Persistent musculoskeletal pain is one of the most common and costly medical issues seen in daily practice. Considerable recent research has highlighted both physical (structural pathology, musculoskeletal dysfunction, deconditioning and weight gain) and psychological (fear of movement, depression, maladaptive beliefs and catastrophic thought processes) variables which contribute to persistent musculoskeletal pain. ⁽¹⁾ It is now known that traditional biomedical variables do not fully account for the level of pain and disability seen in individuals with persistent pain.

Current biopsychosocial rehabilitation programs show promise in successfully managing persistent musculoskeletal pain. These programs target modifiable variables seen in the patient presentation by using a combination of physical exercise, cognitive behavioural therapy and education. A recent study found that a ten hour rehabilitation program delivered in the community over a ten week period which focused on reduction of fear of movement and catastrophic thinking, management of depression and physical reconditioning lead to significant improvements in functional capacities and return to work status. ⁽²⁾

1. Blyth et al. The Contribution of Psychosocial Factors to the Development of Chronic Pain: The Key to Better Outcomes
for Patients. Pain 2007:129:8-11.
2. Sullivan et al. Secondary Prevention of Work Disability: Community Based Psychosocial Intervention for Musculoskeletal
Disorders. J Occ Rehab 2005:15(3):377-392.