Table 4 Final agreed matched treatment options: Full list of agreed treatment options for all five pain presentations across the three risk subgroups. Ticked boxes indicate that > 50% agreement was reached for the listed treatment option for the corresponding risk subgroup and pain presentation
From: Matching treatment options for risk sub-groups in musculoskeletal pain: a consensus groups study
L =Low risk; M=Medium risk; H=High risk | Back | Knee | Multisite | Neck | Shoulder | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
L | M | H | L | M | H | L | M | H | L | M | H | L | M | H | |
Education and advice, including exercise, activity modification, weight loss etc. | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Simple oral and topical pain medications limited to those available over the counter | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Review by primary care practitioner if not improving after 6 weeks | ✓ | ✓ | ✓ | ✓ | ✓ | ||||||||||
Refer to physiotherapy (all modalities) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||||
Refer to MSK interface clinic | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||||
Refer to psychosocial intervention or pain management service | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||||||
Personalised exercise programmes, e.g. personal trainer if available | ✓ | ✓ | ✓ | ✓ | |||||||||||
Occupational Health/workplace advice | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||||||
Address comorbidities, distress and frailty | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||||||||
Atypical analgesia (e.g. amitriptyline, pregabalin, gabapentin) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||||||||
Opioids | ✓ | ✓ | ✓ | ✓ | ✓ | ||||||||||
Refer to supported self-management and locally available community resources e.g. walking group, exercise on prescription | ✓ | ||||||||||||||
Refer to expert patient programme | ✓ | ✓ | ✓ | ✓ | ✓ | ||||||||||
Refer for lifestyle intervention e.g. dietician, slimming world etc. | ✓ | ||||||||||||||
Refer for surgical opinion | ✓ | ✓ | ✓ | ✓ | |||||||||||
Corticosteroid injection | ✓ | ✓ | ✓ | ||||||||||||
Refer to Rheumatology | ✓ | ✓ | |||||||||||||