ArticleAnnals of family medicine
Management decisions in nontraumatic complaints of arm, neck, and shoulder in general practice.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The trial behind it
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Who cites it
9 citing papers in PubMed, 41 citations in OpenAlex.
- Impact of an interdisciplinary digital consultation platform on general practitioner referrals for musculoskeletal symptoms: a stepped wedge cluster randomized trial.Family practice · 2025Trial
- Factors associated with referral to physiotherapists for adult patients consulting for musculoskeletal disorders in primary care; an ancillary study to ECOGEN.BMC primary care · 2023Article
- Sex Differences in Pain and Its Treatment.Handbook of experimental pharmacology · 2023Review
- Article
- The use and safety of corticosteroid injections for shoulder pain in general practice: a retrospective cohort study.Family practice · 2022Article
- The incidence and management of shoulder complaints in general practice: a retrospective cohort study.Family practice · 2021Article
- Prevalence, diagnostics and management of musculoskeletal disorders in primary health care in Sweden - an investigation of 2000 randomly selected patient records.Journal of evaluation in clinical practice · 2017Article
- Musculoskeletal training: are GP trainees exposed to the right case mix for independent practice?Clinical rheumatology · 2016Observational
- Defining gender disparities in pain management.Clinical orthopaedics and related research · 2011Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledOBJECTIVE We wanted to evaluate associations between diagnosis and characteristics of the patient, complaint, and general practitioner (GP), as well as 6 common management decisions, in patients with nontraumatic arm, neck, and shoulder complaints at the time of the first consultation with their physician.
methodsWe undertook an observational cohort study set in 21 Dutch general practices, including 682 patients with nontraumatic complaints of arm, neck, and shoulder. The outcome measure was application (yes/no) of a specific management option: watchful waiting, additional diagnostic tests, prescription of medication, corticosteroid injection, referral for physiotherapy, and referral for medical specialist care.
resultsSeparate multilevel analyses showed that overall, the diagnostic category, having long duration of complaints, and reporting many functional limitations were most frequently associated with the choice of a management option. For watchful waiting, only complaint variables played a role (long duration of complaints, high complaint severity, many functional limitations, recurrent complaint). All these variables were negatively associated with watchful waiting. When opting for 1 of the 5 other management options, several physician characteristics played a role as well. Less clinical experience was associated with additional diagnostic tests and referral to a medical specialist. GPs working in a solo practice more frequently referred to a medical specialist. GPs working in a rural area more frequently referred for physiotherapy. Female GPs prescribed medication less frequently. Physicians with special interest in musculoskeletal complaints gave corticosteroid injections more frequently.
conclusionsDiagnostic category, long duration of complaints, and high functional limitations were key variables in management decisions with these complaints. In addition, several physician characteristics played a role as well.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.