Temporal variations in a modified Neer impingement test can confound clinical interpretation.

Area of Science:

• Orthopedics
• Pain Management
• Musculoskeletal Research

Background:

• Neer-type subacromial impingement tests show high variability in patient pain relief timing.
• This variability complicates treatment guidance and prediction of surgical outcomes.
• Current clinical practice often relies on a 10-minute interval to assess test results.

Purpose of the Study:

• To quantify temporal variability in pain relief following a modified impingement test.
• To test the hypothesis that substantial pain relief can occur after the standard 10-minute assessment period.

Main Methods:

• 14 females and 12 males (mean age 55.6 years) with Stage II impingement received subacromial injections.
• Pain was assessed using 10-cm visual analog scales at 5, 10, 20, 30, and 40 minutes postinjection.
• Patients were categorized as rapid or delayed responders based on pain relief timing.

Main Results:

• 42% of patients achieved ≥75% pain relief by 10 minutes.
• An additional 35% achieved ≥75% relief after 10 minutes, with average relief occurring after 30 minutes.
• A significant portion of patients (delayed responders) showed substantial pain relief beyond the 10-minute mark.

Conclusions:

• Assessing Neer-type impingement tests at only 10 minutes may lead to inaccurate positive test determination.
• The temporal variability in pain relief highlights the need for extended assessment intervals.
• Extended pain assessment is crucial for accurately evaluating impingement test effectiveness and guiding patient treatment.