Shoulder pain prevalence by age and within occupational groups: a systematic review.
Christopher J Hodgetts, Charlotte Leboeuf-Yde, Amber Beynon and 1 others
PMID 34736540WHAT IT FOUND
Shoulder pain prevalence continues to rise after age 50 in working people, especially in physically demanding jobs.
In sedentary roles, findings were mixed, though computer work also increased risk. This suggests retirement or reduced activity, not just aging, drives the drop in pain seen in older general populations.
Key findings
01Shoulder pain prevalence generally increased past the age of 50, with 16 of the 21 included studies reporting higher estimates in older participants.
02In physically active occupations, prevalence estimates or odds ratios increased in 14 of 18 studies, remained stable in two, and decreased in one.
03In sedentary occupations, results were conflicting: two studies showed increasing prevalence over 50, while two showed decreasing prevalence.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The studies were highly heterogeneous, preventing meta-analysis or pooled estimates. Conclusions rely on a visual analysis of direction (increase/decrease/stable) rather than statistical significance. Many included studies had methodological flaws: 11 did not report representative samples, 8 did not use validated questionnaires, and 8 had low or unreported response rates. The 'healthy worker effect' likely biased results downward, meaning the true impact of physically demanding work on shoulder pain in older adults may be underestimated. Occupation classifications did not account for specific load, repetition, or shoulder elevation factors, and did not distinguish between heavy manual work and active non-heavy work. The review did not include retirees, so it cannot determine if retirement itself causes a drop in pain prevalence.
Declared interests
No specific funding sources or author conflicts of interest were explicitly stated in the provided text beyond the standard journal article disclosure context.
The easy way to misread this
Do not interpret the mixed results in sedentary occupations as evidence that desk jobs are safe for older shoulders. The review notes that computer work involves prolonged upper limb use, and two of the four sedentary studies still showed increasing pain prevalence after age 50.