المؤلفون: Yaghoubitajani, Zohreh¹, Gheitasi, Mehdi¹ mehdi.gheitasi@googlemail.com, Bayattork, Mohammad², Andersen, Lars Louis^3,4

المصدر: Work. 2023, Vol. 75 Issue 4, p1403-1411. 9p. 4 Charts.

مصطلحات موضوعية: *NONPARAMETRIC statistics, *STATISTICS, *LABOR productivity, *WORK, *SELF-evaluation, *QUESTIONNAIRES, *DESCRIPTIVE statistics, *DATA analysis, SHOULDER pain, CARDIOVASCULAR fitness, SEDENTARY lifestyles, NECK pain, TIME, MANN Whitney U Test, ABILITY, TREATMENT effectiveness, MUSCULOSKELETAL pain, DATA analysis software, FRIEDMAN test (Statistics), EXERCISE therapy, LONGITUDINAL method, EVALUATION

مستخلص: BACKGROUND: While positive short-term effects from corrective exercise on neck-shoulder pain (NSP) are evident, maintenance effects after cessation of the exercise remain unknown. OBJECTIVE: The objective of the present study was to assess the lasting effects of corrective exercise in NSP and workability after a year of detraining. METHODS: A cohort study with 1-year follow-up was carried out in two previous training groups (n = 24) using a self-reported paper-based questionnaire, which was completed three times (baseline, 8-week exercise, and 1-year detraining). The subjects (mean±SD age: 39.0±6.4, 38.1±8.0) responded to the Visual Analogue Scale (VAS) for NSP as the primary outcome. A single validated item from the Workability Index determined workability as the secondary outcome. Between and within-group differences of the two groups were investigated using non-parametric tests, including 12 subjects in each group. RESULTS: The results indicated that 8-week exercise improvements in NSP and mental and physical workability were largely maintained after one year of detraining. The lasting effects of NSP and physical and mental workability were statistically identified in 8-week and 1-year follow-ups. Nevertheless, it is noticeably warranted to adhere to the exercise program. CONCLUSION: The current study indicates that a brief 8-week exercise period once per year is sufficient to reduce pain and improve workability among workers. This knowledge can make exercise interventions more feasible and cost-effective for companies aiming to improve employee health. [ABSTRACT FROM AUTHOR]

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المؤلفون: Howard, A.^1,2,3,4 (AUTHOR) anthonyjhoward@aol.com, Woods, A.¹ (AUTHOR), Rombach, I.¹ (AUTHOR), Achten, J.¹ (AUTHOR), Appelbe, D.¹ (AUTHOR), Athwal, A.¹ (AUTHOR), Jones, E.¹ (AUTHOR), Draper, K.¹ (AUTHOR), Gwilym, S.¹ (AUTHOR)

المصدر: Pilot & Feasibility Studies. 1/17/2024, Vol. 10 Issue 1, p1-8. 8p.

مصطلحات موضوعية: *SHOULDER pain, *SHOULDER, *RESEARCH protocols, *PILOT projects, *RANDOMIZED controlled trials, *FEASIBILITY studies

مستخلص: Background: The management of subacromial shoulder pain represents a significant challenge and is typically managed through either physiotherapy, joint injection or surgical intervention. Recent surgical trials have questioned the efficacy and there is a need to improve the evidence base for the non-surgical management of this condition. The study aims to provide evidence of the feasibility of conducting a randomised controlled trial to compare the efficacy of autologous protein solution (APS) against the current standard of care, corticosteroid injection (CSI) for subacromial shoulder pain. Autologous protein solution (APS) is a blood-derived biological injection which has been shown to have anti-inflammatory effects. Methods: A parallel-group two-arm randomised control trial will be conducted, comparing APS and CSI for shoulder pain. Fifty patients will be recruited. Feasibility will be assessed by examination of the conversion rate of eligible participants to the total number of participants recruited, whether it is possible to collect the appropriate outcome measures and the levels of retention/data compliance at follow-up dates. Discussion: CSI is the mainstay of conservative management of subacromial shoulder pain. Trials and systematic reviews have reported differing conclusions, but the consensus view is that any benefits seen from CSI use are most likely to be short-term and there remains a significant number of patients who go on to have surgical intervention despite CSI. Biological injections, such as APS are being increasingly used, in the anticipation they may offer improved longer lasting outcomes for shoulder pain. However, the evidence to demonstrate the comparative efficacy of CSI versus APS does not currently exist. If feasible, a fully powered study will offer clarity to the treatment pathway of thousands of patients each year with subacromial pain. Trial registration: The study is funded by the National Institute for Health Research–Research for Patient Benefit, NIHR 201473, Trial Registration Number (ISRCTN12536844: SPiRIT. Shoulder pain: randomised trial of injectable treatments–date of Registration 15/9/2021). Protocol Version V1.0_30Jul2021. IRAS Project ID: 294,982. [ABSTRACT FROM AUTHOR]

المؤلفون: Daripelli, Sushma¹, Uppuluri, Sujatha¹, Vazir, Deepika²

المصدر: Advances in Human Biology. Jan-Mar2024, Vol. 14 Issue 1, p29-35. 7p.

مصطلحات موضوعية: *MORPHOMETRICS, *SHOULDER pain, *ANATOMICAL variation, *DISEASE prevalence, *SYSTEMATIC reviews

مستخلص: Suprascapular notch roofed by STSL is located in the lateral part of the superior border of scapula and medial to the base of the coracoids process. The suprascapular nerve (SN) is entrapped due to anatomical variation of the notch. The SN injury is the main cause of shoulder pain and weakness. Detailed anatomical knowledge of the SSN is necessary to manage entrapment neuropathy and interventional techniques. Therefore, in this study, we will measure the anatomical knowledge of various types of SSNs and the morphology of these structures. We searched multiple computerised databases from 2012 to 2022. Morphometry-based studies of the SSN were included in this systematic review. Those studies have information on various dimensions of SSN. The SSN can be classified into six anatomical types. These include Type I (wide depression), Type II (wide blunted V shape), Type III (symmetric U shape), Type IV (small V shape), Type V (partial ossified STSL), and Type VI (fully ossified STSL). Throughout the review, SSN was categorised as stated by Rengachary classification. There were five types of SSNs in the present review, the most predominant being type III (41.43%). Type III notch has a higher superior transverse diameter (STD) and middle transverse diameter (MTD) than any other notches, while type V notch has the lowest STD and MTD. Based on the outcomes of our review, we can conclude that type III SSN accounted for the most prevalence, followed by the other types of SSN. Type III notch (U-shaped notch through symmetrical and parallel lateral borders) has a higher STD and MTD than any other notch. At the same time, the type V notch has been found to have the lowest STD and MTD. [ABSTRACT FROM AUTHOR]

المؤلفون: de Holanda Santos, Laís Regina¹ (AUTHOR), Batista, Gabriel de Amorim² (AUTHOR) gabriel.amorimbatista@upe.br, da Silva Oliveira, Felipe Augusto¹ (AUTHOR), Pitangui, Ana Carolina Rodarti^1,3 (AUTHOR), de Araújo, Rodrigo Cappato^1,2,3 (AUTHOR)

المصدر: Isokinetics & Exercise Science. 2024, Vol. 32 Issue 1, p49-57. 9p.

مصطلحات موضوعية: *SHOULDER pain, *PAIN, *CONFIDENCE intervals, *ANTHROPOMETRY, *MOVEMENT disorders, *STRENGTH training, *MATHEMATICAL variables, *SCAPULA, *DESCRIPTIVE statistics, *ARM exercises, *ELECTROMYOGRAPHY, *REHABILITATION, *EXERCISE therapy, *CAUSAL models

مستخلص: BACKGROUND: Scapular dyskinesis (SD) is a modification of the positioning and movement of the scapula and is associated with shoulder pain. Exercises to strengthen the shoulder and scapular muscles have been proposed as a therapeutic strategy to reduce pain and improve function. OBJECTIVE: We aimed to investigate the electromyographic activity of the periscapular and trunk muscles in individuals with shoulder pain and SD in different multi-joint exercises. METHODS: Thirty-two subjects with subacromial pain, of both sexes, with the presence or absence of SD, participated in this study. Volunteers performed five repetitions in five exercises (Closed Row; Pronated Row; Push-up; Scapular Push-up; T-push-up). The activity of the upper trapezius, middle trapezius, lower trapezius, serratus anterior, external oblique, and rectus abdominis muscles was recorded using electromyography. RESULTS: Our results showed a decrease in the electromyographic activity of the serratus anterior and external oblique during the T-push-up exercise in individuals with shoulder pain and SD. No differences were observed between groups for the trapezius and the rectus abdominis. CONCLUSIONS: Rehabilitation programs may initially prioritize rowing and push-up exercises to strengthen periscapular muscles. More complex exercises with greater mechanical demand on the kinetic chain, such as the T-push-up, may have to be implemented in later phases. [ABSTRACT FROM AUTHOR]

العنوان البديل: Omuz Ağrısı Olan Hastalarda Supraspinatus Kas Kalınlığı, Akromiohumeral Mesafe ve Korakohumeral Mesafenin Manyetik Rezonans Görüntüleme Ölçümlerinin Değerlendiriciler İçi ve Değerlendiriciler Arası Güvenilirliği

المؤلفون: Dede, Burak Tayyip¹, Oguz, Muhammed¹, Bulut, Berat¹, Bagcier, Fatih², Yildizgoren, Mustafa Turgut³ ftr.mustafaturgut@hotmail.com, Aytekin, Ebru¹

المصدر: Selcuk University Medical Journal. 2024, Vol. 40 Issue 1, p34-38. 5p.

مصطلحات موضوعية: *MAGNETIC resonance imaging, *SHOULDER pain, *SUPRASPINATUS muscles, *MEASUREMENT errors, *INTRACLASS correlation, *UNITS of measurement

الملخص (بالإنجليزية): Aim: The aim of this study was to evaluate the intra- and inter-rater reliability coefficients of the supraspinatus muscle thickness (SMT), acromiohumeral distance (AHD), and coracohumeral distance (CHD) in patients with shoulder pain. Materials and Methods: This retrospective study included 80 patients who presented with complaints of shoulder pain at a single centre between January 2023 and January 2024. The supraspinatus muscle thickness, acromiohumeral distance, and coracohumeral distance measurements were obtained one week apart by two observers. The intraclass correlation coefficient (ICC), minimum detectable change, and standard error of measurement were subsequently calculated. Results: AHD intra-rater reliability results evaluated on coronal sections were excellent (Rater 1, ICC=0.96; 95% CI, 0.94-0.97; Rater 2 ICC=0.75; 95% CI, 0.61-0.84). AHD intra-rater reliability results evaluated on sagittal sections were excellent (Rater 1, ICC=0.94; 95% CI; 0.91-0.96; Rater 2 ICC=0.77; 95% CI, 0.64-0.85). The results of CHD measured using coronal sections were good (Rater 1, ICC=0.85; 95% CI, 0.76-0.90; Rater 2 ICC=0.82; 95% CI, 0.71-0.88). SMT measurement results measured using coronal sections were excellent (Rater 1, ICC=0.98; CI, 0.98-0.99; Rater 2, ICC=0.89; 95% CI, 0.82-0.93). The inter-rater reliability values were good for AHD-Coronal (ICC= 0.75; 95% CI, 0.61-0.84) and AHD-Sagittal (ICC=0.86; 95% CI, 0.79-0.91), were fair for CHD evaluated on coronal sections (ICC=0.74; %95 CI, 0.58-0.83), and were excellent for SMT evaluated on coronal sections (ICC=0.92; 95% CI, 0.87-0.95). Conclusion: These results suggest that magnetic resonance imaging measurements of the supraspinatus muscle thickness and acromiohumeral distance can be reliable and consistent for the clinical evaluation of patients with shoulder pain. [ABSTRACT FROM AUTHOR]

Abstract (Turkish): Amaç: Bu çalışmada omuz ağrısında supraspinatus kas kalınlığı (SKK), akromiohumeral mesafe (AHM) ve korakohumeral mesafenin (KHM) değerlendirici içi ve değerlendiriciler arası güvenilirlik katsayılarının değerlendirilmesi amaçlanmaktadır. Gereçler ve Yöntem: Bu retrospektif çalışma Ocak 2023 ile Ocak 2024 tarihleri arasında tek merkezde gerçekleştirildi. Çalışmaya omuz ağrısı olan 80 hasta dahil edildi. Supraspinatus kas kalınlığı, akromiohumeral mesafe ve korakohumeral mesafe, bir hafta arayla iki gözlemci tarafından elde edildi. Sınıf içi korelasyon katsayısı (ICC), minimum tespit edilebilir değişiklik ve standart ölçüm hatası hesaplandı. Bulgular: Koronal kesitlerde değerlendirilen AHM değerlendirici içi güvenilirlik sonuçları mükemmeldi (Değerlendirici 1, ICC=0,96; %95 GA, 0,94-0,97; Değerlendirici 2 ICC=0,75; %95 GA, 0,61-0,84). Sagital kesitlerde değerlendirilen AHM değerlendirici içi güvenilirlik sonuçları mükemmeldi (Değerlendirici 1, ICC=0,94; %95 GA; 0,91-0,96; Değerlendirici 2 ICC=0,77; %95 GA, 0,64-0,85). Koronal kesitler kullanılarak ölçülen KHM sonuçları iyiydi (Değerlendirici 1, ICC=0,85; %95 GA, 0,76-0,90; Değerlendirici 2 ICC=0,82; %95 GA, 0,71-0,88). Koronal kesitler kullanılarak ölçülen SKK ölçüm sonuçları mükemmeldi (Değerlendirici 1, ICC=0,98; CI, 0,98-0,99; Değerlendirici 2, ICC=0,89; %95 CI, 0,82-0,93). Değerlendiriciler arası güvenilirlik değerleri AHM-Koronal (ICC= 0,75; %95 GA, 0,61-0,84) ve AHM-Sagital için (ICC=0,86; %95 GA, 0,79-0,91) iyi, koronal kesitlerde değerlendirilen KHM ölçümleri için orta (ICC=0,74; %95 GA, 0,58-0,83) ve koronal kesitlerde değerlendirilen SKK için mükemmeldi (ICC=0,92; %95 GA, 0,87-0,95). Sonuç: Bu bulgular, supraspinatus kas kalınlığı, akromiohumeral mesafe ve korakohumeral mesafenin manyetik rezonans görüntüleme ölçümlerinin omuz ağrısı olan hastaların klinik değerlendirmesinde güvenilir ve tutarlı olabileceğini göstermektedir. [ABSTRACT FROM AUTHOR]

المؤلفون: Skazalski, Christopher^1,2 chris.skazalski@gmail.com, Whiteley, Rod¹, Sattler, Tine³, Kozamernik, Tilen⁴, Bahr, Roald^1,2

المصدر: Journal of Athletic Training (Allen Press). Jan2024, Vol. 59 Issue 1, p81-89. 9p.

مصطلحات موضوعية: *VOLLEYBALL injuries, *SHOULDER pain, *SPORTS participation, *TEAMS in the workplace, *KNEE pain, *CONFIDENCE intervals, *AGE distribution, *RESEARCH methodology, *COMPARATIVE studies, *QUESTIONNAIRES, *DESCRIPTIVE statistics, *ATHLETIC ability, *OVERUSE injuries, *EPIDEMIOLOGICAL research

مصطلحات جغرافية: UNITED States, JAPAN, TURKEY, QATAR

مستخلص: The knee, low back, and shoulder account for most overuse injuries in volleyball. Previous researchers have used methodology that did not examine the extent of injury burden and effect on performance. To develop a more accurate and complete understanding regarding the weekly prevalence and burden of knee, low back, and shoulder problems within the highest levels of men's volleyball, including the role that preseason complaints, match participation, player position, team, and age have on complaints. Descriptive epidemiology study. Professional volleyball clubs and the National Collegiate Athletic Association Division I program. A total of 75 male volleyball players, representing 4 teams playing in their country's respective premier league (Japan, Qatar, Turkey, and the United States), participated over a 3-season period. Players completed a weekly questionnaire (Oslo Sports Trauma Research Centre Overuse Injury Questionnaire) reporting pain related to their sport and the extent to which knee, low back, and shoulder problems affected participation, training volume, and performance. Problems leading to moderate or severe reductions in training volume or performance or the inability to participate were considered substantial problems. The mean weekly prevalence of knee, low back, and shoulder problems based on 102 player-seasons was 31% (95% CI = 28%, 34%), 21% (95% CI = 18%, 23%), and 19% (95% CI = 18%, 21%), respectively. Most players (93%, 95/102 player-seasons) reported some level of knee (79%, n = 81/102 player-seasons), low back (71%, n = 72/102 player-seasons), or shoulder (67%, n = 68/102 player-seasons) complaints during the season. Most players (58%, n = 59/102 player-seasons) experienced at least 1 episode of substantial problems affecting the knee (33%, n = 34/102 player-seasons), low back (27%, n = 28/102 player-seasons), or shoulder (27%, n = 28/102 player-seasons). Players with preseason complaints had more in-season complaints than teammates without preseason problems (mean weekly prevalence: knee, 42% versus 8%, t49 = −18.726, P <.001; low back, 34% versus 6%, t32 = −12.025, P <.001; shoulder, 38% versus 8%, t30 = −10.650, P <.001). Nearly all included elite male volleyball players experienced knee, low back, or shoulder problems, and most had at least 1 bout that substantially reduced training participation or sport performance. These findings suggest that knee, low back, and shoulder problems result in greater injury burden than previously reported. [ABSTRACT FROM AUTHOR]

المؤلفون: Kulkarni, Madhur S.¹ madhurkulkarni19@gmail.com, Shaikh, Falak F.²

المصدر: Indian Journal of Occupational & Environmental Medicine. Jan-Mar2024, Vol. 28 Issue 1, p61-64. 4p.

مصطلحات موضوعية: *CROSS-sectional method, *SHOULDER pain, *KNEE pain, *OCCUPATIONAL diseases, *MUSCULOSKELETAL system diseases, *WORK environment, *QUESTIONNAIRES, *DESCRIPTIVE statistics, *JUDGMENT sampling, *QUALITY of life, *MANUFACTURING industries, *METROPOLITAN areas, *DATA analysis software, *LUMBAR pain

مصطلحات جغرافية: INDIA

مستخلص: Context: Corrugated box factory workers routinely perform various tasks at their workplace which may impact their musculoskeletal system and quality of life (QoL). Aim: The aim of this study was to assess work-related musculoskeletal disorders and health related QoL in corrugated box factory workers of an urban city in India. Study Setting: Corrugated box factory. Study Design: Cross-sectional. Methods and Materials: The study encompassed 60 participants fulfilling laid down inclusion criteria. Assessment of work-related musculoskeletal disorders (WRMSDs) was done by using the Hindi version of the Nordic Musculoskeletal Questionnaire. Health-related quality of life (HRQoL) was assessed using World Health Organization Quality of Life brief questionnaire. Statistical Analysis: This was done using descriptive statistics. Mean, standard deviations, and percentages were calculated using Microsoft Excel, and the data were presented in tabular and graphical format. Results: In total, 98.33% workers reported of having work-related musculoskeletal disorders. The area-wise affection showed the highest incidence of musculoskeletal disorders in shoulder and lower back, i.e. 52.54% each followed by knee (41.23%) thereafter the other joints. Conclusions: This study concludes that WRMSDs are significantly prevalent among corrugated box factory workers in urban India along with manifestations of lower HRQoL. [ABSTRACT FROM AUTHOR]

المؤلفون: Kaya, Oğuz¹ oguzkayamd@gmail.com, Gönder, Nevzat²

المصدر: Iranian Journal of Parasitology. Jan-Mar2024, Vol. 19 Issue 1, p123-127. 5p.

مصطلحات موضوعية: *SHOULDER pain, *SHOULDER, *BACKACHE, *ECHINOCOCCUS granulosus, *CONSCIOUSNESS raising, *ECHINOCOCCOSIS

مصطلحات جغرافية: TURKEY

مستخلص: Hydatid cyst is an infestation caused by Echinococcus granulosus, which is endemic in most countries and most commonly affects the liver and lungs. Isolated muscle involvement is very rare and accounts for 3-5% of all cases. In April 2022, Health Sciences University Elaziğ Fethi Sekin City and Research Hospital in Turkey received a referral for a 37-year-old male patient from the physical therapy and rehabilitation outpatient clinic. The patient presented with complaints of chronic pain in his left shoulder and back, which worsened with movement. After the radiological and serological confirmation of diagnosis, the patient underwent wide surgical resection, adjuvant and neoadjuvant anthelmintic chemotherapy. Precise and complete removal of the cyst without infecting the surrounding tissues combined with anthelmintic chemotherapy will not only increase the success of the surgery but will also minimize the possibility of recurrence and distant organ spread. In this study, we aimed to raise awareness by presenting the first reported isolated hydatid cyst in the infraspinatus muscle case from our country, which is extremely rare. [ABSTRACT FROM AUTHOR]

المؤلفون: Waugh, Christopher A.¹ (AUTHOR) chriswaugh@hotmail.co.uk, Onggo, James R.^2,3 (AUTHOR), Donald, Simon⁴ (AUTHOR)

المصدر: European Journal of Orthopaedic Surgery & Traumatology. Jan2024, Vol. 34 Issue 1, p641-646. 6p.

مصطلحات موضوعية: *ONLINE information services, *SHOULDER pain, *MEDICAL information storage & retrieval systems, *RANGE of motion of joints, *SYSTEMATIC reviews, *JOINT instability, *SURGICAL complications, *TREATMENT effectiveness, *SHOULDER joint injuries, *GLENOHUMERAL joint, *SCAPULA, *ARTHRITIS, *MEDLINE, *NEURODEGENERATION, *TOTAL shoulder replacement, *POSTOPERATIVE pain, *BONE fractures, *EVALUATION

مستخلص: Purpose: Reverse total shoulder replacement (rTSR) improves pain and function in patients with a wide range of shoulder pathology. Anterosuperior (AS) and deltopectoral (DP) approaches are widely used to gain access to the glenohumeral joint in arthroplasty. Our aim was to systematically review the literature comparing outcomes of these two approaches when performing rTSR for degenerative glenohumeral arthritis. Methods: Systematic review was performed with an electronic multi-database search (Pubmed, Medline & Embase) according to PRISMA guidelines on 18th September 2022. Data from published studies of any study design that met the inclusion criteria were extracted, reviewed and synthesized. Results: A total of 38 studies were identified for full text review, of which four were included. No significant difference in pain and range of motion were observed between approaches. Scapular notching was more common in the anterosuperior approach. Low rates of instability and intra-operative fracture were observed in both. Conclusion: Both approaches demonstrate similar clinical outcomes with reference to pain, range of motion and complications when performing rTSR indicated for degenerative joint disease. However, further well-designed studies are required. [ABSTRACT FROM AUTHOR]

المؤلفون: Dai, Zhisen^1,2 (AUTHOR), Wu, Yanlin³ (AUTHOR), Chen, Junheng¹ (AUTHOR), Huang, Shuting¹ (AUTHOR), Zheng, Huizhe¹ (AUTHOR) huizhezheng@fjzlhospital.com

المصدر: Age & Ageing. Jan2024, Vol. 53 Issue 1, p1-9. 9p.

مصطلحات موضوعية: *CHRONIC pain, *SHOULDER pain, *SEDENTARY lifestyles, *FRAIL elderly, *SEQUENCE analysis, *NECK pain, *KNEE pain, *GERIATRIC assessment, *JOINT pain, *FACIAL pain, *BACKACHE, *RISK assessment, *GENOME-wide association studies, *FACTOR analysis, *MENTAL depression, *SENSITIVITY & specificity (Statistics), *MOLECULAR epidemiology, *ABDOMINAL pain, *HEADACHE, *SMOKING, *BODY mass index, *EDUCATIONAL attainment, *DISEASE risk factors

مستخلص: Background Previous observational studies have indicated a complex association between chronic pain and frailty. This study aimed to examine the bidirectional causal relationship between frailty and chronic pain and to quantify mediating effects of known modifiable risk factors. Methods A bidirectional two-sample Mendelian randomisation (MR) analysis was applied in this study. Summary genome-wide association statistics for frailty, as defined by both frailty index (FI) and Fried Frailty Score (FFS), pain at seven site-specific chronic pain (SSCP) (headache, facial, neck/shoulder, stomach/abdominal, back, hip and knee) and multisite chronic pain (MCP) were extracted from populations of European ancestry. Genetic instrumental variables strongly correlated with each exposure were selected. The inverse-variance-weighted method was the primary method used in the MR, supplemented by a range of sensitivity and validation analyses. Two-step MR analysis was undertaken to evaluate the mediating effects of several proposed confounders. Results Genetically predicted higher FI and FFS were associated with an increased risk of MCP and specific types of SSCP, including neck/shoulder pain, stomach/abdominal pain, back pain, hip pain and knee pain. In the reverse direction analysis, genetic liability to MCP was found to be associated with increased FI and FFS. These results remained consistent across sensitivity and validation assessments. Two-step MR suggested a mediating role for body mass index, smoking initiation, physical inactivity, educational attainment and depression. Conclusions Our research provided genetic evidence that the association between frailty and chronic pain was bidirectional where the coexistence of both conditions will exacerbate each other. [ABSTRACT FROM AUTHOR]