Dynamic Health, Physiotherapy Department, Cambridgeshire Community Services NHS Trust, Huntingdon, Cambridgeshire, UK.
School of Sport, Rehabilitation & Exercise Sciences, University of Essex, Colchester, UK.
Musculoskeletal Care. 2022 Mar;20(1):86-98. doi: 10.1002/msc.1556. Epub 2021 May 1.
Tendon-related pain is a common and debilitating condition that affects a wide range of people. To inform future research, it is important to understand healthcare professional's current practice.
To describe the practice of First Contact Practitioners (FCPs) and Other Clinicians (OCs) for recent onset tendon pain in a primary contact setting. The secondary aim was to understand if practice differed between the locations of pain.
Cross-sectional online survey METHOD: The online survey asked for responses relating to one scenario of shoulder pain and one of Achilles pain. Except location of pain, the scenarios were identical. Responses were collected over a four-week period to December 2020. The Chi-Square test was used to analyse the difference in proportion of responses between FCPs and OCs, and between locations of pain.
118 responses were received. Rotator Cuff Related Shoulder Pain (RCRSP) was preferred by 64/118 (54.2%) for the shoulder scenario. Achilles tendinopathy was the preferred term by 86/103 (83.5%) for the Achilles. FCPs were more likely to advise NSAIDs for both shoulder (p = 0.006) and Achilles (p = 0.046) scenarios than OCs. Amended duties were more likely to be advised for manual workers for the shoulder scenario compared to Achilles (p = <0.0001).
There were similarities in the management of recent onset tendon-related pain; the majority of respondents recommended against further investigations, steroid injections, and recommended exercise. Understanding whether these approaches are clinically effective requires further investigation.
肌腱相关疼痛是一种常见且使人虚弱的病症,影响范围广泛。为了指导未来的研究,了解医疗保健专业人员的当前实践非常重要。
描述初级接触医生(FCPs)和其他临床医生(OCs)在初级接触环境中对近期发作的肌腱疼痛的治疗实践。次要目的是了解疼痛部位是否存在治疗差异。
横断面在线调查
在线调查要求参与者对一个肩部疼痛和一个跟腱疼痛的情景进行回复。除了疼痛部位外,两个情景完全相同。调查于 2020 年 12 月的四周内收集回复。使用卡方检验分析 FCPs 和 OCs 之间以及不同疼痛部位之间的回复比例差异。
共收到 118 份回复。64/118(54.2%)的参与者选择了肩部疼痛的旋转肌袖相关肩痛(RCRSP),86/103(83.5%)的参与者选择了跟腱病变作为跟腱疼痛的首选术语。与 OCs 相比,FCPs 更倾向于建议肩部(p=0.006)和跟腱(p=0.046)疼痛的非甾体抗炎药(NSAIDs)。与跟腱相比,对于肩部疼痛的体力劳动者,更有可能建议调整工作(p<0.0001)。
对于近期发作的肌腱相关疼痛的管理存在相似之处;大多数参与者建议不进行进一步检查、类固醇注射,并推荐运动。了解这些方法是否具有临床效果需要进一步研究。