Management of patients with shoulder pain in primary care : A pause for reflection

Abstract

Why a pause for reflection? Shoulder pain is one of the most common musculoskeletal disorders. In recent years, much research has been done to improve the diagnosis and treatment of patients with shoulder pain. However, this has not resulted in more patients recovering. If more research into diagnostics and treatment does not lead to a better result, it is time to stop and ask ourselves how we should proceed. On the basis of this doctoral research, it can be concluded that there are more and other possibilities to improve care. It appears that, especially for patients with long-term complaints, multiple treatments are regularly used simultaneously, including referrals to other care providers. By also taking on the role of coach; by making time for a good conversation and providing information, patients themselves can think more actively about what is the best treatment for them. A second point of attention follows from the predictive factors found - higher intensity of shoulder pain, neck pain and / or long-term complaints - for a less good result of the treatment. Because this set corresponds to factors found in other conditions, it seems important to base treatment not only on the specific diagnosis but also on predictive factors that transcend pain location. A final study shows that the clinician himself has a substantial influence on outcome. Although much research is still needed, this appears to be a promising area for improving the treatment of patients with shoulder pain by general practitioners and physiotherapists.