Top 11 recommendations for best practice care in MSK pain
The largest cause of disability worldwide is due to musculoskeletal (MSK) pain. MSK pain has also become a major societal burden due to poor quality healthcare. which is thought to be due to gaps that exist between the growing body of evidence and the daily practice of healthcare providers.
Poor quality healthcare brings about 2 things:
- waste of healthcare resources; and
- inappropriate patient care.
In an effort to search for the best recommendations in MSK pain management, the authors reviewed high-quality Clinical Practice Guidelines (CPGs) to identify a recurring theme.
A total of 44 CPGs (15 for Low Back Pain, 14 for Osteoarthritis, 6 for shoulder conditions and 5 for neck conditions) were selected for inclusion.
The top 11 recommendations for MSK pain conditions are as follows:
- Patient-centered care
- Screen for serious pathology and/or red flag conditions
- Assess psychosocial factors
- Discourage radiological imaging unless: 1) serious pathology is suspected; 2) there is unsatisfactory response to conservative care or unexplained progression of signs and symptoms; and 3) It is likely to change management
- Perform a physical examination which may include neurological screening tests, mobility and/or muscle strength
- Evaluate patient progress through the use of outcome measures
- Educate and inform patients about their condition and management options
- Include physical activity and/or exercise as part of a management plan
- Use manual therapy as an adjunct to other evidence-based treatments
- Unless specifically indicated, offer evidence-informed non-surgical care prior to surgery
- Facilitate continuation or resumption of work
This systematic review provides physiotherapists with a general outline of the best practice with MSK pain.
> From: Lin et al., Br J Sport Med (2019) (Epub ahead of print). All rights reserved to The Author(s). Click here for the online summary.