Prognostic factors in patients with rotator tendinosis (stage II impingement syndrome) of the shoulder.
OBJECTIVE
To evaluate prognostic factors in patients with rotator tendinosis (stage II impingement syndrome) of the shoulder.


METHODS
Analytic retrospective study of factors associated with success or failure of treatment.


METHODS
Departments of orthopaedics and physical medicine and rehabilitation.


METHODS
125 patients aged 18-66 who had rotator tendinosis resistant to treatment in primary health care; some had active treatment (arthroscopic surgery or a supervised exercise regimen), some not (placebo laser or withdrawal from active treatment).


METHODS
Medication, sickness leave, physical and psychosocial measures at baseline.


RESULTS
Active treatment, not on sickness leave, and not on regular medication were the best independent prognostic factors, with an estimated odds ratio for success of 4.8 (1.7 to 13.6), 4.4 (1.6 to 12.1), and 4.2 (1.5 to 11.1), respectively. Reported shoulder-related work demands did not alter the impact of sickness leave. The influence of regular medication was particularly high in those who had no disease apart from the painful shoulder (odds ratio 17.0). Patients who had taken medication for the painful shoulder regularly during the previous year, usually chose two or three agents from the following groups: analgesics, benzodiazepines, muscle relaxants, and antiinflammatory drugs.


CONCLUSIONS
Prognosis for rotator tendinosis is improved by active treatment and a more restricted prescription of medication and sick leave. Polymedication should be avoided.
Brox
J I
JI
Department of Physical Medicine and Rehabilitation, Ullevaal University Hospital, Oslo, Norway.
Brevik
J I
JI
D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D019338:Polypharmacy; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D019534:Shoulder Impingement Syndrome / Q000188:drug therapy / Q000628:therapy*; D018582:Sick Leave; D016896:Treatment Outcome