SHOULDER DISORDERS IN GENERAL-PRACTICE - PROGNOSTIC INDICATORS OF OUTCOME

Background. Shoulder pain is common in primary health care. Neverthele ss, information on the outcome of shoulder disorders is scarce, especi ally for patients encountered in general practice. Aim. To study the c ourse of shoulder disorders in general practice and to determine progn ostic indicators of outcome. Method. For this prospective follow-up st udy, 11 Dutch general practitioners recruited 349 patients with new ep isodes of shoulder pain, The participants filled out a questionnaire a t presentation and further ones after 1, 3, 6 and 12 months; these con tained questions on the nature, severity and course of the shoulder co mplaints. The association between potential prognostic indicators and the status of shoulder complaints (absence or presence of symptoms) wa s evaluated after one and 72 months of follow-up. Results. After one m onth, 23% of all patients showed complete recovery; this figure increa sed to 59% after one year. A speedy recovery seemed to be related to p receding overuse or slight trauma and early presentation. A high risk of persistent or recurrent complaints was found for patients with conc omitant neck pain and severe pain during the day at presentation. Conc lusion. A considerable number of patients (41%) showed persistent symp toms after 12 months. It may be possible to distinguish patients who w ill show a speedy recovery from those with a high risk of long-standin g complaints by determining whether there is a history of slight traum a or overuse, an early presentation or an absence of concomitant neck pain.