18 March 2019
A new study led by The University of Western Australia has identified 11 recommendations to help health professionals and patients better manage musculoskeletal problems. The study comes after the team found many musculoskeletal problems were not being managed effectively.
Musculoskeletal conditions - including back and neck pain, osteoarthritis and shoulder pain - affect nearly 7 million Australians with around one in five visits to the doctor due to a musculoskeletal pain condition. Musculoskeletal pain is very common, and results in disability at a greater rate than any other condition.
The study, published in the British Journal of Sports Medicine examined clinical practice guidelines for musculoskeletal pain conditions.
Lead researcher Dr Ivan Lin from UWA’s Western Australian Centre for Rural Health said the challenge was understanding the best way to manage conditions which could be complex.
"It's important that patients are provided with information about the cause of their pain and what they can do to self-manage it. Although this may sound obvious in a lot of cases people do not manage their condition effectively due to lack of information and understanding," Dr Lin said.
"We also found imaging such as x-rays and scans were overused when they should really only be used selectively when there is a suspicion of a serious condition or the need for further investigation."
Dr Lin said it was also important for clinicians to assess patients’ emotions and beliefs about their condition which could have a big impact on recovery.
"For example if a person has the perception that their condition is caused by severe and permanent damage to a part of their body then they might over-protect it and avoid all physical activity which could worsen the problem."
UWA Clinical Associate Professor and specialist pain physician Dr Roger Goucke, also involved in the study, said the recommendations would improve outcomes for patients.
"If these recommendations are followed when patients first seek care, we will see less patients in trouble later on in the pain clinic," Dr Goucke said.
The study led by UWA researchers was also made possible by the work of researchers and clinicians from Curtin University, University of South Australia, University of Sydney, Harry Perkins Institute of Medical Research, Sir Charles Gardner Hospital, and Geraldton Hospital.
11 key recommendations outlined in the study:
- Care should be patient-centred, such as incorporating effective communication and involving the patient in decision making;
- Screen for ‘red flag’ (serious conditions) such as fractures, cancer or conditions masquerading as musculoskeletal pain;
- Assess psychosocial factors such as depression, anxiety or unhelpful beliefs about pain as they are common predictors of poorer outcomes and require special care;
- Only use radiological imaging when there is a suspicion of a ‘red flag’ condition;
- Undertake a physical examination to assess physical capacity and neurological problems;
- Monitor patient progress, for example with a wellbeing questionnaire;
- Provide education/information about pain and management;
- Giving advice about activity or exercise;
- Only using manual therapies, such as joint manipulation or massage, with other treatments such as exercise;
- Offering high quality non-surgical care, such as rehabilitation, prior to surgery;
- And encouraging patients to continue work if they are employed.
View the full paper here - http://bit.ly/2NWa2AZ
Photo caption: Lead researcher Dr Ivan Lin at the WA Centre for Rural Health of the University of Western Australia.
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