusion: Shoulder pain is common following rehabilitation for tetraplegia and is associated with injury level. Pain is reported during daily tasks and adversely affects quality of life. Areas for further research are identified.