Abstract
BackgroundShoulder pain is a common complaint in primary health care and has an unfavourable outcome in many patients. The objectives were to identify predictors for pain and disability (SPADI) and work status in patients with subacromial shoulder pain.MethodsSecondary analyses of data from a randomized clinical controlled trial were performed. Outcome measures were the absolute values of the combined Shoulder Pain and Disability Index (SPADI) and work status 1 year after treatment with supervised exercises (SE) or radial extracorporeal shockwave therapy (rESWT). Predictors of outcome were investigated using multiple linear regression (SPADI) and logistic regression (work status).Results104 patients were included. Low education (≤ 12 years), previous shoulder pain, and a high baseline SPADI score predicted poor results with these variables explaining 29.9% of the variance in SPADI score at 1 year. Low education and poor self-reported health status predicted a work status of "not working": Odds Ratio, OR = 4.3(95% CI (1.3 to 14.9)), p = 0.02 for education, and OR = 1.06 (95% CI (1.0 to 1.1)), p = 0.001 for self-reported health status, respectively. Adjustments for age, gender, and treatment group were performed, but did not change the results.ConclusionEducation was the most consistent predictor of pain and disability, and work status at 1 year follow-up. Also, baseline SPADI score, previous shoulder pain and self-reported health status predicted outcome.Trial registrationClinical trials NCT00653081
Highlights
Shoulder pain is a common complaint in primary health care and has an unfavourable outcome in many patients
Shoulder pain is a common complaint in primary health care with a 1-year prevalence ranging up to 47% in the adult population [1,2,3]
We have previously reported that while supervised exercises (SE) or arthroscopic surgery improved the prognosis in patients with rotator cuff tendinosis or subacromial pain, sick leave and regular medication were negatively associated with outcome [13,14]
Summary
Shoulder pain is a common complaint in primary health care and has an unfavourable outcome in many patients. The objectives were to identify predictors for pain and disability (SPADI) and work status in patients with subacromial shoulder pain. Shoulder pain is a common complaint in primary health care with a 1-year prevalence ranging up to 47% in the adult population [1,2,3]. To indentify the Prognosis of shoulder pain may be influenced by different factors or a combination of factors such as sociodemographics, genetics, psychological- and personaltraits, occupational factors, work status, characteristics of the shoulder pain, use of medication, and treatment [8,9]. There is some evidence that high pain intensity predicts poorer outcome in primary care populations and that middle age is associated with poor outcome in occupational populations [8,11]
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