Predictors of chronic shoulder pain

Journal/Book: Phys Rehab Kur Med 9 (1999) S. M29-M30 / Rehab in Review Vol. 6 Nr.10 1998. 1999 / 1998;

Abstract: MacFarlane G et al.: Predictors of Chronic Shoulder Pain: A Population Based Prospective Study. J. Rheumatol. 25 (1998) 1612-1615 Previous studies have suggested that most patients with shoulder pain do not present for medical attention. This study sought to determine the natural history of shoulder pain and to determine the individual and clinical factors affecting long-term outcome. In this three-year prospective cohort study subjects registered with a general practice in the United Kingdom (age 18 to 75 years) were randomly selected to receive a mailed questionnaire. From an 80% response rate a total of 135 individuals were identified as having experienced shoulder pain within the previous month. The extent of shoulder pain was identified with the help of a manikin diagram as either broad pain involving the trunk and neck or as a more shoulder-specific painful area. Patients were assessed for pain onset and duration clinical medical attention sought number of restricted shoulder movements and psychological distress and disability as indicated by the General Health Questionnaire (GHQ). All subjects then completed a follow-up questionnaire (median time 35 months). Of the original 135 patients only 92 (68%) completed the follow-up questionnaire. Of these 50 (54%) reported shoulder pain at three-year follow-up. Baseline predictors of pain at follow-up included shoulder pain related disability pain on the day of the examination symptoms of at least one year duration pain in a narrow shoulder region older age and a high GHQ score. However restriction of shoulder movement in one or more planes was not significantly associated with pain at follow-up. Conclusion: This prospective study found that more than half the subjects with shoulder pain had persistent pain and potentially long-term disabling symptoms at three years follow-up. Pain location in a narrow shoulder-specific area seemed related to chronicity of symptoms while restricted range of motion was not. ___MH

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