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dc.contributor.authorLewis, Jeremy
dc.contributor.authorO'Sullivan, Peter
dc.date.accessioned2018-10-10T01:12:04Z
dc.date.available2018-10-10T01:12:04Z
dc.date.issued2018-06-25
dc.identifier.citationLewis , J & O'Sullivan , P 2018 , ' Is it time to reframe how we care for people with non-traumatic musculoskeletal pain? ' , British Journal of Sports Medicine , vol. 52 , no. 24 , pp. 1543-1544 . https://doi.org/10.1136/bjsports-2018-099198
dc.identifier.issn0306-3674
dc.identifier.urihttp://hdl.handle.net/2299/20697
dc.description.abstractThe current approach to musculoskeletal pain is failing The majority of persistent non-traumatic musculoskeletal pain disorders do not have a pathoanatomical diagnosis that adequately explains the individual’s pain experience and disability. We contend this has resulted in two concerning developments in the management of people with such disorders. First, structural changes observed on imaging that are highly prevalent in pain free populations, such as rotator cuff tears, intervertebral disc degeneration, labral tears and cartilage changes, are ascribed to individuals as a diagnosis for their condition. In this context, this information may result in the individual believing that their body is damaged, fragile and in need of protection, resulting in a cascade of movement and activity avoidance behaviours and seeking interventions to correct the structural deficits. This trend has led to exponential increases in elective surgery rates and associated costs, while the efficacy of repairing (eg, rotator cuff and medical meniscal tears), reshaping (eg, subacromial decompression) or replacing (eg, lumbar intervertebral discs) the structures considered to be at fault has been substantially challenged. Second, it is arguable that musculoskeletal clinicians have invented treatments for conditions that may not exist or be readily detected (such as trigger points, sacral torsions), and they have developed and perpetuated treatment paradigms (such as ‘correcting’ upper body posture and muscle imbalances) that do not conform to current research evidence. These two trends have created an expectation that interventions (frequently ‘passive’) will provide a ’cure’, and typically quickly, with minimal self-contribution. This expectation may have been derived from a conversation with a friend or family member, from the Internet or from an advertising campaign, but almost certainly originated from health professionals.en
dc.format.extent2
dc.format.extent147214
dc.language.isoeng
dc.relation.ispartofBritish Journal of Sports Medicine
dc.subjectdisability
dc.subjectphysiotherapy
dc.subjectrehabilitation
dc.subjectsurgery
dc.subjectOrthopedics and Sports Medicine
dc.subjectPhysical Therapy, Sports Therapy and Rehabilitation
dc.titleIs it time to reframe how we care for people with non-traumatic musculoskeletal pain?en
dc.contributor.institutionDepartment of Allied Health Professions and Midwifery
dc.contributor.institutionPhysiotherapy
dc.contributor.institutionSchool of Health and Social Work
dc.contributor.institutionDepartment of Allied Health Professions, Midwifery and Social Work
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85054667758&partnerID=8YFLogxK
rioxxterms.versionofrecord10.1136/bjsports-2018-099198
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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