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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Pain intensity, neck pain and longer duration of complaints predict poorer outcome in patients with shoulder pain – a systematic review

BMC Musculoskeletal Disorders > Ausgabe 1/2015
Margit K. Kooijman, Di-Janne A. Barten, Ilse CS Swinkels, Ton Kuijpers, Dinny de Bakker, Bart W. Koes, Cindy Veenhof
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12891-015-0738-4) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

MK, IS, CV and TK conceived the study and design. MK and DB performed independent searches, retrieved the articles and read titles, abstracts and full-text articles, assessed methodological quality and sorted the prognostic factors. MK drafted the manuscript and performed the first version of the best evidence synthesis which was commented on by all authors. TK contributed to editing of manuscript drafts. IS, CV, DB and BK made a substantial contribution to interpretation of the data and revising it critically for important intellectual content. All authors approve of the final version.

Authors’ information

Not applicable.



Shoulder complaints are common and have an unfavourable prognosis in many patients. Prognostic information is helpful for both patients and clinicians in managing the complaints. The research question was which factors have prognostic value on (un)favourable outcome in patients with shoulder complaints in primary care, secondary care and occupational settings.


Update of a systematic review in primary care, secondary care and occupational settings.


Nine articles were published since the original review in 2004. Six were of high quality covering a wide variety of prognostic factors and outcome measures. Four studies were conducted in primary care settings. A best evidence synthesis, including the results of the previous systematic review on this topic shows that there is strong evidence that higher shoulder pain intensity, concomitant neck pain and a longer duration of symptoms predict poorer outcome in primary care settings. In secondary care populations, strong evidence was found for the association between greater disability and poorer outcome and between the existence of previous shoulder pain and poorer outcome.


Clinicians may take these factors into account in the management of their patients. Those with a worse prognosis may be monitored more frequently and the treatment plan modified if complaints persist.
Additional file 1: Explanation of the criteria from Table 1. (DOCX 106 kb)
Additional file 2: Table S1. Summary of study characteristics of prognostic cohort studies on shoulder disorders. (DOCX 73 kb)
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