Stepped care for persistent shoulder pain
Improving access to shoulder‑pain care in Aotearoa New Zealand
Many New Zealanders with musucloskeletal pain can only attend one or two physiotherapy sessions. Barriers such as rural distance, rigid work schedules, whānau (family) commitments, and the cost of private care—or ACC surcharges—mean that frequent visits are often impossible.
In the Te Whatu Ora – Health NZ outpatient system, ‘non‑urgent’ cases often face long waiting lists, and some clinics now offer just a single or double 'patient‑education' appointment to stretch capacity. While this eases wait times, it risks compromising care quality.
A stepped‑care approach could bridge this gap.
Our recent StePS‑NZ randomised trial (four sites: Auckland, Ōtorohanga, Christchurch, Dunedin) tested a stepped‑care model for persistent rotator‑cuff related shoulder pain (also called rotator cuff tendinopathy). With 200 volunteers, we’re evaluating whether two initial sessions with targeted patient-therapist conversations ('patient education') and self‑management tools can deliver effective, cost‑efficient outcomes while preserving high‑quality care.
Thank you to all participants, clinics, and collaborators who made this research possible.
Read the study protocol here.
📅 Stay tuned for our forthcoming results.
Research team and clinic providers
New Zealand: Gisela Sole, Margie Olds, Nicola Swain, Ricky Bell, Trudy Sullivan, Ari Saramanyaka, Charlotte Marshall
Canada: François Desmeules, Jean-Sébastien Roy
Auckland Shoulder Clinic, Focused Physiotherapy, Christchurch Physiotherapy & Sports Clinic, University of Otago School of Physiotherapy Clinic