title: Predictors for persistent neck/shoulder pain, medical care-seeking due to neck/shoulder pain and sickness absence.
abstract: OBJECTIVE
  To determine whether symptoms and clinical signs can predict persistent neck/shoulder pain, future medical care-seeking and sickness absence.
  
  
  METHODS
  A population-based cohort was followed prospectively over a 5-6 year period.
  
  
  METHODS
  Subjects from the district of Norrtälje (Sweden).
  
  
  METHODS
  Subjects with self-rated neck/shoulder pain were included (n = 1471).
  
  
  METHODS
  Cox regression analyses were used to test the predictive value of single and combinations of symptoms and clinical signs obtained with questionnaires and simple tests concerning persistent neck/shoulder pain, future medical care-seeking and sickness absence.
  
  
  RESULTS
  Several symptoms and clinical signs were associated with the outcomes of interest: the relative risk (RR) for persistent neck/shoulder pain was 1.38 (95% confidence interval (CI) 1.14-1.52) for subjects with pain for over three months at baseline and concerning future medical care-seeking RR was 2.10 (95% CI 1.73-2.54) for subjects who had previously sought medical care. An episode of sickness absence during the year of enrolment increased the risk for future sickness absence (RR = 2.42, 95% CI 1.95-3.00). Having five or seven concurrent symptoms and clinical signs was common and more strongly associated with persistent pain (RR = 1.77, 95% CI 1.39 - 2.27) and future medical care-seeking (RR = 4.51, 95% CI 2.54-9.94), respectively, but not concerning sickness absence.
  
  
  CONCLUSIONS
  By simply counting the number of concurrent symptoms and clinical signs, it is possible to predict persistent neck/shoulder pain and future medical care-seeking, but not sickness absence.
authors: Department of Public Health Sciences, Division of Occupational Medicine, Karolinska Institutet and Department of Occupational and Environmental Health, Stockholm County Council, Stockholm, Sweden. Wim.Grooten@ki.se
authors: Wilhelmus Johannes Andreas
authors: WJ
authors: Grooten
mesh_terms: D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000150:complications*; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020069:Shoulder Pain / Q000150:complications*; D018582:Sick Leave; D013548:Sweden