Abstract
BackgroundRegional musculoskeletal pain such as back or shoulder pain are commonly reported symptoms in the community. The extent of consultation to primary care with such problems is unknown as a variety of labels may be used to record such consultations. The objective was to classify musculoskeletal morbidity codes used in routine primary care by body region, and to determine the annual consultation prevalence of regional musculoskeletal problems.MethodsMusculoskeletal codes within the Read morbidity Code system were identified and grouped by relevant body region by four GPs. Consultations with these codes were then extracted from the recorded consultations at twelve general practices contributing to a general practice consultation database (CiPCA). Annual consultation prevalence per 10,000 registered persons for the year 2006 was determined, stratified by age and gender, for problems in individual regions and for problems affecting multiple regions.Results5,908 musculoskeletal codes were grouped into regions. One in seven of all recorded consultations were for a musculoskeletal problem. The back was the most common individual region recorded (591 people consulting per 10,000 registered persons), followed by the knee (324/10,000). In children, the foot was the most common region. Different age and gender trends were apparent across body regions although women generally had higher consultation rates. The annual consultation-based prevalence for problems encompassing more than one region was 556 people consulting per 10,000 registered persons and increased in older people and in females.ConclusionsThere is an extensive and varied regional musculoskeletal workload in primary care. Musculoskeletal problems are a major constituent of general practice. The output from this study can be used as a resource for planning future studies.
Highlights
Regional musculoskeletal pain such as back or shoulder pain are commonly reported symptoms in the community
UK databases such as the Fourth National Survey of Morbidity in General Practice (MSGP4) conducted by the Royal College of General Practitioners (RCGP) last carried out in 1991/2 [11] and the linked annual RCGP Weekly Returns Service (WRS) reports [2] provide figures on annual prevalence of consultation to primary care
The most common musculoskeletal problems diagnosed in primary care by the RCGP WRS in 2007 within the Musculoskeletal Read Code Chapter were listed as "Back disorders unspecified other", "Pain in Limb", "Joint Disorder Other Unspecified", "Osteoarthritis & Allied Disorders" and "Peripheral Enthesopathies & Allied Syndromes"[2]
Summary
Regional musculoskeletal pain such as back or shoulder pain are commonly reported symptoms in the community. The objective was to classify musculoskeletal morbidity codes used in routine primary care by body region, and to determine the annual consultation prevalence of regional musculoskeletal problems. Musculoskeletal problems are one of the most common reasons for seeking primary care, with estimates of up to 20% of adults consulting their general practitioner with a musculoskeletal problem over the course of a year[1,2]. The Read Code hierarchy, a common system for recording morbidity in UK primary care, is structured into diagnostic chapters (for example, Musculoskeletal diseases, Mental disorders, Circulatory disorders)[12]. The most common musculoskeletal problems diagnosed in primary care by the RCGP WRS in 2007 within the Musculoskeletal Read Code Chapter were listed as "Back disorders unspecified other", "Pain in Limb", "Joint Disorder Other Unspecified", "Osteoarthritis & Allied Disorders" and "Peripheral Enthesopathies & Allied Syndromes"[2]
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