Pain and Function in Chronic Musculoskeletal Pain—Treating the Whole Person

Abstract

Chronic pain is often associated with functional limitations that have a huge impact on patients’ lives. However, despite being relatively common, chronic musculoskeletal pain is still viewed by some as a symptom of another disease rather than its own condition, and is therefore poorly addressed. This is compounded by other challenges in the field, including education gaps for both healthcare professionals and patients, a lack of universal and comprehensive assessment tools, poor societal perceptions of chronic pain, and the current stigma around the use of opioids. Here, we review the current chronic musculoskeletal pain management landscape in the United States and offer professional insight into emerging methods that can be used to improve patient outcomes, in particular, the achievement of meaningful functional goals. This perspective incorporates our combined multidisciplinary (psychiatry, psychology, nursing, physical therapy, and general medicine) experience and insights. We believe that chronic pain is a multifactorial experience and treatment requires an integrated, multidisciplinary approach from a range of healthcare providers. For the best patient outcomes, this team should work together to assess and treat the patient as a whole, addressing their pain and also providing education, empowerment, and support to enable patients to set and achieve meaningful functional goals that will provide real improvement in their quality of life. We believe that the healthcare community should elevate the conversation around chronic musculoskeletal pain management beyond that of just pain, to encompass the meaningful benefits that improvement in functional outcomes brings to patients.

Preventing Chronic Pain: Listening to the Patient, Treating the Person

“…In other words, we do not know the cause. 1 Low back pain is the single leading cause of disabil ity worldwide, and most people experience it at least once in their life.…”

Pursuing the Recovery of Severe Chronic Musculoskeletal Pain in Italy: Clinical and Organizational Perspectives from a SIAARTI Survey

“…19,20 Indeed, guidelines recommend encouraging strategies that address psychosocial factors and focus on improvement in function when it comes to both LBP [21][22][23][24] and OA patients. 25 As strongly advocated by Mallick-Searle et al, it is of utmost importance to elevate the conversation around chronic MSK pain management beyond that of just pain, to encompass the meaningful benefits that improvement in functional outcomes brings to patients. 26 A future, full implementation in everyday clinical practice of the coding introduced by ICD-11 and ICF along with a greater clinicians' awareness of the relevance of recovering patients' functioning may successfully optimize MSK pain care.…”

Improving consultations for persistent musculoskeletal low back pain in orthopaedic spine settings: an intervention development

“…The post-consultation letter includes individualised options, and agreed decisions about gaol setting in terms of daily routines. Goal setting is considered imperative to effective self-management because it entails measuring progress towards achieving a functional outcome that is meaningful to patients life [ 53 ]. The findings from a Cochrane systematic review of 39 RCTs involving 2846 patients mainly with persistent musculoskeletal disorders and chronic pain, indicates that goal setting may have positive effects for psychosocial outcomes (e.g.…”