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Shoulder Pain Indicative of Heart Disease Risk

While most people blame excessive and/or repeated physical strain for rotator cuff problems, Kurt Hegmann, M.D., M.P.H., Director of the Rocky Mountain Center for Occupational and Environmental Health and a Professor of Family and Preventive Medicine, who was the lead author of a study at the University of Utah School of Medicine, discovered otherwise.

The findings were that individuals with rotator cuff injury and aggravating joint pain in a shoulder and the surrounding tendons and muscles should realize that those symptoms could be a sign that they are at an increased risk for heart disease and may find it necessary to manage heart disease risk factors.

Physical exertion can be an irritant, but evidence points to other factors that could also be to blame. It is also to be noted that previous research has found that those people who had an increased risk for heart disease also experienced a tendency toward the musculoskeletal disorders of Achilles tendinitis, carpal tunnel syndrome, and/or tennis elbow. 

This study adds problems with shoulders to that list, because the more risk factors for heart disease that the study participants had, the more likelihood that they had shoulder pains as well.

What are those risk factors? Some of them are diabetes, high cholesterol, and high blood pressure. The study participants with the largest number of the risk factors were found to have 4.6 times more likelihood than those having none of those factors to have had shoulder joint pain and had almost six times the likelihood of having had the second shoulder condition named tendinopathy of the rotator cuff. Those with their heart risk at a mid-level had less likelihood of having had either shoulder condition.

Again, it would seem that physical strain would be the big cause of shoulder pain, but opposite results were found from the 1,226 skilled laborers who participated in the study. Careful monitoring by ergonomists was done on skilled laborers including cabinet makers, airbag manufacturers, and meat processors as every forceful push, pull and twist were factored into an index that was assigned to every worker. However, the more straining jobs and other physical activities did not produce more shoulder difficulties.

Hegmann noted that such high physical strain may accelerate issues with the rotator cuff, but does not seem to be the primary driver. Cardiovascular disease risk factors could possibly be more important than the job factors when a worker incurs those problems.

Therefore, there could be a relationship between heart risk and shoulder problems, but researchers need to follow up with a prospective study to prove that. Hegmann also says it is possible that controlling the above-mentioned heart risk factors might alleviate the shoulder discomfort.

The research was supported by the National Institute on Occupational Safety and Health and published as "Association as Cardiovascular Disease Risk Factors and Rotator Cuff Tendinopathy".

In addition to Hegmann, co-authors include Kara Applegate, Matthew Thiese, Eric Wood, Richard Kendall and Andrew Merryweather from the University of Utah, Jay Kapellusch, James Foster and Arun Garg from the University of Wisconsin-Milwaukee, and David Drury from the Veterans Administration Medical Center, Milwaukee, Wisconsin.

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