British medical bulletin · 2026
Regional musculoskeletal pain in workers-is the traditional medical model increasing disability?
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Walker-Bone Karen, Buchbinder Rachelle
Аннотация
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.
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.