Abstract
BACKGROUND: Shoulder pain is common in primary health care. Nevertheless, information on the outcome of shoulder disorders is scarce, especially for patients encountered in general practice. AIM: To study the course of shoulder disorders in general practice and to determine prognostic indicators of outcome. METHOD: For this prospective follow-up study, 11 Dutch general practitioners recruited 349 patients with new episodes of shoulder pain. The participants filled out a questionnaire at presentation and further ones after 1, 3, 6 and 12 months; these contained questions on the nature, severity and course of the shoulder complaints. The association between potential prognostic indicators and the status of shoulder complaints (absence or presence of symptoms) was evaluated after one and 12 months of follow-up. RESULTS: After one month, 23% of all patients showed complete recovery; this figure increased to 59% after one year. A speedy recovery seemed to be related to preceding overuse or slight trauma and early presentation. A high risk of persistent or recurrent complaints was found for patients with concomitant neck pain and severe pain during the day at presentation. CONCLUSION: A considerable number of patients (41%) showed persistent symptoms after 12 months. It may be possible to distinguish patients who will show a speedy recovery from those with a high risk of long-standing complaints by determining whether there is a history of slight trauma or overuse, an early presentation or an absence of concomitant neck pain.
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Selected References
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- Bergenudd H., Lindgärde F., Nilsson B., Petersson C. J. Shoulder pain in middle age. A study of prevalence and relation to occupational work load and psychosocial factors. Clin Orthop Relat Res. 1988 Jun;(231):234–238. [PubMed] [Google Scholar]
- Binder A. I., Bulgen D. Y., Hazleman B. L., Roberts S. Frozen shoulder: a long-term prospective study. Ann Rheum Dis. 1984 Jun;43(3):361–364. doi: 10.1136/ard.43.3.361. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bjelle A. Epidemiology of shoulder problems. Baillieres Clin Rheumatol. 1989 Dec;3(3):437–451. doi: 10.1016/s0950-3579(89)80003-2. [DOI] [PubMed] [Google Scholar]
- Bulgen D. Y., Binder A. I., Hazleman B. L., Dutton J., Roberts S. Frozen shoulder: prospective clinical study with an evaluation of three treatment regimens. Ann Rheum Dis. 1984 Jun;43(3):353–360. doi: 10.1136/ard.43.3.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chakravarty K. K., Webley M. Disorders of the shoulder: an often unrecognised cause of disability in elderly people. BMJ. 1990 Mar 31;300(6728):848–849. doi: 10.1136/bmj.300.6728.848-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chard M. D., Hazleman R., Hazleman B. L., King R. H., Reiss B. B. Shoulder disorders in the elderly: a community survey. Arthritis Rheum. 1991 Jun;34(6):766–769. doi: 10.1002/art.1780340619. [DOI] [PubMed] [Google Scholar]
- Chard M. D., Sattelle L. M., Hazleman B. L. The long-term outcome of rotator cuff tendinitis--a review study. Br J Rheumatol. 1988 Oct;27(5):385–389. doi: 10.1093/rheumatology/27.5.385. [DOI] [PubMed] [Google Scholar]
- Fearnley M. E., Vadasz I. Factors influencing the response of lesions of the rotator cuff of the shoulder to local steroid injection. Ann Phys Med. 1969 May;10(2):53–63. doi: 10.1093/rheumatology/10.2.53. [DOI] [PubMed] [Google Scholar]
- Hazleman B. L. The painful stiff shoulder. Rheumatol Phys Med. 1972 Nov;11(8):413–421. doi: 10.1093/rheumatology/11.8.413. [DOI] [PubMed] [Google Scholar]
- Miettinen O. S. The need for randomization in the study of intended effects. Stat Med. 1983 Apr-Jun;2(2):267–271. doi: 10.1002/sim.4780020222. [DOI] [PubMed] [Google Scholar]
- Mulcahy K. A., Baxter A. D., Oni O. O., Finlay D. The value of shoulder distension arthrography with intraarticular injection of steroid and local anaesthetic: a follow-up study. Br J Radiol. 1994 Mar;67(795):263–266. doi: 10.1259/0007-1285-67-795-263. [DOI] [PubMed] [Google Scholar]
- Pollock R. G., Duralde X. A., Flatow E. L., Bigliani L. U. The use of arthroscopy in the treatment of resistant frozen shoulder. Clin Orthop Relat Res. 1994 Jul;(304):30–36. [PubMed] [Google Scholar]
- Reeves B. The natural history of the frozen shoulder syndrome. Scand J Rheumatol. 1975;4(4):193–196. doi: 10.3109/03009747509165255. [DOI] [PubMed] [Google Scholar]
- Shaffer B., Tibone J. E., Kerlan R. K. Frozen shoulder. A long-term follow-up. J Bone Joint Surg Am. 1992 Jun;74(5):738–746. [PubMed] [Google Scholar]
- Vecchio P. C., Kavanagh R. T., Hazleman B. L., King R. H. Community survey of shoulder disorders in the elderly to assess the natural history and effects of treatment. Ann Rheum Dis. 1995 Feb;54(2):152–154. doi: 10.1136/ard.54.2.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yamanaka K., Matsumoto T. The joint side tear of the rotator cuff. A followup study by arthrography. Clin Orthop Relat Res. 1994 Jul;(304):68–73. [PubMed] [Google Scholar]
- van der Heijden G. J., van der Windt D. A., Kleijnen J., Koes B. W., Bouter L. M. Steroid injections for shoulder disorders: a systematic review of randomized clinical trials. Br J Gen Pract. 1996 May;46(406):309–316. [PMC free article] [PubMed] [Google Scholar]
- van der Windt D. A., Koes B. W., de Jong B. A., Bouter L. M. Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis. 1995 Dec;54(12):959–964. doi: 10.1136/ard.54.12.959. [DOI] [PMC free article] [PubMed] [Google Scholar]
- van der Windt D. A., van der Heijden G. J., Scholten R. J., Koes B. W., Bouter L. M. The efficacy of non-steroidal anti-inflammatory drugs (NSAIDS) for shoulder complaints. A systematic review. J Clin Epidemiol. 1995 May;48(5):691–704. doi: 10.1016/0895-4356(94)00170-u. [DOI] [PubMed] [Google Scholar]