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Biopsychosocial influence on shoulder pain: results from a randomized preclinical trial of exercise-induced muscle injury.

Publication ,  Journal Article
George, SZ; Bishop, MD; Wu, SS; Staud, R; Borsa, PA; Wallace, MR; Greenfield, WH; Dai, Y; Fillingim, RB
Published in: Pain
February 1, 2023

Prior cohort studies validated that a subgroup defined by a specific COMT genotype and pain catastrophizing is at increased risk for heightened responses to exercise-induced or surgically induced shoulder pain. In this clinical trial, we used our preclinical model of exercise-induced muscle injury and pain to test the efficacy of interventions matched to characteristics of this high-risk subgroup (ie, personalized medicine approach). Potential participants provided informed consent to be screened for eligibility based on subgroup membership and then, as appropriate, were enrolled into the trial. Participants (n = 261) were randomized to 1 of 4 intervention groups comprised of pharmaceutical (propranolol or placebo) and informational (general education or psychologic intervention) combinations. After muscle injury was induced, participants received randomly assigned treatment and were followed for the primary outcome of shoulder pain intensity recovery over 4 consecutive days. Recovery rates were 56.4% (placebo and psychologic intervention), 55.4% (placebo and general education), 62.9% (propranolol and psychologic intervention), and 56.1% (propranolol and general education). No statistical differences were found between intervention groups in the primary analyses. Additional analyses found no differences between these intervention groups when shoulder pain duration was an outcome, and no differential treatment responses were detected based on sex, race, or level of pain catastrophizing. This trial indicates that these treatments were not efficacious for this high-risk subgroup when shoulder pain was induced by exercise-induced muscle injury. Accordingly, this phenotype should only be used for prognostic purposes until additional trials are completed in clinical populations.

Duke Scholars

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Published In

Pain

DOI

EISSN

1872-6623

Publication Date

February 1, 2023

Volume

164

Issue

2

Start / End Page

305 / 315

Location

United States

Related Subject Headings

  • Shoulder Pain
  • Propranolol
  • Muscles
  • Humans
  • Exercise Therapy
  • Cohort Studies
  • Anesthesiology
  • 52 Psychology
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
 

Citation

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George, S. Z., Bishop, M. D., Wu, S. S., Staud, R., Borsa, P. A., Wallace, M. R., … Fillingim, R. B. (2023). Biopsychosocial influence on shoulder pain: results from a randomized preclinical trial of exercise-induced muscle injury. Pain, 164(2), 305–315. https://doi.org/10.1097/j.pain.0000000000002700
George, Steven Z., Mark D. Bishop, Samuel S. Wu, Roland Staud, Paul A. Borsa, Margaret R. Wallace, Warren H. Greenfield, Yunfeng Dai, and Roger B. Fillingim. “Biopsychosocial influence on shoulder pain: results from a randomized preclinical trial of exercise-induced muscle injury.Pain 164, no. 2 (February 1, 2023): 305–15. https://doi.org/10.1097/j.pain.0000000000002700.
George SZ, Bishop MD, Wu SS, Staud R, Borsa PA, Wallace MR, et al. Biopsychosocial influence on shoulder pain: results from a randomized preclinical trial of exercise-induced muscle injury. Pain. 2023 Feb 1;164(2):305–15.
George, Steven Z., et al. “Biopsychosocial influence on shoulder pain: results from a randomized preclinical trial of exercise-induced muscle injury.Pain, vol. 164, no. 2, Feb. 2023, pp. 305–15. Pubmed, doi:10.1097/j.pain.0000000000002700.
George SZ, Bishop MD, Wu SS, Staud R, Borsa PA, Wallace MR, Greenfield WH, Dai Y, Fillingim RB. Biopsychosocial influence on shoulder pain: results from a randomized preclinical trial of exercise-induced muscle injury. Pain. 2023 Feb 1;164(2):305–315.

Published In

Pain

DOI

EISSN

1872-6623

Publication Date

February 1, 2023

Volume

164

Issue

2

Start / End Page

305 / 315

Location

United States

Related Subject Headings

  • Shoulder Pain
  • Propranolol
  • Muscles
  • Humans
  • Exercise Therapy
  • Cohort Studies
  • Anesthesiology
  • 52 Psychology
  • 42 Health sciences
  • 32 Biomedical and clinical sciences