Annals of Behavioral Medicine

, Volume 31, Issue 3, pp 297–308 | Cite as

The course and prognosis of hip complaints in general practice

  • Johanna M. van der Waal
  • Sandra D. M. Bot
  • Caroline B. Terwee
  • Daniëlle A. W. M. van der Windt
  • Lex M. Bouter
  • Joost Dekker
Article

Abstract

Background: The general practitioner needs to discriminate complaints with need of specialist care from those that can be managed in primary care. However, no previous research has studied prognostic indicators for the course of hip complaints in a primary care population.Purpose: The purpose of this study was to investigate the course of hip complaints presented in general practice and to identify relevant prognostic indicators of outcome.Methods: Data were collected by means of self-administered questionnaires containing questions about sociodemographic variables, characteristics of the complaints, and several intraindividual and extraindividual factors, including several psychosocial variables (e.g., pain coping, distress, and kinesiophobia). After 3 and 12 months of follow-up perceived recovery, change in pain intensity and change in functioning were assessed. Multiple regression analyses were performed to investigate the association between the potential prognostic indicators and the 3 outcome measures.Results: We included 139 patients with hip complaints, presented in general practice. Only 24% reported recovery after 3 months, increasing to 37% after 12 months. A history of hip complaints, a longer duration of the current episode of hip complaints, or more severe complaints, were associated with a less favorable prognosis. Furthermore, more vital patients and patients who met the Norm for Healthy Activity had a higher probability of a favorable outcome. Pain transformation and worrying were significant associated with recovery and changes in functioning after 3 months.Conclusions: Different prognostic indicators were found to be associated with perceived recovery, changes in pain intensity, and changes in functioning. Future research should aim at investigating the mechanisms that can underlie these associations.

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References

  1. (1).
    Picavet HS, Schouten JS: Musculoskeletal pain in the Netherlands: Prevalences, consequences and risk groups, the DMC(3)-study.Pain. 2003,102:167–178.PubMedCrossRefGoogle Scholar
  2. (2).
    Dawson J, Linsell L, Zondervan K, et al.: Epidemiology of hip and knee pain and its impact on overall health status in older adults.Rheumatology (Oxford). 2004,43:497–504.CrossRefGoogle Scholar
  3. (3).
    Christmas C, Crespo CJ, Franckowiak SC, et al.: How common is hip pain among older adults? Results from the third national health and nutrition examination survey.Journal of Family Practice. 2002,51:345–348.PubMedGoogle Scholar
  4. (4).
    Frankel S, Eachus J, Pearson N, et al.: Population requirement for primary hip-replacement surgery: A cross-sectional study.Lancet. 1999,353:1304–1309.PubMedCrossRefGoogle Scholar
  5. (5).
    Birrell F, Croft P, Cooper C, et al.: Health impact of pain in the hip region with and without radiographic evidence of osteoarthritis: A study of new attenders to primary care. The PCR hip study group.Annals of the Rheumatic Disorders. 2000,59:857–863.CrossRefGoogle Scholar
  6. (6).
    Odding E, Valkenburg HA, Algra D, et al.: Association of locomotor complaints and disability in the Rotterdam study.Annals of the Rheumatic Disorders. 1995,54:721–725.Google Scholar
  7. (7).
    van der Waal JM, Terwee CB, van der Windt DA, Bouter LM, Dekker J: The impact of chronic hip and knee complaints in general practice on health-related and overall quality of life.Quality of Life Research. 2005,14:795–803.PubMedCrossRefGoogle Scholar
  8. (8).
    Elliott AM, Smith BH, Penny KI, Smith WC, Chambers WA: The epidemiology of chronic pain in the community.Lancet. 1999,354:1248–1252.PubMedCrossRefGoogle Scholar
  9. (9).
    Straaton KV, Fine PR: Addressing work disability through vocational rehabilitation services.Bulletin on the Rheumatic Diseases. 1997,46:1–3.PubMedGoogle Scholar
  10. (10).
    Hoffman C, Rice D, Sung HY: Persons with chronic conditions. Their prevalence and costs.Journal of the American Medical Association. 1996,276:1473–1479.PubMedCrossRefGoogle Scholar
  11. (11).
    Lievense AM, Bierma-Zeinstra SM, Verhagen AP, Verhaar JA, Koes BW: Prognostic factors of progress of hip osteoarthritis: A systematic review.Arthritis and Rheumatism. 2002,47:556–562.PubMedCrossRefGoogle Scholar
  12. (12).
    Birrell F, Afzal C, Nahit E, et al.: Predictors of hip joint replacement in new attenders in primary care with hip pain.British Journal of General Practice. 2003,53:26–30.PubMedGoogle Scholar
  13. (13).
    Cooper C, Inskip H, Croft P: Individual risk factors for hip osteoarthritis: Obesity, hip injury, and physical activity.American Journal of Epidemiology. 1998,147:516–522.PubMedGoogle Scholar
  14. (14).
    Dougados M, Gueguen A, Nguyen M, et al.: Radiological progression of hip osteoarthritis: Definition, risk factors and correlations with clinical status.Annals of the Rheumatic Disorders. 1996,55:356–362.Google Scholar
  15. (15).
    Burton AK, Tillotson KM, Main CJ, Hollis S: Psychosocial predictors of outcome in acute and subchronic low back trouble.Spine. 1995,20:22–728.CrossRefGoogle Scholar
  16. (16).
    Jorgensen CK, Fink P, Olesen F: Psychological distress and somatisation as prognostic factors in patients with musculoskeletal illness in general practice.British Journal of General Practice. 2000,50:537–541.PubMedGoogle Scholar
  17. (17).
    Evers AW, Kraaimaat FW, Geenen R, Bijlsma JW: Psychosocial predictors of functional change in recently diagnosed rheumatoid arthritis patients.Behaviour Research and Therapy. 1998,36:179–193.PubMedCrossRefGoogle Scholar
  18. (18).
    Schellevis FG, Westert GP, de Bakker DH, et al.: De tweede nationale studie naar ziekten en verrichtingen in de huisartsenpraktijk: Aanleiding en methoden [The second Dutch national survey of general practice: Reason and methods].Huisarts en Wetenschap. 2003,46:7–12.Google Scholar
  19. (19).
    van der Waal JM, Bot SD, Terwee CB, et al.: Determinants of the clinical course of musculoskeletal complaints in general practice: Design of a cohort study.BioMed Central Musculoskeletal Disorders. 2003, 4:3.PubMedCrossRefGoogle Scholar
  20. (20).
    Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW: Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.Journal of Rheumatology. 1988,15:1833–1840.PubMedGoogle Scholar
  21. (21).
    Bellamy N: Pain assessment in osteoarthritis: Experience with the WOMAC osteoarthritis index.Seminars in Arthritis and Rheumatism. 1989,18:14–17.PubMedCrossRefGoogle Scholar
  22. (22).
    Kraaimaat FW, Bakker A, Evers AWM: Pain coping strategies in chronic pain patients: The development of the pain coping inventory (PCI).Gedragstherapie. 1997,30:185–201.Google Scholar
  23. (23).
    Kraaimaat FW, Evers AW: Pain-coping strategies in chronic pain patients: Psychometric characteristics of the pain-coping inventory (PCI).International Journal of Behavioral Medicine. 2003,10:343–363.PubMedCrossRefGoogle Scholar
  24. (24).
    Terluin B: The four dimensional symptom questionnaire (4DSQ) in general practice.De Psycholoog. 1998,33:18–24.Google Scholar
  25. (25).
    Goubert L, Crombez G, Vlaeyen JW, et al.: The Tampa scale for kinesiophobia: Psychometric characteristics and norms.Gedrag en Gezondheid. 2000,28:54–62.Google Scholar
  26. (26).
    Waddell G, Newton M, Henderson I, Somerville D, Main CJ: A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability.Pain. 1993,52:157–168.PubMedCrossRefGoogle Scholar
  27. (27).
    Ware JE Jr., Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.Medical Care. 1992,30:473–483.PubMedCrossRefGoogle Scholar
  28. (28).
    Picavet HS, van Gils HWV, Schouten JSAG:Klachten Van Het Bewegingsapparaat In De Nederlandse Bevolking, Prevalenties, Consequenties En Risicogroepen. [Complaints of the Musculoskeletal System in the Dutch Population: Prevalences, Consequences, and Risk Groups], RIVM Report No. 266807002. Bilthoven, The Netherlands: Central Bureau of Statistics/ The National Institute for Public Health and the Environment (RIVM), 2000.Google Scholar
  29. (29).
    Pate RR, Pratt M, Blair SN, et al.: Physical activity and public health. A recommendation from the centers for diseasecontrol and prevention and the American college of sports medicine.Journal of the American Medical Association. 1995,27:402–407.CrossRefGoogle Scholar
  30. (30).
    Kemper HCG, Ooijendijk WTM, Stiggelbout M: Consensus over de Nederlandse norm voor gezond bewegen. [Consensus about the Dutch norm for healthy activity].Tijdschrift voor gezondheidswetenschappen. 1998,78:180–183.Google Scholar
  31. (31).
    American College of Sports Medicine: American college of sports medicine position stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults.Medicine and Science in Sports and Exercise. 1998,30:975–991.CrossRefGoogle Scholar
  32. (32).
    Feij JA, Doorn CD, van Kampen D, van den Berg PT, Resing WCM: Sensation seeking and social support as moderators of the relationship between life events and physical illness/psychological distress. In Winnubst JAM, Maes S (eds),Lifestyles Stress and Health. Leiden, The Netherlands: DSWO Press, 1992, 285–302.Google Scholar
  33. (33).
    Bekkering GE, Hendriks HJ, van Tulder MW, et al.: Prognostic factors for low back pain in patients referred for physiotherapy: comparing outcomes and varying modeling techniques.Spine. 2005,30:1881–1886.PubMedCrossRefGoogle Scholar
  34. (34).
    van der Waal JM, Bot SDM, Terwee CB, et al.: The course and prognosis of knee complaints in general practice.Arthritis Care Research. 2005,53:920–930.PubMedCrossRefGoogle Scholar
  35. (35).
    Oleske DM, Andersson GB, Lavender SA, Hahn JJ: Association between recovery outcomes for work-related low back disorders and personal, family, and work factors.Spine. 2000,25:1259–1265.PubMedCrossRefGoogle Scholar
  36. (36).
    Andersson H, Ejlertsson G, Leden I: Widespread musculoskeletal chronic pain associated with smoking. An epidemiological study in a general rural population.Scandinavian Journal of Rehabilitation Medicine. 1998,30:185–191.PubMedCrossRefGoogle Scholar
  37. (37).
    Brage S, Bjerkedal T: Musculoskeletal pain and smoking in Norway.Journal of Epidemiology and Community Health. 1996,50:166–169.PubMedGoogle Scholar
  38. (38).
    Palmer KT, Syddall H, Cooper C, Coggon D: Smoking and musculoskeletal disorders: Findings from a British national survey.Annals of the Rheumatic Disorders. 2003,62:33–36.CrossRefGoogle Scholar
  39. (39).
    Ernst E: Smoking, a cause of back trouble?British Journal of Rheumatology. 1993,32:239–242.PubMedCrossRefGoogle Scholar
  40. (40).
    Leino-Arjas P: Smoking and musculoskeletal disorders in the metal industry: A prospective study.Occupational and Environmental Medicine. 1998,55:828–833.PubMedGoogle Scholar
  41. (41).
    Holmen TL, Barrett-Connor E, Holmen J, Bjermer L: Health problems in teenage daily smokers versus nonsmokers, Norway, 1995-1997: The Nord-Trondelag health study.American Journal of Epidemiology. 2000,151:148–155.PubMedGoogle Scholar
  42. (42).
    Schouten JS, Van den Ouweland FA, Valkenburg HAA: 12 year follow up study in the general population on prognostic factors of cartilage loss in osteoarthritis of the knee.Annals of the Rheumatic Disorders. 1992,51:932–937.CrossRefGoogle Scholar
  43. (43).
    Felson DT, Lawrence RC, Dieppe PA, et al.: Osteoarthritis: New insights. Part 1: The disease and its risk factors.Annals of Internal Medicine. 2000,133:635–646.PubMedGoogle Scholar
  44. (44).
    Evers AW, Kraaimaat FW, Geenen R, Jacobs JW, Bijlsma JW: Pain coping and social support as predictors of long-term functional disability and pain in early rheumatoid arthritis.Behaviour Research and Therapy. 2003,41:1295–1310.PubMedCrossRefGoogle Scholar
  45. (45).
    Steultjens MP, Dekker J, Bijlsma JW: Coping, pain, and disability in osteoarthritis: A longitudinal study.Journal of Rheumatology. 2001,28:1068–1072.PubMedGoogle Scholar
  46. (46).
    Carroll L, Mercado AC, Cassidy JD, Cjte PA: Population-based study of factors associated with combinations of active and passive coping with neck and low back pain.Journal of Rehabilitation Medicine. 2002,34:67–72.PubMedCrossRefGoogle Scholar
  47. (47).
    Covic T, Adamson B, Spencer D, Howe GA: Biopsychosocial model of pain and depression in rheumatoid arthritis: A 12-month longitudinal study.Rheumatology (Oxford). 2003,42:1287–1294.CrossRefGoogle Scholar
  48. (48).
    Geisser ME, Robinson ME, Keefe FJ, Weiner ML: Catastro-phizing, depression and the sensory, affective and evaluative aspects of chronic pain.Pain. 1994,59:79–83.PubMedCrossRefGoogle Scholar
  49. (49).
    Sullivan MJ, Thorn B, Haythornthwaite JA, et al.: Theoretical perspectives on the relation between catastrophizing and pain.The Clinical Journal of Pain. 2001,17:52–64.PubMedCrossRefGoogle Scholar
  50. (50).
    Keefe FJ, Rumble ME, Scipio CD, Giordano LA, Perri LM: Psychological aspects of persistent pain: Current state of the science.The Journal of Pain. 2004,5:195–211.PubMedCrossRefGoogle Scholar
  51. (51).
    Hopman-Rock M, Kraaimaat FW, Odding E, Bijlsma JWJ: Coping with pain in the hip or knee in relation to physical disability in community-living elderly people.Arthritis Care and Research. 1998,11:243–252.PubMedCrossRefGoogle Scholar
  52. (52).
    Halbert J, Crotty M, Weller D, Ahern M, Silagy C: Primary care-based physical activity programs: Effectiveness in sedentary older patients with osteoarthritis symptoms.Arthritis and Rheumatism. 2001,45:228–234.PubMedCrossRefGoogle Scholar
  53. (53).
    Bot SD: Course and Prognosis of Complaints at the Arm, Neck and Shoulder. Doctoral Thesis, VU University Medical Center, Amsterdam: 2005.Google Scholar
  54. (54).
    Pope DP, Hunt IM, Birrell FN, Silman AJ, Macfarlane GJ: Hip pain onset in relation to cumulative workplace and leisure time mechanical load: a population based case-control study.Annals of the Rheumatic Disorders. 2003,62:322–326.CrossRefGoogle Scholar
  55. (55).
    Coggon D, Kellingray S, Inskip H, et al.: Osteoarthritis of the hip and occupational lifting.American Journal of Epidemiology. 1998,147:523–528.PubMedGoogle Scholar
  56. (56).
    Yoshimura N, Sasaki S, Iwasaki K, et al.: Occupational lifting is associated with hip osteoarthritis: A Japanese case-control study.Journal of Rheumatology. 2000,27:434–440.PubMedGoogle Scholar
  57. (57).
    Lau EC, Cooper C, Lam D, et al.: Factors associated with osteoarthritis of the hip and knee in Hong Kong Chinese: Obesity, joint injury, and occupational activities.American Journal of Epidemiology. 2000,152:855–862.PubMedCrossRefGoogle Scholar
  58. (58).
    Schouten JS, de Bie RA, Swaen G: An update on the relationship between occupational factors and osteoarthritis of the hip and knee.Current Opinion in Rheumatology. 200214:89–92.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2006

Authors and Affiliations

  • Johanna M. van der Waal
    • 1
  • Sandra D. M. Bot
    • 1
  • Caroline B. Terwee
    • 1
  • Daniëlle A. W. M. van der Windt
    • 2
  • Lex M. Bouter
    • 1
  • Joost Dekker
    • 2
  1. 1.EMGO InstituteVU University Medical CenterAmsterdamThe Netherlands
  2. 2.EMGO Institute and Department of General PracticeVU University Medical CenterUSA

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