Pain management in musculoskeletal conditions

This chapter describes a biopsychosocial model of pain and the way in which it can provide a basis for the assessment of pain and the use of non-pharmacological pain management strategies. Various non-pharmacological interventions for musculoskeletal pain are described and evaluated. These include physical, psychological and social/environmental interventions. Given the often complex nature of patients presenting with persisting pain, it is not surprising that single-modality treatments are rarely sufficient on their own, and combinations of interventions offer advantages, on theoretical grounds at least. However, a number of challenges facing clinicians and researchers in applying these methods, especially when done alongside invasive and/or pharmacological interventions, remains to be fully addressed. These challenges have implications for the roles of clinicians from all disciplines, as well as for their patients and the community at large.

Key words: biopsychosocial models of pain, acute and chronic pain, psychosocial assessment and management, self-management, evidence, cost–benefits, collaborative care