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

Abstract

Abstract Background It is estimated that 18.8 million people in the United Kingdom are living with a musculoskeletal (MSK) condition. It is a major cause of morbidity and a significant reason for presentation to primary care. Aim To determine the prevalence of MSK conditions presenting for consultation in general practice (GP), and how they are managed. Design and setting Epidemiological study. Method Patient episode consultations were reviewed at an urban community general practice. This involved evaluating morning consultations over a 1-week period from each of January, April, July, and October 2018. This included all the morning consultations from all GPs present. The number of MSK consultations was recorded, and within that the different presentations and their management plan. Results A total of 545 consultations were reviewed, of which 115 were related to an MSK presentation: an overall prevalence of 21.1%. The commonest MSK presentations related to the lumbosacral spine (18.3%) and the knee joint (17.4%). Re-presentations of an existing condition accounted for 73.9% of all MSK consultations. Steroid injections were administered in 33% of knee related consultations. Conclusion MSK presentations account for a large proportion of GP workload, but there is currently no mandatory training in orthopedics as part of the GP curriculum. Structured MSK education for GPs is important and may reduce the burden of re-presentations. Competency in joint injection is also an important skill for GPs.