Incidence and prevalence of complaints of the neck and upper extremity in general practice

Abstract

Objective: To study the incidence and prevalence of neck and upper extremity musculoskeletal complaints in Dutch general practice. Methods: Data were obtained from the second Dutch national survey of general practice. In all, 195 general practitioners (GPs) from 104 practices across the Netherlands recorded all contacts with patients during 12 consecutive months. Incidence densities and consultation rates were calculated. Results: The total number of contacts during the registration period of one year was 1 524 470. The most commonly reported complaint was neck symptoms (incidence 23.1 per 1000 person-years), followed by shoulder symptoms (incidence 19.0 per 1000 person-years). Sixty six GP consultations per 1000 personyears were attributable to a new complaint or new episode of complaint of the neck or upper extremity (incidence density). In all, the GPs were consulted 147 times per 1000 registered persons for complaints of the neck or upper extremity. For most complaints the incidence densities and consultation rates were higher for women than for men. Conclusions: Neck and upper extremity symptoms are common in Dutch general practice. The GP is consulted approximately seven times each week for a complaint relating to the neck or upper extremity; of these, three are new complaints or new episodes. Attention should be paid to training GPs to deal with neck and upper limb complaints, and to research on the prognosis and treatment of these common complaints in primary care. N eck or upper extremity complaints are a common reason for consulting a general practitioner (GP). It has been estimated that the 12 month period prevalence of neck pain is 31.4%, of shoulder pain 30.3%, of elbow pain 11.2%, and of wrist or hand pain 17.5% in the general population of the Netherlands.1 Roughly 30-40% of people reporting musculoskeletal pain during the past year indicated that they had contacted their GP for these complaints. 1Despite the high prevalence of complaints of the neck and upper extremity in the general population, detailed information on the number of GP consultations attributable to these complaints is scarce. In Finland, musculoskeletal pain was found to be the reason for approximately 18% of the visits to health centre doctors 2 and 9.3% in Iceland. 3 In England and Wales, 15% of all registered patients consulted their GP for a disorder of the musculoskeletal system. 4 These figures refer to musculoskeletal complaints in general and do not tell us about the number of consultations attributable to different types of complaint. There is a need for information on the number of consultations attributable to neck and upper extremity complaints, for the following reasons.First, the incidence of neck and upper extremity complaints in general practice informs us about the burden of these complaints in the general population-in other words, the number of people with neck and upper extremity complaints that are serious, painful, or annoying enough to seek medical care. In the Netherlands, nearly every citizen is registere...

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