Abstract

Introduction: Weaknesses in training of general practitioners (GPs) in musculoskeletal care havebeen identified. Little is known about methods of training GPs in shoulder pain management or theassessments they use in clinical practice. The aim of this study was to assess the effect of trainingmethods in shoulder pain management on GPs’ clinical practice.Methods: A validated, self-administered postal questionnaire on dealing with shoulder pain wassent to 1081 GPs.Results: Response rate was 48% (n = 520). The majority (82%) identified training at postgraduatemeetings, 17% had attended clinics and 11% attended musculoskeletal courses. Practitioners whohad been trained at clinics (odds ratio [OR] 17.5) and musculoskeletal courses (OR 8.2) were likelyto perform injections. Similarly, GPs’ confidence in shoulder examination was related to theirattendance at clinics (P = 0.019) and musculoskeletal courses (P < 0.001) but not postgraduatemeetings. In their clinical examination, GPs found that assessing the active range of movement(ROM), passive ROM and painful arc were the most useful clinical findings and they foundcorticosteroid injection, NSAIDs and physiotherapy equally effective in treatment and each moreeffective than doing nothing.Conclusions: General practitioners’ confidence in assessment of shoulder pain and their likelihoodof performing injections was increased by training either at a clinic or specific musculoskeletalcourse but not by simply attending postgraduate meetings. They found the most useful methods ofassessment to be range of movement and painful arc, and considered injection, physiotherapy andNSAIDs as equally effective.