The prevalence of musculoskeletal presentations in general practice: an epidemiological study

Abstract

BackgroundIt is estimated that 28.9% (17.8 million) of the UK population live with a musculoskeletal (MSK) condition. They are a major cause of morbidity, and a significant reason for presentation to primary care.AimThe primary aim of this study was to determine the prevalence of MSK conditions presenting for consultation in general practice. The secondary aim was to determine specifically which MSK conditions present most frequently in general practice.MethodA total of 545 consultations were reviewed at an urban community general practice, which included evaluating morning consultations over a 1-week period taken from each of January, April, July and October 2018. This encompassed all morning consultations from all GPs present. The number of MSK consultations were recorded and, within that, the different presentations and their management plan.ResultsA total of 115 of all consultations were regarding an MSK presentation yielding an overall prevalence of 21.1%. The commonest MSK presentations included the lumbosacral spine (18.3%) and the knee (17.4%). Re-presentations of original condition accounted for 73.9% of all MSK consultations. Steroid injections were administered in 33% of knee related consultations.ConclusionThis study demonstrates that MSK presentations account for a large proportion of GP workload. There are no current mandatory training requirements in orthopaedics as part of the GP curriculum. Structured MSK education for GPs is important and would reduce the burden of re-presentations, particularly that of the lumbosacral spine and knee. Competency in joint injection is also a valuable skill for GPs.