Rotator cuff-related pain: Patients' understanding and experiences

Background: Persistent musculoskeletal pain is a multi-factorial entity, influenced by biological, genetic and psychosocial factors. Psychosocial factors, such as individuals' beliefs and experiences, need to be considered in the management of such pain. While extensive research has explored beliefs of individuals with spinal pain, less is known about individuals' beliefs regarding shoulder pain. Objectives: To explore beliefs about the cause of pain in individuals with persistent rotator cuff-related pain, as well as the experiences of the effect of pain on their daily lives. Design: A mixed methods design, using semi-structured interviews and validated outcome questionnaires. Method: Five men and five women, aged 47-68 years, with shoulder pain for at least three months were recruited. Individual semi-structured interviews were audio-recorded, transcribed verbatim and analysed using the general inductive approach. Results/findings: Four key themes emerged. The cause of pain, Understanding the pain', was described in terms of anatomical factors within the context of the participants' lives. The pain impacted all areas of life, creating another theme, 'It affects everything'. Participants responded to their pain by adopting certain, Pain-associated behaviours' and sought information for diagnosis, general management and exercise prescription, 'Emotional responses and the future'. Conclusions: The participants with rotator cuff-related pain believed the cause of their pain to be local to the shoulder region. However, they also described various stressors in their work-, sports- and family related lives. Rehabilitation may need to include educating the individual, expanding their understanding regarding pain mechanisms and appropriate interventions, based on individual goal-setting. (C) 2017 Elsevier Ltd. All rights reserved.