Examining outcome of early physician specialist assessment in injured workers with shoulder complaints.

Helen Razmjou,Dragana Boljanovic,Chris Geddes,Iona Macritchie,Sandra Lincoln,Caterina Virdo-Cristello,Robin R Richards

doi:10.1186/s12891-015-0488-3

Abstract

BackgroundThere is minimal research on demographics, type of injury and diagnosis of injured workers with shoulder problems. The purposes of this study were: 1) to document the demographics of patients with shoulder complaints referred to an Early Shoulder Physician Assessment (ESPA) Program and to describe the recommended management, and 2) to examine the relationship between patient characteristics and their subjective complaints of pain and functional difficulty.MethodsThis study involved a retrospective review of electronic files of injured workers mostly seen within the first 16 weeks of injury or recurrence. Measures of functional difficulty and pain were the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Numeric Pain Scale (NPS).ResultsFiles of 550 consecutive patients, 260 females (47%), 290 men (53%) were examined. The average age was 49 (SD = 11, range 22–77), with 28 (5%) patients being 65 years of age or older. Patients who were not working were the most disabled group based on Quick DASH (F = 49.93, p < 0.0001) and NPS (F = 10.24, p = 0.002). Patients who were working full time performing regular duties were the least disabled according to both measures, the QuickDASH (F = 10.24, p = 0.002) and NPS (F = 7.57, p = 0.006).Patients waiting more than 16 weeks were slightly older (53 years of age vs. 49, p = 0.045) than those who met the criteria for early assessment with similar levels of pain and functional difficulty. Biceps pathology had the highest prevalence (37%). Full thickness tear had a prevalence of 14%. Instability, labral lesions and osteoarthritis of glenohumeral joint were uncommon conditions (3, 2 and 1% respectively). Fifty-five patients (10%) were surgical candidates and had higher scores on QuickDASH (F = 7.16, p = 0.008) and NPS (F = 4.24, p = 0.04) compared to those who did not require surgery.ConclusionsThis study provides information on characteristics and prevalence of important variables in injured workers with shoulder problems and highlights the impact of these characteristics on pain and disability.

Highlights

There is minimal research on demographics, type of injury and diagnosis of injured workers with shoulder problems
Demographics Five hundred and fifty consecutive patients were seen by an orthopedic surgeon and a physical therapist
The majority of patients (50%) were taking Non-steroidal anti-inflammatory drugs (NSAID), with 44% taking a variety of analgesics including narcotics (Table 2)

Summary

Introduction

There is minimal research on demographics, type of injury and diagnosis of injured workers with shoulder problems. When frequency and cost of injury is taken into consideration, shoulder injuries are among the most expensive single injury types [4] and remain prevalent in the workplace environment [5,6,7,8,9,10]. These injuries have a significant negative effect on work productivity [11,12] and are often associated with poor surgical recovery [13,14,15]. The classification of injured workers in this simplistic fashion may have contributed to inaccurate claims and perpetuated stigmas regarding the prognosis, treatment effect and overall outcomes of injured workers with disorders of the shoulder

Methods

Results

Conclusion