Patient-centered management strategy for concurrent musculoskeletal complaints in elbows, shoulders, and neck after an isolated hand/forearm complaint: A prospective interventional study

The aim was to evaluate patient-reported outcomes before and after a patient-centered management strategy targeting concurrent proximal musculoskeletal complaints (MSCs) in patients with an isolated hand/forearm complaint. A prospective interventional study included 66 patients. Intervention targeting concurrent MSCs was implemented as a patient-centered add-on to standard treatment for primary hand/forearm complaints. The patient-centered management strategy included patient education, individualized exercises, and manual therapy. Patient reported outcome measures and pain questionnaires regarding the location, frequency and intensity of pain in hands, elbows, shoulders and neck were collected at baseline, after the last session of the patient-centered management strategy, and at 3 months’ follow-up. There were significant improvements in all patient-reported outcomes between baseline and follow-up. DASH scores improved significantly, by 17 to 29 points on the 3 subscales. There was a significant improvement of 6 points in PCS, 2 points in HADS, and 0.051 points in EQ-5D index. Median pain intensity on VAS decreased from 6 (4–8) to 5 (2.5–7) in hands, 3 (0–6) to 0 (0–3) in elbows, 5 (2–7) to 2.5 (0–5) in shoulders, and 3 (0–6) to 2 (0–3) in the neck, between baseline and discharge. Patients reporting concurrent MSCs in the elbow, shoulder and neck after an isolated hand/forearm complaint may benefit from patient-centered management comprising patient education, individualized exercises and manual therapy targeting pain and functional deficits in the upper limb and neck. Level of evidence IV Résumé