Musculoskeletal conditions in children and adolescents managed in Australian primary care

Abstract

BackgroundPrimary care settings play a vital role in the early detection and appropriate management of musculoskeletal conditions in paediatric populations. However, little data exist regarding these conditions in a primary care context or on the presentation of specific musculoskeletal disorders in children. The aim of this study was to estimate the caseload and describe typical management of musculoskeletal conditions in children and adolescents presenting to primary care in Australia.MethodsAn analysis of data from the Bettering the Evaluation and Care of Health (BEACH) study was performed. The BEACH study is a continuous national study of general practice (GP) activity in Australia. We identified all GP encounters with children and adolescents over the past five years and extracted data on demographic details, the problems managed, and GP management of each problem. SAS statistical software was used to calculate robust proportions and after adjustment for the cluster, the 95% confidence intervals (CIs).ResultsFrom the period April 2006 to March 2011, there were 65,279 encounters with children and adolescents in the BEACH database. Of the 77,830 problems managed at these encounters, 4.9% (95%CI 4.7% to 5.1%) were musculoskeletal problems. The rate of musculoskeletal problems managed increased significantly with age, however there was a significant decrease for girls aged 15–17 years. Upper and lower limb conditions were the most common, followed by spine and trunk conditions. Spine and trunk conditions were significantly more likely to be managed with medication, but less likely to receive imaging, than upper or lower limb problems.ConclusionsMusculoskeletal problems in children and adolescents present a significant burden and an important challenge to the primary health care system in Australia. There is variability in rates of presentation between different age groups, gender and affected body region.

Consultation prevalence among children, adolescents and young adults with pain conditions: A description of age‐ and gender differences

“…Overall consultation prevalence increased up to the age of 11 for both females and males, after which the females' consultation prevalence continued to rise with age, while for males it stabilised. Consultation patterns for back/neck pain and joint pain/myalgia by age groups were similar to those found in studies on musculoskeletal disorders (Gunz et al, 2012;Henschke et al, 2014;Michaleff et al, 2017). We found a high consultation prevalence of abdominal pain already among the youngest.…”

“…A comprehensive investigation with concomitant focus on many different pain conditions would require a large, population-based data source that allows for sex and age stratification. Until now, register-based studies among young people have mainly investigated musculoskeletal pain problems (Gunz, Canizares, Mackay, & Badley, 2012;Henschke et al, 2014;Michaleff, Campbell, Protheroe, Rajani, & Dunn, 2017;Tan, Strauss, Protheroe, & Dunn, 2018), which is only one of many types of pain (Kamper, Yamato, & Williams, 2016b).…”

Consultation patterns of children and adolescents with knee pain in UK general practice: analysis of medical records

“…Patients under 3 years old were excluded as consultations for musculoskeletal problems in general practice are rare in this age group [7, 26]. The upper age range (19 years) was chosen based on the World Health Organisation’s definition of an “adolescent” which is a person aged 10 to 19 years old.…”

Increased Substance Use and Poorer Mental Health in Adolescents With Problematic Musculoskeletal Pain

“…This would suggest that the burden posed by both painful conditions and substance use may not be limited to conditions that lead to health care seeking. 20 Consequently, a population health framework could provide an important perspective in addressing the joint burden of problematic pain and substance use. Our findings point to implications for public health interventions aimed at reducing substance use, and for interventions aimed at reducing pain in clinical populations.…”