Shoulder pain in primary care – clinical outcome predictors
Previous research into shoulder pain has identified among others longer duration of symptoms at baseline, a gradual onset of pain and higher pain intensity as factors correlated to a poorer prognosis. The aim of this study was to identify baseline variables associated with clinical outcomes and to combine them in clinical prediction models, useful for selecting appropriate management strategies and imaging diagnostics.
Baseline variables were collected in a cohort of 208 subjects and evaluated at 3 weeks, 3, 6 and 12 months. More than 160 variables were taken into account, of which 26 were having sufficient cases and associations of sufficient strength for statistic analysis.
Most noteworthy, pain eased or better at rest and pain referred below the elbow had the strongest correlation to excellent outcomes at 12 months of follow-up – although pain may be severe at baseline, good to excellent results are possible over the medium to long term (see for instance the natural history of adhesive capsulitis). Furthermore if lower pain levels were reported with physical testing at 3 weeks, the chance of excellent outcomes at 12 months of follow-up increased.
> From: Laslett et al., J Rehabil Med (2014) (Epub ahead of print). All rights reserved to The Author(s). Click here for the Pubmed summary.