Transcutaneous electrical nerve stimulation for the management of tennis elbow: a pragmatic randomized controlled trial: the TATE trial (ISRCTN 87141084).

Background: Tennis elbow is a common and often extremely painful musculoskeletal condition, which has considerable impact on individuals as well as economic implications for healthcare utilization and absence from work. Many management strategies have been studied in clinical trials. Whilst corticosteroid injections offer short term pain relief, this treatment is unpleasant and is used with caution due to an associated high risk of pain recurrence in the long term.

Prescription and comorbidity screening following consultation for acute gout in primary care.

Objective: To describe prescribing patterns and cardiovascular risk factor screening in patients, following consultation for acute gout in primary care.

Methods: This study was undertaken in two inter-linked regional primary care databases: Consultations in Primary Care Archive (CiPCA) and Prescriptions in Primary Care Archive (PiPCA). During 2001-04, consultations in CiPCA were identified at 10 participating practices from gout-related Read morbidity codes.

Discussing prognosis with older people with musculoskeletal pain: a cross-sectional study in general practice.

Background: Prognosis has been described as an important but neglected branch of clinical science. While patients' views have been sought in the context of life-threatening illness, similar research is lacking for patients presenting with common, non-life-threatening musculoskeletal complaints. The aim of this study was to gauge whether and why older patients with musculoskeletal pain think prognostic information is important, and how often they felt prognosis was discussed in the general practice consultation.

Identification of UK sickness certification rates, standardised for age and sex.

Background: There is growing interest in tackling the perceived 'sick note' culture in the UK.

Aim: The aim of this paper was to report the rates of sickness certification in a UK population, using sick certification rates as a precursor to addressing fitness for work.

Method: Electronic records from all 14 practices included in the Keele GP Research Network were reviewed; all sickness certification records from 2005 were retrieved and corresponding consultation records were examined.

Co-occurrence and associations of pain and fatigue in a community sample of Dutch adults.

Widespread pain and chronic fatigue are common in the general population. Previous research has demonstrated co-occurrence of syndromes that are associated with pain and fatigue (fibromyalgia and chronic fatigue syndrome), but there is limited existing data on the co-occurrence of these symptoms in general. This study investigates the co-occurrence of pain and fatigue, and characterises people with these symptoms individually, and in combination.

Rates of sickness certification in European primary care: a systematic review.

Background: General practitioners (GPs) are responsible for assessing a patient's capacity for work and issuing a sickness certificate, enabling a patient to receive statutory sick pay and take time away from the workplace. The management of sickness absence across Europe varies considerably, and there is a need for comparable rates of certification to facilitate appropriate health and economic planning.

Objective: To systematically review the literature reporting rates of sickness certification in general practice settings.

Cognitive complaints in a general population of older adults: prevalence, association with pain and the influence of concurrent affective disorders.

Previous studies examining the associations between pain and cognitive complaints have been in pain clinic outpatients; there has been no research in the general population setting. A cross-sectional postal survey of 7878 older adults, aged 50 years and over, registered with three general practices (n=11230) in North Staffordshire using self-complete questionnaires was conducted. The questionnaire included the Alertness Behaviour Subscale from the Sickness Impact Profile to measure cognitive complaint, a full-body manikin to record presence and location of any recent pain (past 4 weeks) and the Hospital Anxiety and Depression Scale.

Is childhood pain associated with future mental health problems? A population based study of young adults in North Staffordshire.

Background: Depression is frequently associated with pain, yet the exact nature of this relationship is still not completely understood. Increasingly it is thought that pain and depression may share a common causal pathway that may originate in childhood.

Methods: A cross-sectional population-based survey recruited participants aged 18-25 years.

Thicker paper and larger font increased response and completeness in a postal survey.

Objective: To investigate the effect of font size and paper thickness on the response to, and completion of, a self-completion postal questionnaire among older people with joint pain.

Study Design And Setting: Randomized trial. People aged 50 years and older with joint pain who consulted a general practitioner at one of five general practices in Central Cheshire were sent a postal questionnaire.

Screening older people with musculoskeletal pain for depressive symptoms in primary care.

Background: Older patients presenting to GPs with musculoskeletal pain are at high risk of having concurrent depression.

Aim: To investigate the performance of ultra-short (1-4 items tools) screening questions used during the consultation, and through a patient questionnaire to detect depressive symptoms among older adults presenting with musculoskeletal pain to general practice.

Design Of Study: Cross-sectional survey, linked GP consultation data.

A woman living with osteoarthritis: A case report.

Osteoarthritis is a common condition that is typically associated with older adults. Other causes of osteoarthritis, such as those cases resulting from childhood Perthes disease, can affect younger people and frequently have a major impact on the lives of those affected. This case report describes the experiences of one patient with osteoarthritis, using examples of her poetry to illustrate her social, psychological and emotional transformation.

Birth-related exposures and asthma and allergy in adulthood: a population-based cross-sectional study of young adults in North Staffordshire.

The rise in the prevalence of asthma and other allergic disorders over the past two decades has been well documented, yet this increase has still to be fully explained. One possible hypothesis is that the rise in atopic disease is related to recent changes in obstetric practice. Using a population based survey, with linked general practice and hospital birth records, we investigated the association between 6 birth related exposures (birth weight, mode of delivery, artificial commencement of labour, prematurity, neonatal intensive care unit admission and foetal distress) and asthma, allergic rhinitis, eczema and hay fever in adulthood.

Impact of physical symptoms on perceived health in the community.

Objective: Physical symptoms, such as musculoskeletal pain, dizziness, or headache, are common. People with more symptoms are reported to use more healthcare and have higher sickness absenteeism. We studied the impact of the number of symptoms on perceived health in a community sample.

Prognostic factors for musculoskeletal pain in primary care: a systematic review.

Background: Estimating the future course of musculoskeletal pain is an important consideration in the primary care consultation for patients and healthcare professionals. Studies of prognostic indicators tend to have been viewed in relation to each site separately, however, an alternative view is that some prognostic indicators may be common across different sites of musculoskeletal pain.

Aim: To identify generic prognostic indicators for patients with musculoskeletal pain in primary care.

Predicting poor functional outcome in community-dwelling older adults with knee pain: prognostic value of generic indicators.

Background: In longitudinal studies across a range of regional musculoskeletal pain syndromes, certain prognostic factors consistently emerge. They are "generic" in the sense that they appear to apply regardless of the particular anatomical site or underlying cause of the pain.

Objective: To investigate the value of generic indicators of poor functional outcome for knee pain and osteoarthritis in the community.

The assessment of the prognosis of musculoskeletal conditions in older adults presenting to general practice: a research protocol.

Background: Musculoskeletal conditions represent a common reason for consulting general practice yet with the exception of low back pain, relatively little is known about the prognosis of these disorders. Recent evidence suggests that common 'generic' factors may be of value when assessing prognosis, irrespective of the location of the pain. This study will test a generic assessment tool used as part of the general practice consultation to determine prognosis of musculoskeletal complaints.

Is chronic pain in adulthood related to childhood factors? A population-based case-control study of young adults.

Objective: To investigate whether recalled childhood pain experiences and illnesses are associated with chronic pain in young adults.

Methods: A cross-sectional population-based survey recruited participants aged 18-25 years for a case-control study and obtained information on current pain and recalled childhood experiences. In total, 858 respondents were classified as either non-pain controls (n = 276), non-chronic pain cases (pain for < or = 3 months in the previous 6 months, n = 435), or chronic pain cases (pain of > 3 months' duration, n = 119).

Is chronic musculoskeletal pain in adulthood related to factors at birth? A population-based case-control study of young adults.

Chronic musculoskeletal pain affects one-third of the general population, yet apart from occupational and psychosocial risk factors, relatively little is known about its aetiology. Exposures in very early life may influence the development of chronic pain as a young adult. However, unlike the study of early life influences on some other common chronic diseases, little research has been conducted in this area.