Margit Kooijman

30 TABLE 2. Treatment characteristics in general practice General practice (GP) Only GP (n = 2134) GP -> PT (n = 294) * Significant difference between ‘only GP patients’ and ‘GP => PT patients’ In physiotherapy practice, 2.6% (n = 1182) of all patients presented with shoulder syndromes, accounting for 27% (n = 1182) of all shoulder complaints. Of these, 76% (n = 895) were referred by a GP, 12% (n = 139) by a medical specialist and 12% (n = 148) accessed the service directly. Self-referrals differed from referred patients; they were younger and more often male (Table 1). Furthermore, they more often had recurrent problems and these were more frequently related to sports and leisure activities and less often to work (Table 3). The treatment also differed; in self-referrals, treatment goals were more often aimed at muscle function. There were no differences between referred patients and self-referrals in terms of the duration of the com- plaint at the start of treatment, previous physiotherapy, severity of the complaint or the onset. Of patients with shoulder syndromes, 35% (n = 365) waited more than three months before visiting a physiotherapist, 45% (n = 469) had already had physiotherapy previously, severity of the complaint (between 0 and 10) was rated 7 and in 75% (n = 224) of the patients the symptoms had developed gradually. Common combinations of interventions were exercises aimed at functions and mobilisation or massage. At the end of treatment, the results did not differ between referred patients and self-referrals: in 64% (n = 668) of all patients with shoulder syndromes the treatment goals were fully reached. Prescriptions (%) * 69 50 Paracetamol 4 8 NSAID * 50 38 Corticosteroids 24 19 Local anaesthetic 11 9 Opioids 7 7 Interventions Consultation (mean number ± SD) * 1.5 (1.4) 2.0 (1.6) Duration of care episode (in days) 46 60 Cyriax injection (%) * 29 21