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Musculoskeletal disorders in referrals for suspected cervical radiculopathy

PainSci » bibliography » Cannon et al 2007
Tags: diagnosis, etiology, neck, neurology, muscle pain, pro, head/neck, spine, muscle, pain problems

Two articles on PainSci cite Cannon 2007: 1. Tennis Elbow Guide2. The Complete Guide to Neck Pain & Cricks

PainSci notes on Cannon 2007:

This study of 190 patients with cervical radiculopathy (irritated nerve roots) showed that they have a higher prevalence of other kinds of musculoskeletal conditions, things like lateral epicondylitis (tennis elbow), de Quervain's tenosynovitis (a tendinitis-like problem in the thumb).

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVES: To determine (1) the prevalence of selected common musculoskeletal disorders in patients referred for electrodiagnosis when cervical radiculopathy is suspected and (2) whether these findings predict electrodiagnostic study outcome.

DESIGN: Prospective study.

SETTING: Electrodiagnostic laboratories in departments of physical medicine and rehabilitation at 5 participating institutions.

PARTICIPANTS: A total of 191 subjects undergoing electrodiagnostic evaluations for upper-limb symptoms when cervical radiculopathy was suspected.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Prevalence of certain musculoskeletal disorders (myofascial pain, shoulder impingement, lateral epicondylitis, de Quervain's tenosynovitis) and outcomes of electrodiagnostic testing (normal study, cervical radiculopathy, or another electrodiagnostically confirmed diagnosis).

RESULTS: The total prevalence of musculoskeletal disorders was 42%. The prevalence in those with a normal study was 69%, compared with 29% in those with cervical radiculopathy (P<.001) and 45% in those with another diagnosis (P=.02).

CONCLUSIONS: Musculoskeletal disorders are common in patients with suspected cervical radiculopathy. Although the presence of certain musculoskeletal disorders makes having a normal electrodiagnostic evaluation significantly more likely, the high prevalence among both patients with normal studies and those with radiculopathy and other disorders limits the usefulness of this information in precisely predicting study outcome. The presence of musculoskeletal disorders should not preclude electrodiagnostic testing when otherwise indicated.

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