Shoulder complaints. Incidence, prevalence, interventions and outcome

PhD ceremony: Mr. O. Dorrestein, 16.15 uur, Academiegebouw, Broerstraat 5, Groningen

Title: Shoulder complaints. Incidence, prevalence, interventions and outcome

Promotor(s): prof. R.L. Diercks, prof. K. van der Meer

Faculty: Medical Sciences

Shoulder complaints have a high incidence in general practice: 29 of 1000 patients visit their GP with this complaint. Nearly half of these patients consulted the GP only once, and for the majority of this group a wait-and-see policy or a prescription for NSAIDs sufficed. 38% of the patients with new shoulder complaints were sooner or later referred to a physiotherapist (84%) or a hospital specialist (16%).

The most common shoulder complaint is subacromial impingement syndrome (SIS). The subject of this thesis is a randomised controlled trial for treatment of SIS comparing a new treatment strategy involving early operation and physiotherapy as needed, and usual care involving NSAIDs, corticosteroids and/or physiotherapy. There were no statistically significant differences between the groups regarding the functional status of patients. The new treatment was more expensive and patients experienced statistically more complications. These data do not justify the conclusion that an early operation is beneficial over usual treatment of SIS.