Regional musculoskeletal pain in workers-is the traditional medical model increasing disability?
Karen Walker-Bone1, Rachelle Buchbinder2
1Monash Centre for Occupational and Environmental Health Research, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
Introduction:
Musculoskeletal disorders frequently cause work disability. For low back pain, a de-medicalized approach is advocated, whereas a biomedical approach is taken for shoulder and elbow/forearm pain.
Sources Of Data:
PubMed, Cochrane Library, Google Scholar.
Areas Of Agreement:
Guidelines for the management of low back pain recommend de-medicalization, rapid mobilization, avoidance of imaging, second-line use of pharmacological treatments, and an emphasis on self-management and remaining in or rapidly returning to work.
Areas Of Controversy:
Despite evidence for many treatment modalities, shoulder pain and elbow/forearm pain are still managed using a biomedical model that separates conditions into distinct diseases and treats them accordingly.
Growing Points:
Should pain at the shoulder and elbow/forearm be de-medicalized, with greater emphasis on maintaining mobility and work participation?
Areas Timely For Developing Research:
Testing integrated occupational and health interventions for musculoskeletal disorders, focusing on their effectiveness in work rehabilitation and reducing disability.
