Management of musculoskeletal pain

Best Pract Res Clin Rheumatol. 2007 Feb;21(1):153-66. doi: 10.1016/j.berh.2006.10.001.


Chronic musculoskeletal pain is a major public health problem affecting about one third of the adult population. Pain is often present without any specific findings in the musculoskeletal system and a strictly biomedical approach could be inadequate. A biopsychosocial model could give a better understanding of symptoms and new targets for management. Identification of risk factors for chronicity is important for prevention and early intervention. The cornerstones in management of chronic non-specific, and often widespread, musculoskeletal pain are non-pharmacological. Physical exercise and cognitive behavioral therapy, ideally in combination, are first line treatments in e.g. chronic low back pain and fibromyalgia. Analgesics are useful when there is a specific nociceptive component, but are often of limited usefulness in non-specific or chronic widespread pain (including fibromyalgia). Antidepressants and anticonvulsants could be of value in some patients but there is a need for more knowledge in order to give general recommendations.

Publication types

  • Review

MeSH terms

  • Analgesics / therapeutic use
  • Cognitive Behavioral Therapy
  • Combined Modality Therapy
  • Humans
  • Musculoskeletal Diseases / psychology
  • Musculoskeletal Diseases / therapy*
  • Pain / psychology
  • Pain Management*
  • Physical Therapy Modalities
  • Stress, Psychological
  • Transcutaneous Electric Nerve Stimulation


  • Analgesics