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4: Best Practice Recommendations for Musculoskeletal Pain

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    The medical community is acutely aware of the economic and social burden of musculoskeletal disorders and the overuse of radiological imaging and invasive interventions and opioids. Contemporary best-practices for musculoskeletal pain supports a multidisciplinary approach that addresses biopsychosocial influences and empowers patients to actively self-manage.

    If a best practice approach for musculoskeletal pain was adopted, it would massively reduce suffering and costs associated with musculoskeletal pain in our society. A systematic review and narrative synthesis published in the British Journal of Sports Medicine identified eleven consistent best-practice recommendations for musculoskeletal pain (Lin et al., 2020):


    Key Takeaways

    If massage therapists adopt these best-practice recommendations, we could be part of the solution as we can reduce the suffering and costs of musculoskeletal pain in our society.

    References and Sources

    Busse, J. W., Craigie, S., Juurlink, D. N., Buckley, D. N., Wang, L., Couban, R. J., … Guyatt, G. H. (2017). Guideline for opioid therapy and chronic noncancer pain. CMAJ: Canadian Medical Association journal, 189(18), E659–E666. doi:10.1503/cmaj.170363

    Caneiro, J. P., Roos, E. M., Barton, C. J., O’Sullivan, K., Kent, P., Lin, I., Choong, P., Crossley, K. M., Hartvigsen, J., Smith, A. J., & O’Sullivan, P. (2020). It is time to move beyond ‘body region silos’ to manage musculoskeletal pain: five actions to change clinical practice. British journal of sports medicine, 54(8), 438–439.

    Chou, R., Hartung, D., Turner, J., Blazina, I., Chan, B., Levander, X., … Pappas, M. (2020). Opioid Treatments for Chronic Pain. Agency for Healthcare Research and Quality (US). DOI:

    Djulbegovic, B., & Guyatt, G. H. (2017). Progress in evidence-based medicine: a quarter century on. Lancet (London, England), 390(10092), 415–423.

    Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science (New York, N.Y.), 196(4286), 129–136.

    Engel, G. L. (1980). The clinical application of the biopsychosocial model. The American journal of psychiatry, 137(5), 535–544. doi:10.1176/ajp.137.5.535

    Lin, I., Wiles, L., Waller, R., Goucke, R., Nagree, Y., Gibberd, M., … O’Sullivan, P. (2020). What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. British journal of sports medicine, 54(2), 79–86. doi:10.1136/bjsports-2018-099878

    Lin, I., Wiles, L., Waller, R., Caneiro, J. P., Nagree, Y., Straker, L., Maher, C. G., & O’Sullivan, P. (2020). Patient-centred care: the cornerstone for high-value musculoskeletal pain management. British journal of sports medicine, 54(21), 1240–1242.

    Skelly, A.C., Chou, R., Dettori, J.R., Turner, J.A., Friedly, J.L., Rundell, S.D., … Ferguson, A.J.R. (2020). Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update. Agency for Healthcare Research and Quality (US).

    This page titled 4: Best Practice Recommendations for Musculoskeletal Pain is shared under a CC BY-NC license and was authored, remixed, and/or curated by Richard Lebert (eCampus Ontario) .

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