Abstracts & Literature Review 3

Standards of Care for Acute and Chronic Musculoskeletal Pain.

Nicolas E. Walsh, MD, Peter Brooks, MBBS, J. Mieke Hazes, MD, PhD, Rorey M. Walsh, BS,
Karsten Dreinhöfer, MD, Anthony D. Woolf, BSc, Kristina Åkesson, MD, PhD,
Lars Lidgren, MD, PhD
Arch Phys Med Rehabil Vol 89, September 2008.
© 2008 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

JACO Editorial Reviewer: Steven G. Yeomans, DC, FACO

Published: December, 2009
Journal of the Academy of Chiropractic Orthopedists
December 2009, Volume 6, Issue 4
Received: October 2009
Accepted: October 2009

The original article copyright belong s to the original publisher. This review is available from: http://www.dcorthoacademy.com © 2009 Yeomans and the Academy of Chiropractic Orthopedists. This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

JACO Editorial Summary

• The goals of the document are to 1) “to inform health care providers in the management of acute and chronic musculoskeletal [MSK] pain; and 2) to promote partnerships among the community, patients, and clinicians in decision-making in relation to pain – its prevention and management.”
• Three themes are utilized: 1) access to information/self-management; 2) early access to the best services to prevent chronicity; and 3) access to ongoing responsive treatment/support.
• 13 national and international guidelines/standards of care were reviewed to prepare this document.
• Standards of care for acute and chronic musculoskeletal care are included.
• Broad categories included prevention, initial assessment, initial management, follow-up care, rehabilitation, prevention of recurrent MSK pain, and prevention of chronic MSK pain.
• Charts are included utilizing the broad categories (last bullet above) and the goal, standard of care and needs are reported for both acute and chronic MSK care.
• The biopsychosocial model is fully embraced (red flags, yellow flags, occupational flags, and sociooccupational flags).
• A “Management Plan” algorithm is included with 4 main aspects to MSK care that include assess, manage, evaluate and exit.
• Six appendices include: 1) MSK signs & symptoms of serious causes; 2) MSK signs & symptoms of specific causes; 3) Conservative management for MSK pain; 4) Techniques of effective communication; 5) Psychosocial barriers to recovery; 6) predictors of chronicity (non-organic signs).