title: Management of musculoskeletal pain in a compensable environment: Implementation of helpful and unhelpful Models of Care in supporting recovery and return to work.
abstract: Models of Care (MoCs) for injured workers in the compensation environment recommend adoption of biopsychosocial management approaches. Still, widespread dominance of biomedical constructs at the system, organisational and individual levels of the compensation system prevails, contributing to suboptimal management practices and outcomes for injured workers. Efforts to implement contemporary MoCs in the compensation environment show some promise in improving outcomes. Areas of promise at the organisational level, particularly in the workplace, and at the system level are discussed. Implementation of a contemporary understanding of pain biology as part of the biopsychosocial approach in the management of the person with pain and associated disability has been effective in the non-compensable environment. The implications of this for the compensable environment are explored. Resultant helpful and unhelpful perspectives and behaviours are presented as a blueprint for areas of potential change in development and implementation of MoCs in a compensable environment.
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth WA6845, Australia.
authors.forename: Darren
authors.initials: D
authors.lastname: Beales
authors.affiliation: Rehabilitation Medicine Group, Box 7145 Gardenvale LPO, Brighton, Victoria 3186, Australia. Electronic address: kalfried@bigpond.net.au.
authors.forename: Kal
authors.initials: K
authors.lastname: Fried
authors.affiliation: Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Nicholas
authors.affiliation: Concord Clinical School, Faculty of Medicine, University of Sydney, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Blyth
authors.affiliation: Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, St Leonards, NSW 2065, Australia; Department of Anaesthesia, University of Sydney at Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
authors.forename: Damien
authors.initials: D
authors.lastname: Finniss
authors.affiliation: Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide 5001, Australia.
authors.forename: G Lorimer
authors.initials: GL
authors.lastname: Moseley
mesh_terms: D003695:Delivery of Health Care / Q000379:methods* / Q000458:organization & administration; D006233:Persons with Disabilities; D006801:Humans; D059352:Musculoskeletal Pain; D062707:Return to Work; D017132:Workplace
keywords: Compensation; Musculoskeletal; Pain; Rehabilitation; Workers