Management of musculoskeletal pain.
Chronic musculoskeletal pain is a major public health problem affecting about one third of the adult population. Pain is often present without any specific findings in the musculoskeletal system and a strictly biomedical approach could be inadequate. A biopsychosocial model could give a better understanding of symptoms and new targets for management. Identification of risk factors for chronicity is important for prevention and early intervention. The cornerstones in management of chronic non-specific, and often widespread, musculoskeletal pain are non-pharmacological. Physical exercise and cognitive behavioral therapy, ideally in combination, are first line treatments in e.g. chronic low back pain and fibromyalgia. Analgesics are useful when there is a specific nociceptive component, but are often of limited usefulness in non-specific or chronic widespread pain (including fibromyalgia). Antidepressants and anticonvulsants could be of value in some patients but there is a need for more knowledge in order to give general recommendations.
Bergman
Stefan
S
Spenshult Hospital, SE 313 92 Oskarström, Sweden. stefan.bergman@spenshult.se
D000700:Analgesics / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D006801:Humans; D009140:Musculoskeletal Diseases / Q000523:psychology / Q000628:therapy*; D010146:Pain / Q000523:psychology; D059408:Pain Management; D026741:Physical Therapy Modalities; D013315:Stress, Psychological; D004561:Transcutaneous Electric Nerve Stimulation
D000700:Analgesics