Course and prognosis of elbow complaints: a cohort study in general practice.
OBJECTIVE
To describe the course of new episodes of elbow complaints in general practice, and to identify predictors of short term and long term outcome in terms of pain intensity and functional disability.


METHODS
181 patients with elbow complaints filled in questionnaires at baseline and at 3, 6, and 12 months of follow up. Baseline scores of pain and disability, characteristics of the complaint, sociodemographic and psychosocial factors, physical activity, general health, and comorbidity were investigated as possible predictors of outcome. Outcome measures were analysed separately using multiple regression analyses.


RESULTS
13% of the patients reported recovery at the 3 month follow up and 34% at 12 months. Irrespective of outcome and length of follow up, a longer duration of the complaint before consulting the general practitioner, having musculoskeletal comorbidity, and using "retreating" as coping style increased the likelihood of an unfavourable outcome. Less social support was associated with an unfavourable outcome at 3 months, and having a history of elbow complaints and using "worrying" as coping style were associated with an unfavourable outcome at 12 months. The explained variance of the models ranged from 46% to 49%.


CONCLUSIONS
Recovery of patients with elbow complaints in general practice was poor. Besides characteristic of the complaint, passive coping and less social support were related to a worse prognosis. The results of this study may help general practitioners to provide patients with more accurate information about their prognosis.
Bot
S D M
SD
Institute for Research in Extramural Medicine EMGO Institute, VU University Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam.
van der Waal
J M
JM
Terwee
C B
CB
van der Windt
D A W M
DA
Bouter
L M
LM
Dekker
J
J
D000223:Adaptation, Psychological; D000328:Adult; D004185:Disability Evaluation; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011379:Prognosis; D012944:Social Support; D013716:Tennis Elbow / Q000523:psychology / Q000534:rehabilitation*