OBJECTIVE:Shoulder pain is a common complaint in primary care, and the factors associated with persisting shoulder pain are varied. We therefore explored prognostic factors associated with shoulder pain problems. STUDY DESIGN AND SETTING: Patients (n=109) were randomly allocated to 6 weeks of treatment with either corticosteroid injections (53 patients) or physiotherapy (56 patients). Patients were followed for 52 weeks. Severity of pain and shoulder disability was repeatedly scored at baseline and at 3, 7, 13, 26, and 52 weeks after randomization. Logistic regressions and mixed-effects models were used to explore prognostic factors. RESULTS: The data showed that during the 52 weeks of follow-up, 22% of the patients had persistent-recurrent symptoms (high risk of disability); the associated prognostic factors were gender (female) and age (>60 years). For the remaining patients, who had steady improvement in pain severity during the 52 weeks, there were still large between-patient variations in the rate of reaching recovery; this was influenced by treatment types: corticosteroid injections were associated with a faster relief of the pain. CONCLUSION: Age and gender might be the two important prognostic factors associated with persistent-recurrent problems. The effect of corticosteroid injections seems to be temporal.
RCT Entities:
OBJECTIVE: Shoulder pain is a common complaint in primary care, and the factors associated with persisting shoulder pain are varied. We therefore explored prognostic factors associated with shoulder pain problems. STUDY DESIGN AND SETTING:Patients (n=109) were randomly allocated to 6 weeks of treatment with either corticosteroid injections (53 patients) or physiotherapy (56 patients). Patients were followed for 52 weeks. Severity of pain and shoulder disability was repeatedly scored at baseline and at 3, 7, 13, 26, and 52 weeks after randomization. Logistic regressions and mixed-effects models were used to explore prognostic factors. RESULTS: The data showed that during the 52 weeks of follow-up, 22% of the patients had persistent-recurrent symptoms (high risk of disability); the associated prognostic factors were gender (female) and age (>60 years). For the remaining patients, who had steady improvement in pain severity during the 52 weeks, there were still large between-patient variations in the rate of reaching recovery; this was influenced by treatment types: corticosteroid injections were associated with a faster relief of the pain. CONCLUSION: Age and gender might be the two important prognostic factors associated with persistent-recurrent problems. The effect of corticosteroid injections seems to be temporal.
Authors: Kaia Engebretsen; Margreth Grotle; Erik Bautz-Holter; Leiv Sandvik; Niels G Juel; Ole Marius Ekeberg; Jens Ivar Brox Journal: BMJ Date: 2009-09-15
Authors: Yasmaine H J M Karel; Wendy G M Scholten-Peeters; Marloes Thoomes-de Graaf; Edwin Duijn; Ramon P G Ottenheijm; Maaike P J van den Borne; Bart W Koes; Arianne P Verhagen; Geert-Jan Dinant; Eric Tetteroo; Annechien Beumer; Joost B van Broekhoven; Marcel Heijmans Journal: BMC Musculoskelet Disord Date: 2013-02-11 Impact factor: 2.362