POS1458-HPR TRENDS OF PREVALENCE AND INCIDENCE OF CHRONIC SHOULDER PAIN IN THE UNITED KINGDOM: FINDINGS FROM THE CLINICAL PRACTICE RESEARCH DATALINK (CPRD)
Authors: N. Alotaibi, S. Swain, Y. Vinogradova, B. Iyen, M. Doherty, W. Zhang, M. Hall
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Chronic shoulder pain (CSP) is a common musculoskeletal condition that can lead to sleeping difficulties, work disability and functional limitations in daily activities [1,2]. There is a gap in the evidence on the current prevalence and incidence of CSP in the UK, any variation that may exist between regions, and whether the occurrence of shoulder pain has changed in the past 20 years. <h3>Objectives:</h3> To investigate the prevalence and incidence of CSP in the UK in the year 2019 by age, sex and geographical regions and to examine the trends of prevalence and incidence of CSP from 2000 to 2020. <h3>Methods:</h3> We conducted cross-sectional and cohort studies using a large nationally representative primary care database (CPRD) to examine the prevalence and incidence of CSP in people in the UK aged 18 years and above. CSP was defined as having at least 2 General Practitioner (GP) consultations for shoulder pain within a 6 month period. We excluded severe acute trauma, including fracture, in the 6 months prior to the first consultation and shoulder surgery within the previous 3 months. We used the data in 2019 (prior to the COVID-19 pandemic) to estimate the current prevalence and incidence of shoulder pain UK. The trend of prevalence and incidence was examined using Joinpoint regression analysis. Prevalence and incidence for each year from 2000 until 2020 was standardised according to the age and sex structure of the 2019 CPRD population. Additionally, we examined the prevalence of shoulder pain using different codes used by GPs. <h3>Results:</h3> The prevalence of CSP in 2019 in 11,092,332 eligible adults was 1.91% (95%CI 1.91-1.92%). It increased with age and was higher in women (2.04 %,95%CI 2.03 -2.05%) than men (1.68%, 95%CI 1.67-1.69%) (Figure 1). There was a total of 11,164,066 person years of follow-up in 2019 of which 13,514 incident cases of CSP were identified, giving an incidence of 1.2 (95%CI 1.19-1.23) per 1,000 person-years. The incidence was higher in women than men, being 1.35 (95%CI 1.32-1.38) and 1.06 (95%CI 1.04-1.09) per 1,000 person-years, respectively (Figure 1). The age and sex standardised prevalence of CSP increased over the study period from 0.42% (95%CI 0.42-0.43) in 2000 to 1.83% (95%CI 1.83-1.84) in 2020. The age and sex-standardised incidence also increased from 0.88 (95%CI 0.86-0.9) in 2000 to 2.00 (95%CI 1.96-2.00) in 2011, then subsequently decreased. Shoulder pain and rotator cuff syndrome were most commonly coded by GPs with prevalence of 0.75% (95% CI 0.75-0.76) and 0.49% (95% CI 0.49-0.50), respectively. The prevalence and incidence of CSP varied across regions, with Yorkshire and Humber having the highest, and Northern Ireland having the lowest (Figure 2). <h3>Conclusion:</h3> About one in fifty adults have chronic shoulder pain in the UK. The risk increases with age and women are at higher risk than men. While the prevalence increased gradually, the incidence increased until 2011, then decreased in the past 20 years. Some regional variations have been observed but the reason needs further investigation. This study provides insight into the burden of CSP in the UK which may inform primary healthcare utilisation. <h3>REFERENCES:</h3> [1] Noten, S., Struyf, F., Lluch, E., D'Hoore, M., Van Looveren, E. &amp; Meeus, M. 2017. Central Pain Processing in Patients with Shoulder Pain: A Review of the Literature. Pain Pract, 17, 267-280. [2] jade, C. D., Porgo, T. V., Zomahoun, H. T. V., Perrault-Sullivan, G. &amp; Dionne, C. E. 2020. Incidence of shoulder pain in 40 years old and over and associated factors: A systematic review. Eur J Pain, 24, 39-50. <h3>Acknowledgements:</h3> This study was sponsored by the University of Nottingham and the Kuwait Cultural Office. We thank all the people who participated in this work. <h3>Disclosure of Interests:</h3> <b>None declared.</b>