Early identification and intervention in the prevention of musculoskeletal pain

Am J Ind Med. 2002 May;41(5):433-42. doi: 10.1002/ajim.10052.


Background: A large number of people suffer from upper extremity disorders, but a few apparently consume the majority of the resources. Early interventions are badly needed to prevent the development of persistent disability. Since psychological factors are central in the development of a chronic problem these might be utilized in this endeavor.

Methods: A series of studies are described where a screening procedure based on psychological risk factors was employed to help identify people at risk for developing long-term work disability. The utility of a cognitive-behavioral group intervention that focuses on coping strategies as prevention was assessed in three randomized-controlled studies where participants had low, medium, and high risk, respectively.

Results: The study with low risk showed no significant difference between the groups, while the studies with medium- and high-risk populations demonstrated significantly lower work disability than control groups receiving treatment as usual.

Conclusions: It appears to be feasible to identify patients with high levels of risk and to subsequently lower the risk for work disability by administering a cognitive-behavioral intervention focusing on psychological aspects of the pain problem.

MeSH terms

  • Arm Injuries / etiology
  • Arm Injuries / prevention & control*
  • Back Pain / etiology
  • Back Pain / prevention & control
  • Cognitive Behavioral Therapy
  • Cumulative Trauma Disorders / etiology
  • Cumulative Trauma Disorders / prevention & control*
  • Humans
  • Neuromuscular Diseases / etiology
  • Neuromuscular Diseases / prevention & control*
  • Occupational Diseases / etiology
  • Occupational Diseases / prevention & control*
  • Pain / etiology
  • Pain / prevention & control*
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Treatment Outcome