LIFE STRESS, EMOTIONS AND PAINFUL STIFF SHOULDER

Abstract

60 of 300 patients seen in psychosomatic consultation complained of pain and stiffness in the shoulder or adjacent bodily structures. In general, the physical findings were compatible with a diagnosis of subacromial bursitis or contracted shoulder. X-ray of the shoulders revealed aberrant calcification in 5 of the 60 patients in the series. Detailed history revealed that pain and stiffness in the shoulder region occurred in a setting which was emotionally stressful for these patients and, in general, the course of their shoulder discomfort and disability parelleled their day-to-day emotional reactions. As a group these patients were aggressive-dependent, obsessive-compulsive, "hyperkinetic", and resentful. Their attitudes toward their life situations and the manner in which they reacted to them were remarkably similar. From this study it is concluded that certain types of emotional disturbances are important factors in the development and course of the painful, stiff shoulder syndrome. As a possible mechanism it is suggested that increased muscle tension, secondary to emotional stress, imposes a resistance to voluntary muscular activity and thus contributes to local tissue injury in the vulnerable shoulder joint.