Non-traumatic Arm, Neck, and Shoulder Complaints in General Practice: Incidence, Course and Management
Niet-traumatische klachten aan arm, nek, en schouder in de huisartsenpraktijk: Incidentie, beloop en beleid
Non-traumatic complaints of arm, neck, and shoulder are common and can result in functional limitations in daily life and may sometimes lead to sickness absence. Reported symptoms are e.g. pain, tingling, stiffness, numbness, loss of hand coordination. When seeking medical care for these complaints, the general practitioner (GP) is usually the first person to consult. This thesis studies patients who consult their GP with a new non-traumatic complaint of arm, neck or shoulder, with a focus on incidence, course and management. The incidence study showed that a fulltime GP is consulted about 3 times every week for a new non-traumatic complaint of arm, neck, or shoulder, most frequently located at neck or shoulder. Six months after the first consultation with their GP, 46% of the patients in the cohort study reported no recovery. Next to several complaint specific variables, the psychosocial variables little social support and high score on somatization were predicitve of non-recovery at 6 months. Management upto 6 months after the first consultation most frequently consisted of prescribed analgesics and referral for physiotherapy. Specific and non-specific diagnostic subgroups differed in the frequency that corticosteroid injections were applied, and referrals to physiotherapy and to a medical specialist. In addition variables associated with five common management options within a few weeks after the first consultation were evaluated. Overall, besides diagnosis, most frequently long duration of complaints, more functional limitations but also several GP characteristics were associated with the application of a treatment option in non-traumatic arm, neck and shoulder complaints.
|Keywords||arm, course, general practice, incidence, management, neck, primary care, prognosis, shoulder, treatment, upper extremity|
|Promotor||B.W. Koes (Bart) , J.A.N. Verhaar (Jan)|
|Publisher||Erasmus MC: University Medical Center Rotterdam|
|Sponsor||Dutch Arthritis Association, Stichting Anna Fonds in Leiden, Departments of General Practice and Orthopaedics, Netherlands Expert Centre for Workrelated Musculoskeletal Complaints of the Erasmus Medical Center in Rotterdam.|
Feleus, A. (2008, September 24). Non-traumatic Arm, Neck, and Shoulder Complaints in General Practice: Incidence, Course and Management. Erasmus MC: University Medical Center Rotterdam. Retrieved from http://hdl.handle.net/1765/13288