Prognostic indicators for non-recovery of non-traumatic complaints at arm, neck and shoulder in general practice—6 months follow-up

Feleus, Anita; Bierma-Zeinstra, Sita M A; Miedema, Harald S.; Verhagen, Arianne P.; Nauta, A. P.; Burdorf, Alex; Verhaar, Jan A N; Koes, Bart W.

doi:10.1093/rheumatology/kel164

Cited by 70 publications

(45 citation statements)

References 22 publications

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“…Feleus et al (4) reported an annual incidence rate of 1.1 per 100 patients in general practice in Holland and Silverstein et al (5) reported an annual incidence rate for claims of 0.1 per 100 full-time workers in the Washington state. In France, Roquelaure et al (7) reported an annual incidence rate of 2.1 per 100 workers in a shoe factory and Leclerc et al (9) reported an annual incidence rate of 4.0 per 100 workers highly exposed to physical constraints.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of lateral epicondylitis has been estimated in general practice (3,4), on the basis of compensation claims (5), hospitals (6), and certain specific activity sectors (7)(8)(9). The estimated incidence of lateral epicondylitis ranges from 0.3-1.1 per 100 patient-years in general practice to 2.0-11.3 per 100 worker-years in specific activity sectors.…”

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confidence: 99%

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Work-related risk factors for incidence of lateral epicondylitis in a large working population

Herquelot¹,

Guéguen²,

Roquelaure³

et al. 2013

Scand J Work Environ Health

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Work-related risk factors for incidence of lateral epicondylitis in a large working population

Herquelot¹,

Guéguen²,

Roquelaure³

et al. 2013

Scand J Work Environ Health

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“…For example, elevated scores on the Tampa Scale of Kinesiophobia or the Fear-Avoidance Beliefs Questionnaire have been associated with a longer recovery, chronic symptoms, and work loss in patients with shoulder pain. 42,59,79 Accordingly, identifying cognitive behavioral tendencies during the patient's evaluation can direct the therapist to employ specific patient education strategies to optimize patient outcomes to physical therapy interventions and potentially provide indications for referring the patient for consultation with another medical or mental health practitioner. 10 …”

Section: Componentmentioning

confidence: 99%

Shoulder Pain and Mobility Deficits: Adhesive Capsulitis

Kelley¹,

Shaffer²,

Kuhn³

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

282

222

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The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these clinical practice guidelines is to describe the peer-reviewed literature and make recommendations related to adhesive capsulitis. J Orthop Sports Phys Ther 2013;43(5):A1–A31. doi:10.2519/jospt.2013.0302

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“…In our earlier study in this population, indicators of poor prognosis were long duration of the complaints at baseline, having musculoskeletal comorbidity, recurrent complaint, low social support, and a high somatization level. 11 Although GP characteristics, such as sex, years of experience, and type of practice, are also reported to infl uence management decisions, 12,13 in a well-organized health care system, their infl uence would be expected to be marginal and that the diagnosis, patient, and complaint characteristics would show the strongest associations with management. Furthermore, highly variable treatment that cannot be explained by differences in diagnoses and patient or complaint characteristics could indicate the need for treatment guidelines to ensure that management decisions at least can be based on available knowledge on preferable outcomes or, when not available, on costs.…”

Section: Introductionmentioning

confidence: 99%

Management Decisions in Nontraumatic Complaints of Arm, Neck, and Shoulder in General Practice

Feleus¹,

Bierma-Zeinstra²,

Bernsen³

et al. 2009

The Annals of Family Medicine

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OBJECTIVE We wanted to evaluate associations between diagnosis and characteristics of the patient, complaint, and general practitioner (GP), as well as 6 common management decisions, in patients with nontraumatic arm, neck, and shoulder complaints at the time of the fi rst consultation with their physician. METHODSWe undertook an observational cohort study set in 21 Dutch general practices, including 682 patients with nontraumatic complaints of arm, neck, and shoulder. The outcome measure was application (yes/no) of a specifi c management option: watchful waiting, additional diagnostic tests, prescription of medication, corticosteroid injection, referral for physiotherapy, and referral for medical specialist care.RESULTS Separate multilevel analyses showed that overall, the diagnostic category, having long duration of complaints, and reporting many functional limitations were most frequently associated with the choice of a management option. For watchful waiting, only complaint variables played a role (long duration of complaints, high complaint severity, many functional limitations, recurrent complaint). All these variables were negatively associated with watchful waiting. When opting for 1 of the 5 other management options, several physician characteristics played a role as well. Less clinical experience was associated with additional diagnostic tests and referral to a medical specialist. GPs working in a solo practice more frequently referred to a medical specialist. GPs working in a rural area more frequently referred for physiotherapy. Female GPs prescribed medication less frequently. Physicians with special interest in musculoskeletal complaints gave corticosteroid injections more frequently.CONCLUSIONS Diagnostic category, long duration of complaints, and high functional limitations were key variables in management decisions with these complaints. In addition, several physician characteristics played a role as well. Ann Fam Med 2009;7:446-454. doi:10.1370/afm.993. INTRODUCTIONC omplaints of arm, neck, and shoulder are very common in Western societies. 1,2 In the Netherlands the estimated 12-month prevalence in the general population was 31% for neck pain, 30% for shoulder pain, 11% for elbow pain, and 18% for wrist or hand pain.1,2 Studies have reported that of the respondents with noninfl ammatory musculoskeletal pain, about 30% to 45% contacted their general practitioner (GP).1,3 In Dutch general practice, incidence data for patients with nontraumatic arm, neck, or shoulder complaints show 97 consultations per 1,000 registered persons annually. 4 Common management options for patients with nontraumatic arm, neck, and shoulder complaints are watchful waiting, additional diagnostic tests, prescription of medication, referral for physiotherapy, a corticosteroid injec- 447A R M, NEC K , A ND SHOUL DER CO MPL A IN T S tion, and referral for medical specialist care. Use of these 6 management options shows wide variation, however, both between and within diagnostic groups.5 Until now, no studies have ...

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Prognostic indicators for non-recovery of non-traumatic complaints at arm, neck and shoulder in general practice—6 months follow-up

Abstract: Besides questions on complaint characteristics, information on somatization and support can help a general practitioner to recognize patients at risk of persistent complaints.

Cited by 70 publications

References 22 publications

Work-related risk factors for incidence of lateral epicondylitis in a large working population

Work-related risk factors for incidence of lateral epicondylitis in a large working population

Shoulder Pain and Mobility Deficits: Adhesive Capsulitis

Management Decisions in Nontraumatic Complaints of Arm, Neck, and Shoulder in General Practice

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