Musculoskeletal Pain Due to Wheelchair Use: A Systematic Review and Meta-Analysis.

ABSTRACT

INTRODUCTION: Wheelchair users are at a high risk of experiencing non-neuropathic pain of musculoskeletal origin as a result of being wheelchair-bound. The aim of this systematic review was to establish the prevalence of musculoskeletal pain in wheelchair users that is attributable to wheelchair use, and to describe the different pain syndromes and discuss risk factors and management options. METHODS: After a systematic MEDLINE search, we identified 40 papers eligible for inclusion. RESULTS: The pooled prevalence of musculoskeletal pain at any location was 50% (95% CI 33-67%). The most common pain syndrome was shoulder pain (pooled prevalence 44%, 95% CI 36-52%). Wheelchair users were 5.8 times as likely to suffer from shoulder pain as controls (95% CI 2.7-12.2, p < 0.0001). Other pain syndromes included neck, elbow, wrist, hand and low back pain. Older age and increased duration of wheelchair use were the most significant determinants of pain in wheelchair users. CONCLUSIONS: Musculoskeletal pain as a result of wheelchair use is very common amongst wheelchair users. Management of pain should follow national and international guidelines. Optimal adjustment of seating position may prevent pain, and is important to be taken into consideration.