ArticleBMC musculoskeletal disorders2014
Pain medication management of musculoskeletal conditions at first presentation in primary care: analysis of routinely collected medical record data.
Article in BMC musculoskeletal disorders, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Comparative effectiveness and safety of analgesic medicines for adults with acute non-specific low back pain: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2023Pooled it
- A Systematic Review and Meta-Analysis of Mindfulness-Based (Baduanjin) Exercise for Alleviating Musculoskeletal Pain and Improving Sleep Quality in People with Chronic Diseases.International journal of environmental research and public health · 2018Pooled it
- Trial
- Physical activity and factors associated with the costs of low back pain among adults after 18 months of follow-up: a cohort study.Sao Paulo medical journal = Revista paulista de medicina · 2025Article
- The prescribing of opioids for chronic non-cancer pain in the menopausal and postmenopausal population: a drug utilisation study in the UK.BJGP open · 2025Article
- Benchmarks for low back pain in general practice in Flanders: electronic audit of INTEGO.BMC primary care · 2024Article
- Increased Use and Large Variation in Strong Opioids and Metamizole (Dipyrone) for Minor and Major Musculoskeletal Injuries Between 2008 and 2018: An Analysis of a Representative Sample of Swiss Workers.Journal of occupational rehabilitation · 2024Article
- Household Income as a Predictor for Surgical Outcomes and Opioid Use After Spine Surgery in the United States.Global spine journal · 2023Article
- Geospatial Variations and Neighborhood Deprivation in Drug-Related Admissions and Overdoses.Journal of urban health : bulletin of the New York Academy of Medicine · 2020Article
- Development and validation of a pain monitoring app for patients with musculoskeletal conditions (The Keele pain recorder feasibility study).BMC medical informatics and decision making · 2019Article
- Variation in Prescription Opioid Dispensing across Neighborhoods of Diverse Socioeconomic Disadvantages in Victoria, Australia.Pharmaceuticals (Basel, Switzerland) · 2018Article
- Frequency and Associations of Prescription Nonsteroidal Anti-inflammatory Drug Use Among Patients With a Musculoskeletal Disorder and Hypertension, Heart Failure, or Chronic Kidney Disease.JAMA internal medicine · 2018Article
- Worsening trends in analgesics recommended for spinal pain in primary care.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018Article
- Predictors of chronic prescription opioid use after orthopedic surgery: derivation of a clinical prediction rule.Perioperative medicine (London, England) · 2018Article
- Efficacy and safety of guaifenesin for upper back, neck, and shoulder pain: a Phase II proof-of-concept, multicenter, placebo-controlled, repeat-dose, parallel-group study.Journal of pain research · 2017Article
- Observational
- Digital rehabilitation for hand and wrist pain: a single-arm prospective longitudinal cohort study.Pain reportsArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPrimary care pharmacological management of new musculoskeletal conditions is not consistent, despite guidelines which recommend prescribing basic analgesics before higher potency medications such as opioids or non-steroidal inflammatory drugs (NSAIDs).The objective was to describe pharmacological management of new musculoskeletal conditions and determine patient characteristics associated with type of medication prescribed.
methodsThe study was set within a UK general practice database, the Consultations in Primary Care Archive (CiPCA). Patients aged 15 plus who had consulted for a musculoskeletal condition in 2006 but without a musculoskeletal consultation or analgesic prescription in the previous 12 months were identified from 12 general practices. Analgesic prescriptions within two weeks of first consultation were identified. The association of socio-demographic and clinical factors with receiving any analgesic prescription, and with strength of analgesic, were evaluated.
results3236 patients consulted for a new musculoskeletal problem. 42% received a prescribed pain medication at that time. Of these, 47% were prescribed an NSAID, 24% basic analgesics, 18% moderate strength analgesics, and 11% strong analgesics. Increasing age was associated with an analgesic prescription but reduced likelihood of a prescription of NSAIDs or strong analgesics. Those in less deprived areas were less likely than those in the most deprived areas to be prescribed analgesics (odds ratio 0.69; 95% CI 0.55, 0.86). Those without comorbidity were more likely to be prescribed NSAIDs (relative risk ratios (RRR) compared to basic analgesics 1.89; 95% CI 0.96, 3.73). Prescribing of stronger analgesics was related to prior history of analgesic medication (for example, moderate analgesics RRR 1.88; 95% CI 1.11, 3.10).
conclusionOver half of patients were not prescribed analgesia for a new episode of a musculoskeletal condition, but those that were often received NSAIDs. Analgesic choice appears multifactorial, but associations with age, comorbidity, and prior medication history suggest partial use of guidelines.
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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.