Musculoskeletal pain - presentations to general practice

In order to understand more about pain presentations in primary care, the authors undertook a descriptive study on musculoskeletal pain presentations to a general practice with a special interest in musculoskeletal medicine. The aim was to describe and categorise musculoskeletal pain presentations into pain subtypes.

Over a 5 week period in 2009, 133 consecutive musculoskeletal pain patients consented to participate in a study on pain presentations. Patients were categorised into: somatic, somatic referred, neuropathic or a combination of these. Further information was collected on age, gender, length of attendance, mode of referral, and current pain history.

Patients were predominantly female with chronic pain problems. Somatic low back pain was the commonest pain presentation. Neuropathic pain was a feature of 25% of cases, with pure somatic referred pain presenting in 1 in 7 cases. Nearly half of the patients were referred by their usual general practitioner. DISCUSSION Differentiating pain types is important in pain management. Neuropathic and somatic referred pain are common presentations to primary practice but may be difficult to detect. Data on pain presentation subtypes in primary practice is important to inform medical educators and research organisations and instruct future planning for primary care.