Epidemiology of musculoskeletal pain in primary care

Aims: ( 1) To determine the proportion of children evaluated for musculoskeletal pain in a paediatric primary care clinic over a three year period; ( 2) to describe the number of office visits due to musculoskeletal pain; ( 3) to categorise the more common presenting complaints; and ( 4) to characterise the aetiology of musculoskeletal pain in a paediatric primary care clinic. Methods: Retrospective chart review of all children greater than or equal to 3 and,15 years of age evaluated in an urban paediatric primary care clinic in Madrid between 1 January 1997 and 31 December 1999. Results: ( 1) A total of 317 children were evaluated for musculoskeletal pain throughout the study. The prevalence of musculoskeletal pain increased as children grew older, from 2.4 - 5.7% at age 3 to 27.5-36% at age 14. Regression analysis showed that age ( OR 1.20) and gender ( OR 0.75) were associated with MSP. ( 2) Musculoskeletal pain was reported in 397 of 6500 office visits (6.1%; 95% CI 5.5 to 6.7%). ( 3) Arthralgias and soft tissue pain represented 65% of the presenting musculoskeletal complaints. ( 4) Trauma was the most common aetiology, responsible for 44% of all musculoskeletal pain related office visits. Mechanical/overuse pathology (23.9%) and osteochondroses (10.3%) represented the second and third leading aetiologies. Conclusions: Musculoskeletal pain is a common presenting complaint in primary care. The number of children presenting with musculoskeletal pain increases as they grow older, being particularly frequent among the adolescent population. The spectrum of aetiologies involved is limited, to the extent that three are responsible for almost 80% of cases.