Format

Send to

Choose Destination
Br J Sports Med. 2019 Mar 2. pii: bjsports-2018-099878. doi: 10.1136/bjsports-2018-099878. [Epub ahead of print]

What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review.

Author information

1
WA Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia.
2
Centre for Population Health Research, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia.
3
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
4
Pain Management Centre, Sir Charles Gardner Hospital, Perth, Western Australia, Australia.
5
Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia.
6
Emergency Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
7
Emergency Department, Geraldton Hospital, Geraldton, Western Australia, Australia.
8
School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia.
9
School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
10
Department of Physiotherapy, Curtin University, Perth, Western Australia, Australia.

Abstract

OBJECTIVES:

To identify common recommendations for high-quality care for the most common musculoskeletal (MSK) pain sites encountered by clinicians in emergency and primary care (spinal (lumbar, thoracic and cervical), hip/knee (including osteoarthritis [OA] and shoulder) from contemporary, high-quality clinical practice guidelines (CPGs).

DESIGN:

Systematic review, critical appraisal and narrative synthesis of MSK pain CPG recommendations.

ELIGIBILITY CRITERIA:

Included MSK pain CPGs were written in English, rated as high quality, published from 2011, focused on adults and described development processes. Excluded CPGs were for: traumatic MSK pain, single modalities (eg, surgery), traditional healing/medicine, specific disease processes (eg, inflammatory arthropathies) or those that required payment.

DATA SOURCES:

Four scientific databases (MEDLINE, Embase, CINAHL and Physiotherapy Evidence Database) and four guideline repositories.

RESULTS:

6232 records were identified, 44 CPGs were appraised and 11 were rated as high quality (low back pain: 4, OA: 4, neck: 2 and shoulder: 1). We identified 11 recommendations for MSK pain care: ensure care is patient centred, screen for red flag conditions, assess psychosocial factors, use imaging selectively, undertake a physical examination, monitor patient progress, provide education/information, address physical activity/exercise, use manual therapy only as an adjunct to other treatments, offer high-quality non-surgical care prior to surgery and try to keep patients at work.

CONCLUSION:

These 11 recommendations guide healthcare consumers, clinicians, researchers and policy makers to manage MSK pain. This should improve the quality of care of MSK pain.

KEYWORDS:

education; effectiveness; evidence based; knowledge translation; review

Conflict of interest statement

Competing interests: None declared.

Publication type

Publication type

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center