Data from a study of effectiveness suggested potential prognostic factors related to the patterns of shoulder pain.
OBJECTIVE
Shoulder pain is a common complaint in primary care, and the factors associated with persisting shoulder pain are varied. We therefore explored prognostic factors associated with shoulder pain problems.


METHODS
Patients (n=109) were randomly allocated to 6 weeks of treatment with either corticosteroid injections (53 patients) or physiotherapy (56 patients). Patients were followed for 52 weeks. Severity of pain and shoulder disability was repeatedly scored at baseline and at 3, 7, 13, 26, and 52 weeks after randomization. Logistic regressions and mixed-effects models were used to explore prognostic factors.


RESULTS
The data showed that during the 52 weeks of follow-up, 22% of the patients had persistent-recurrent symptoms (high risk of disability); the associated prognostic factors were gender (female) and age (>60 years). For the remaining patients, who had steady improvement in pain severity during the 52 weeks, there were still large between-patient variations in the rate of reaching recovery; this was influenced by treatment types: corticosteroid injections were associated with a faster relief of the pain.


CONCLUSIONS
Age and gender might be the two important prognostic factors associated with persistent-recurrent problems. The effect of corticosteroid injections seems to be temporal.
Zheng
Xiaohong
X
Department of Information Services, King Edward VII Hospital, St. Leonards Road, Windsor, Berks, SL4 3DP, UK. XiaohongZheng_4@hotmail.com
Simpson
Julie A
JA
van der Windt
Daniëlle A W M
DA
Elliott
Alison M
AM
D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010147:Pain Measurement / Q000379:methods; D026741:Physical Therapy Modalities; D011379:Prognosis; D012008:Recurrence; D012737:Sex Factors; D020069:Shoulder Pain / Q000188:drug therapy / Q000534:rehabilitation / Q000628:therapy*; D017211:Treatment Failure; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide