Are Rotator Cuff Tendon Tears Associated with Cervical Foraminal Stenosis? An Imaging Study to Explore the Association between Shoulder and Neck Pain
Coexistence of shoulder and neck pain is not rare in patients visiting pain clinics, and this might result from the biological associations between the two regions. In this regard, elaboration of the relationship between shoulder and cervical spine pathologies would be helpful in the diagnosis and treatment of relevant painful syndromes. Therefore, the present study aimed to explore the possible association between rotator cuff tendon tears and cervical radiculopathies at C5 and C6 root levels.
The current study has been approved by the institutional review board. The participants are 126 patients with cervical spine radiographs within one year before or after ultrasound examinations for shoulder pain. Foraminal stenosis was grouped into four categories: (1) C4/5 intervertebral foramen only, (2) C5/6 intervertebral foramen only, (3) both C4/5 and C5/6 intervertebral foramina and (4) neither C4/5 nor C5/6 intervertebral foramen. A univariate analysis was applied on groups with and without rotator cuff tendon tears, comparing continuous variables by Mann-Whitney U test and categorical variables by the Chi-square test. A multivariate analysis was conducted by using a logistic regression model for elaborating the association between rotator cuff tendon tears and cervical foraminal stenoses.
Patients with rotator cuff tendon tears tended to be older, having more night pain as well. No significant association was identified between rotator cuff tendon tears and cervical foraminal stenosis at C5 and C6 levels. The only factor predicting the presence of rotator cuff tendon tears was older age.
In patients with shoulder or neck pain, no association existed between rotator cuff tendon tears and cervical foraminal stenoses (at C5 and C6 levels). When patients present with undifferentiated shoulder and neck pain, physicians should better perform a detailed history taking, physical examination and imaging studies for the neck and shoulder regions independently.
Keywords: shoulder, ultrasound, aging, neck, spondylosis