Infographic
Br J Sports Med: first published as 10.1136/bjsports-2019-101681 on 20 January 2020. Downloaded from http://bjsm.bmj.com/ on January 30, 2020 at University of Limerick (UL). Protected
Infographic. Roadmap to managing a person with
musculoskeletal pain irrespective of body region
J P Caneiro  ‍ ‍,1,2 Ewa M Roos  ‍ ‍,3 Christian J Barton,4,5 Kieran O’Sullivan  ‍ ‍,6,7 Peter Kent,1 Ivan Lin  ‍ ‍,8
Peter Choong,5 Kay M Crossley  ‍ ‍,4 Jan Hartvigsen,3 Anne J Smith,1 Kevin Wernli  ‍ ‍,1,2
Peter B O’Sullivan  ‍ ‍1,2
Persistent musculoskeletal (MSK) pain
across different body regions is frequently
comorbid and shares common biopsycho-
social risk profiles for pain and disability.1–3
Biopsychosocial factors require consider-
ation; these include underactivity or over-
activity, poor sleep, obesity as well as poor
general and psychological health. As such,
there is consensus across clinical guidelines
on the recommendations for best practice
irrespective of body region.4 However,
current clinical research, education and
practice commonly approach MSK pain as
separate entities, such as knee, hip, neck,
shoulder and back pain.
We have previously proposed that a shift
in understanding and management of MSK
pain is needed, including suggested actions
Caneiro JP, et al. Br J Sports Med Month 2020 Vol 0 No 0
for clinicians.5 This infographic provides
a roadmap outlining the five actions clini-
cians can take to adopt a ‘person-­centred’
active approach for the management of a
person with persistent MSK pain irrespec-
tive of body region. Health decision-­makers
and the public can also use this infographic
as an outline of key principles that underpin
high-­value care.
1
Curtin University, School of Physiotherapy and Exercise
Science, Perth, Western Australia, Australia
2
Body Logic Physiotherapy Clinic, Perth, Twickenham,
Australia
3
University of Southern Denmark, Center for Muscle
and Joint Health, Department of Sports Science and
Clinical Biomechanics, Odense, Denmark
4
LaTrobe Sport and Exercise Medicine Research Centre,
School of Allied Health, Melbourne, Victoria, Australia
5
University of Melbourne Department of Surgery, St
Vincent’s Hospital, Melbourne, Victoria, Australia
6
University of Limerick, School of Allied Health,
Limerick, Ireland
by copyright.
7
University of Limerick, Ageing Research Centre,
Limerick, Ireland
8
University of Western Australia, Western Australian
Centre for Rural Health, Geraldton, Western Australia,
Australia
Correspondence to Dr J P Caneiro, School of
Physiotherapy and Exercise Science, Curtin University,
Perth, WA 6102, Australia;
​jp.​caneiro@​postgrad.​curtin.​edu.​au
Twitter J P Caneiro @jpcaneiro, Ewa M Roos @
ewa_roos, Christian J Barton @DrChrisBarton,
Kieran O'Sullivan @kieranosull and Kevin Wernli @
KWernliPhysio
Contributors  KW developed the infographic. JPC
and POS contributed and all authors approved the final
version of the image. JPC and POS drafted the editorial.
All authors contributed and approved the final version
submitted.
Funding  The authors have not declared a specific
grant for this research from any funding agency in the
public, commercial or not-­for-­profit sectors.
Competing interests  Several authors (JPC, CJB, KOS,
KMC and POS) are members of the editorial board of
BJSM. Four authors (JPC, POS, KOS and CJB) deliver
educational workshops on patient-­centred care.
Patient consent for publication  Not required.
Provenance and peer review  Not commissioned;
externally peer reviewed.
© Author(s) (or their employer(s)) 2020. No commercial
re-­use. See rights and permissions. Published by BMJ.
To cite Caneiro JP, Roos EM, Barton CJ, et al.
Br J Sports Med Epub ahead of print: [please include
Day Month Year]. doi:10.1136/bjsports-2019-101681
Accepted 8 January 2020
   1
 Infographic
Br J Sports Med 2020;0:1–2.
doi:10.1136/bjsports-2019-101681
ORCID iDs
J P Caneiro http://​orcid.​org/​0000-​0001-​5555-​4412
Ewa M Roos http://o​ rcid.​org/​0000-​0001-​5425-​2199
Kieran O’Sullivan http://​orcid.​org/​0000-​0002-​7137-​
3125
Ivan Lin http://​orcid.​org/​0000-​0001-6​ 901-​2569
Kay M Crossley http://​orcid.​org/​0000-​0001-5​ 892-​129X
Kevin Wernli http://o​ rcid.​org/​0000-​0001-​6035-​9873
2 Caneiro JP, et al. Br J Sports Med Month 2020 Vol 0 No 0
Peter B O’Sullivan http://​orcid.​org/​0000-​0002-​3982-​
4088
References
1 Kittelson AJ, George SZ, Maluf KS, et al. Future
directions in painful knee osteoarthritis: harnessing
complexity in a heterogeneous population. Phys Ther
2014;94:422–32.
2 Hartvigsen J, Hancock MJ, Kongsted A, et al. What low
back pain is and why we need to pay attention. The
Lancet 2018;391:2356–67.
Br J Sports Med: first published as 10.1136/bjsports-2019-101681 on 20 January 2020. Downloaded from http://bjsm.bmj.com/ on January 30, 2020 at University of Limerick (UL). Protected
3 Lewis J, O’Sullivan P. Is it time to reframe how we care
for people with non-­traumatic musculoskeletal pain?
(1473-0480.
4 Lin I, Wiles LK, Waller R, et al. What does best practice
care for musculoskeletal pain look like? consensus from
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5 Caneiro JP, Roos EM, Barton CJ, et al. It is time to move
beyond ’body region silos’ to manage musculoskeletal
pain: five actions to change clinical practice. Br J Sports
Med;2019:bjsports-2018-100488.
by copyright.