Box 1.

A suggested list of evidence-informed strategies^* to help promote and enhance healthcare professionals’ awareness of psychosocial factors associated with musculoskeletal pain.

Suggestion 1: Applying the International Classification of Functioning, Disability and Health (ICF) framework to gauge the level of health or disability for a person’s pain presentation, by taking into account the person’s bodily function, activity limitation and participation restriction and contextual factors that might influence function (86, 87). This may increase awareness of the impact of pain on a person’s life.

Suggestion 2: Providing information about the social determinants of health (SDH) that can influence recovery of patients with musculoskeletal impairments (88), may increase awareness and early recognition of the contribution of SDH to disparities in musculoskeletal pain conditions, such as low back pain outcomes (89).

Suggestion 3: Providing evidence that early life stress, adverse childhood experiences, stressful life events, perceived injustice, and iatrogenic factors are associated with musculoskeletal pain and increased risk of developing chronic pain (90–99). Pain can be triggered by all these factors, and these factors can also lead to /prolong pain.

Suggestion 4: Applying a lifespan perspective to the teaching and understanding of acute, recurrent, and chronic musculoskeletal pain to raise awareness that pain can emerge, resolve, recur, and persist from childhood to old age (100, 101).

Suggestion 5: Incorporating medical humanities into the teaching of pain science in musculoskeletal pain may provide a more authentic and compelling understanding of peoples’ pain narratives, and a more vivid description of the impact of pain on quality of life (102, 103).

Suggestion 6: Providing evidence that psychological factors such as fear avoidance beliefs, increased fear of pain and pain-related anxiety are associated with greater pain intensity and disability (104–106), giving agency to enquire about these factors when assessing and managing people experiencing pain.

Suggestion 7: Providing evidence that chronic musculoskeletal pain is associated with higher prevalence and levels of depression, disability, decreased participation in social aspects of daily life, lower quality of life and close relationships conflicts (107), giving agency on what to expect when managing people experiencing chronic pain.

ICF, international classification of functioning, disability and health; SDH, social determinants of health.

^* References to inform and support suggestions are drawn from systematic reviews or best-level evidence where possible.