Athletic therapist's management of persistent musculoskeletal pain: Time to embrace a biopsychosocial lens.

Abstract

Abstract Chronic musculoskeletal pain continues to be a rising cost and burden on individuals and society on a global level, thus driving the demand for improved management strategies. Despite the fact that the biopsychosocial model has long been a recommended approach to help manage chronic pain with its' consideration of the person and their experiences, psychosocial context and societal considerations, the biomedical model continues to be the basis of athletic therapy/training education programs and therefore clinical practice. For over 30 years, psychosocial factors have been identified in the literature to be predictors of outcomes relating to chronic pain, including (but not limited to) catastrophizing, fear-avoidance, and self-efficacy. Physical assessment strategies including use of validated outcome measures can be used by the Athletic Therapist and Athletic Trainer to determine the presence and/or severity of non-biogenic pain. Knowledge of these predictors and strategies will allow the Athletic Therapist and Athletic Trainer to frame use of exercise (e.g. graded exposure), manual therapy and/or therapeutic modalities in the appropriate way to improve clinic outcomes. Through change in educational curricula content, such as that recommended by the International Association for the Study of Pain (IASP), Athletic Therapists and Athletic Trainers can develop profession-specific knowledge and skills that will enhance clinical practice to better assist those living with chronic musculoskeletal pain conditions.