The study aimed to analyse and compare how baseline variables are associated with future outcomes in patients with low back, neck, and shoulder pain.The study aimed to analyse and compare how baseline variables are associated with future outcomes in patients with low back, neck, and shoulder pain.
The study was a prospective cohort of 816 patients seeking physiotherapy for neck, shoulder, or low-back pain in practices across Denmark. Questionnaires containing information on potential predictors were collected at baseline and three months follow-up. Multiple regression analyses were employed, with one interaction term at a time, to examine potential differences in associations between baseline characteristics and outcomes for pain and disability (0-10) across pain sites. This methodology was chosen to allow for a comprehensive analysis of the data and to identify potential variations in prognostic factors across different pain sites.
During 3 months of follow-up, patients experienced clinically relevant improvements in pain (mean difference for reduction in pain and disability were 2.8 [95% CI 2.5 to 3.0] and 1.9 [95% CI 1.7 to 2.1], respectively). Poorer outcomes were significantly associated with neck pain, longer pain duration, poorer general health, low expectations of recovery, and higher baseline levels of pain and disability, irrespective of pain site. Interaction tests revealed some variation between pain sites. For shoulder and neck pain, sex and health perception were associated with outcomes, while pain duration and recovery expectations had a larger impact for low back pain.
The study identified several baseline variables that significantly affected outcomes for patients with musculoskeletal pain. While some site-specific variations in prognostic factors were noted, the key predictors of poorer outcomes were consistent across pain sites. These findings highlight the potential value of focusing on these common prognostic factors in physiotherapy interventions to improve treatment effectiveness across various musculoskeletal pain presentations. The results encourage further research and support the implementation of these insights in clinical practice.
This research supports a prognostic approach to managing musculoskeletal disorders in physiotherapy, focusing on key factors such as general health, pain duration, recovery expectations, and baseline disability, rather than tailoring treatments solely to specific pain locations. Implementing this approach could lead to more personalized care, improved patient outcomes, and more efficient clinical workflows, particularly in resource-limited settings. Future studies should explore the long-term benefits of addressing these factors across broader populations
Musculoskeletal disorders
