THE RELATIONSHIP BETWEEN SLEEP DISTURBANCE AND PAIN SEVERITY IN FROZEN SHOULDER: A REVIEW OF CURRENT EVIDENCE

Abstract

Introduction: Frozen shoulder or adhesive capsulitis is an example of a frequent problem involving the musculoskeletal system characterized by a slow development of pain, stiffness, and limited mobility of the shoulder joint. Insomnia can often be seen in people with this kind of pathology, mainly due to pain at night. Research suggests a strong connection between sleep quality and pain intensity.

Objective: The aim of the present review is to analyze the available literature on the correlation between sleep disturbance and pain intensity in patients suffering from frozen shoulder and understand the possible pathophysiology behind this correlation.

Key Findings; From the analysis of the current literature, it can be stated that there is a significant relationship between poor sleep and pain intensity among patients with frozen shoulder. The higher pain level, in particular, at night time, is related to poor quality of sleep, higher level of arousal, and less sleep duration. Insufficient sleep can lead to an enhanced perception of pain because of inflammation, neurophysiology processes, and psychological aspects. The relationship appears to be reciprocal, as pain causes insomnia and, vice versa, insomnia leads to pain perception enhancement. The following factors are likely to cause the mentioned condition: inflammation, central sensitization, maladaptive pain modulation, and psychological disorders.

Conclusion; According to available studies, there appears to be a high level of association between poor sleeping patterns and pain intensity for patients with frozen shoulder syndrome. The consideration of such variables may prove useful when trying to improve measures for the alleviation of pain. Additional research needs to be carried out in order to explore this relationship further.