Q J Med 2002; 95: 389-395
© 2002 Association of Physicians
Upper-limb pain in long-term poliomyelitis
From the Department of Orthopaedic Surgery, St Thomas' Hospital, London, and 1 The Lane Fox Unit, St Thomas' Hospital, London, UK
Received 6 June 2001 and in revised form 19 February 2002
Background: Late functional deterioration is common in long-term poliomyelitis patients. While upper-limb pain in individual functional regions is common, its overall prevalence and pattern in long-term poliomyelitis is poorly documented.
Aim: To assess the nature of upper-limb pain in these patients and examine its association with dependence on mobility aids (and therefore upper limb ‘overuse’).
Design: Questionnaire-based survey of patients attending a specialist unit.
Methods: Questionnaires were sent to 139 patients with known long-term poliomyelitis (mean 49.8 years post polio), attending the Lane Fox Unit out-patient clinic at St Thomas’ Hospital between January 1998 and December 1998. There were questions on the nature of the patient's acute illness, limb involvement at initial infection (‘polio-affected’ limbs), the site and onset of upper-limb pain, hand dominance, previous injuries and surgery, and the use of mobility aids. Limbs that had sustained an injury or undergone surgery, at or preceding onset of upper-limb pain, were excluded from analysis.
Results: Among 103 valid replies, the prevalence of upper limb pain was 64%. Mobility aids were used by 74%, and were associated with an increased risk of upper-limb pain, while ‘polio-affected’ limbs were at reduced risk.
Discussion: These data support ‘overuse’ due to greater mobility aid dependence as a cause of increasing upper-limb pain in long-term poliomyelitis.
Address correspondence to Dr B. Povlsen, Department of Orthopaedic Surgery, Guy's & St Thomas' NHS Trust, Guy's Hospital, St Thomas Street, London SE1. e-mail: bo{at}povlsen.U\|[hyphen]\|net.com