title: Social and psychological factors influenced the course of arm, neck and shoulder complaints.
abstract: OBJECTIVE
  To investigate the clinical course and prognostic factors of complaints of arm, neck, and shoulder.
  
  
  METHODS
  A prospective cohort study in physical therapy practice. Participating physiotherapists recruited new consulters with musculoskeletal complaints of the neck and/or upper extremities. Participants filled in questionnaires at baseline, 3 months, and 6 months. The main outcome measure was the persistence of complaints over 6-month follow-up. Possible predictors like social and psychological factors, physical factors, and complaint specific factors were tested in univariate and multivariate logistic regression analyses for repeated measurements.
  
  
  RESULTS
  Of the 624 participants at baseline 543 (87%) returned at least one follow-up questionnaire. At 6-month follow-up, 40% had persisting pain and discomfort. Somatization, kinesiophobia, catastrophizing, and a long duration of complaints at baseline were significantly related to the persistence of complaints over 6 months in the total population. In those with paid work (77%), catastrophizing, low decision authority at work, and a long duration of complaints at baseline were significantly related to the persistence of complaints over 6 months.
  
  
  CONCLUSIONS
  40% of the participants had persisting pain and discomfort after 6 months and mainly social and psychological factors played a role in this course.
authors.affiliation: Department of General Practice, Erasmus MC, The Netherlands. c.karels@erasmusmc.nl
authors.forename: C H
authors.initials: CH
authors.lastname: Karels
authors.forename: S M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.forename: A
authors.initials: A
authors.lastname: Burdorf
authors.forename: A P
authors.initials: AP
authors.lastname: Verhagen
authors.forename: A P
authors.initials: AP
authors.lastname: Nauta
authors.forename: B W
authors.initials: BW
authors.lastname: Koes
mesh_terms: D000328:Adult; D001134:Arm Injuries / Q000523:psychology / Q000628:therapy; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009140:Musculoskeletal Diseases / Q000523:psychology / Q000628:therapy*; D019547:Neck Pain / Q000523:psychology / Q000628:therapy; D009426:Netherlands; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011379:Prognosis; D011446:Prospective Studies; D020069:Shoulder Pain / Q000523:psychology / Q000628:therapy; D013001:Somatoform Disorders / Q000523:psychology / Q000628:therapy; D013315:Stress, Psychological; D013647:Task Performance and Analysis; D016896:Treatment Outcome