Doctors are using a new tool called Clinical Prediction Rules (CPRs) to help tell what a patient’s outcome might be for various problems. In this study researchers try to find CPRs for shoulder pain. Knowing what factors in patients with shoulder pain will predict the prognosis is helpful. Treatment decisions can be made with this information in mind. And patients have some idea of what to expect.
Other studies in this area found high pain intensity as the only predictor of poor outcome. Studying 587 patients with new shoulder pain was more helpful. All patients in the study received the same treatment. Data was collected on many possible factors that could affect the outcome.
Questions were asked about physical activity, workload, and psychosocial factors. Information about the patient’s age, gender, education, and lifestyle was included. Pain intensity, frequency, and duration were recorded. An exam of the shoulder was done.
The main measure of outcome was shoulder pain. Patients were contacted six weeks after treatment and again at three and six months. Persistent symptoms at six weeks were linked with psychologic complaints, repetitive movements, and neck pain. Continued pain at six months was linked with gradual onset of symptoms, high intensity of pain, and longer duration of pain at the time of the first appointment.
The authors conclude if the physician must rely on only one thing to predict the outcome of shoulder pain it would be the duration and severity of symptoms. They suggest this clinical prediction rule should be further tested before putting it into daily use.