Factors associated with delayed presentation of musculoskeletal complaints in primary care clinics in Jordan

Ahmad Fuad Alelaumi; Aisha Bader Shabakouh; Ali Adil Alzubaidi; Malek Jazee; Mohammed Abdullah Almutairi; Asmaa Bader Shabakouh; Fawaz Alkandari; Fahad Talal

doi:10.18203/issn.2455-4510.IntJResOrthop20262891

Authors

Ahmad Fuad Alelaumi Department of Orthopedic Surgery, Jordan University Hospital, Amman, Jordan
Aisha Bader Shabakouh University of Jordan, School of Medicine, Amman, Jordan
Ali Adil Alzubaidi University of Jordan, School of Medicine, Amman, Jordan
Malek Jazee University of Jordan, School of Medicine, Amman, Jordan
Mohammed Abdullah Almutairi University of Jordan, School of Medicine, Amman, Jordan
Asmaa Bader Shabakouh University of Jordan, School of Medicine, Amman, Jordan
Fawaz Alkandari University of Jordan, School of Medicine, Amman, Jordan
Fahad Talal University of Jordan, School of Medicine, Amman, Jordan

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20262891

Keywords:

Delayed presentation, Family medicine, Jordan, Musculoskeletal complaints, Primary care

Abstract

Background: Musculoskeletal (MSK) complaints are common in primary care clinics. Delayed presentation may worsen symptoms and reduce quality of life. Limited data are available from Jordan regarding delayed presentation among patients with MSK complaints. This study aims to evaluate delayed presentation and describe the characteristics of patients presenting with MSK complaints in primary care in Jordan.

Methods: This cross-sectional study was conducted at the family medicine clinics of Jordan University Hospital. A total of 100 adult patients with MSK complaints were included. Data regarding demographics, symptom duration, healthcare experience, emotional impact, and comorbidities were collected from electronic records and a previously established database. Delayed presentation was defined as presentation more than four weeks after symptom onset.

Results: The mean age was 47.4±5.4 years, and 55% of patients were female. The mean symptom duration before presentation was 4.1±1.8 weeks. Delayed presentation was observed in 49% of patients. Functional limitation was reported in 58% of patients, while 53% reported reduced daily activity. Emotional distress related to symptoms was common, with a mean anxiety/frustration score of 6.6±1.9. Most patients had at least one chronic medical condition.

Conclusions: Delayed presentation among patients with musculoskeletal complaints was common. MSK symptoms were associated with important functional and emotional effects. These findings highlight the importance of early medical consultation and improving musculoskeletal care in primary healthcare settings.

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References

Haas R, Gorelik A, Busija L, O’Connor D, Pearce C, Mazza D, et al. Prevalence and characteristics of musculoskeletal complaints in primary care: an analysis from the population level and analysis reporting (POLAR) database. BMC Prim Care. 2023;24(1):40, DOI: https://doi.org/10.1186/s12875-023-01976-z

Zirek E, Mustafaoglu R, Yasaci Z, Griffiths MD. A systematic review of musculoskeletal complaints, symptoms, and pathologies related to mobile phone usage. Musculoskeletal Sci Pract. 2020;49:102196. DOI: https://doi.org/10.1016/j.msksp.2020.102196

Behringer C, Nagib N, Nagib N. Introduction to multimodal musculoskeletal treatment models: a viewpoint. Discover Appl Sci. 2025;7(8):820. DOI: https://doi.org/10.1007/s42452-025-07480-6

Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, et al. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Translat Medi. 2020;8(6):299. DOI: https://doi.org/10.21037/atm.2020.02.175

Enabulele O. Referral decision-making: an assessment of family physicians in a tertiary hospital in Nigeria. J Niger Medi Associat. 2022;62(5):273.

Chang MC. Conservative treatments frequently used for chronic pain patients in clinical practice: a literature review. Cureus. 2020;12(8). DOI: https://doi.org/10.7759/cureus.9934

Chindhalore CA, Dakhale GN, Giradkar AB. Comparison of self-medication practices with analgesics among undergraduate medical and paramedical students of a tertiary care teaching institute in Central India-A questionnaire-based study. J Educat Heal Promot. 2020;9(1):309. DOI: https://doi.org/10.4103/jehp.jehp_378_20

Agarwal-Harding KJ, Chokotho LC, Mkandawire NC, Martin Jr C, Losina E, Katz JN. Risk factors for delayed presentation among patients with musculoskeletal injuries in Malawi. J Bone Joint Surg. 2019;101(10):920. DOI: https://doi.org/10.2106/JBJS.18.00516

Sun Q, Shi X. Delayed medical consultation and influencing factors in elderly patients with obstructive sleep apnea syndrome. Fronti Medi. 2025;12:1555926. DOI: https://doi.org/10.3389/fmed.2025.1555926

Bloomberg M, Bu F, Fancourt D, Steptoe A. Demographic and socioeconomic risk factors for pain progression and recurrence in middle-aged and older adults: multistate analysis of a prospective English cohort study. Age Ageing. 2026;55(1):afaf364. DOI: https://doi.org/10.1093/ageing/afaf364

Patangia B, Srinivasan PM, Lee MC. “We just keep pushing through”: a mixed-method study on musculoskeletal discomfort and mental well-being among nurses in resource-limited settings. BMC Nurs. 2025;24(1):1301. DOI: https://doi.org/10.1186/s12912-025-03698-2

Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453-7. DOI: https://doi.org/10.1016/S0140-6736(07)61602-X

Montesinos GF, Fabregas A, Gonzalez NL, Baralt C, Morales A, Jimenez S, et al. Prevalence of musculoskeletal complaints in underserved populations attending a student-run free clinic in puerto rico: a cross-sectional analysis. Cureus. 2026;18(5).

Wei S, Long H, Tian Y. Factors influencing healthcare-seeking behavior and its process analysis among ethnic minority residents: a qualitative study in rural China. Fronti Publ Health. 2025;13:1627392. DOI: https://doi.org/10.3389/fpubh.2025.1627392

Lan P, Chen X, Fang Z, Zhang J, Liu S, Liu Y. Effects of comorbidities on pain and function after total hip arthroplasty. Fronti Surg. 2022;9:829303. DOI: https://doi.org/10.3389/fsurg.2022.829303

Nguyen A, Lee P, Rodriguez EK, Chahal K, Freedman BR, Nazarian A. Addressing the growing burden of musculoskeletal diseases in the ageing US population: challenges and innovations. Lancet Healt Long. 2025;6(5). DOI: https://doi.org/10.1016/j.lanhl.2025.100707