Flag spotting: obstacles to recovery in patients with musculoskeletal disorders

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A recent systematic review by Alexanders et al published in Physiotherapy in 2015 reports that Physiotherapists working in a musculoskeletal environment commonly encounter psychological symptoms when working with individuals undergoing rehabilitation.

Question1

What are the most frequently encountered psychological symptoms in patients undergoing MSK rehabilitation and how would you identify them?

The most common psychological symptoms are anxiety, depression, fear avoidance beliefs and behaviors and low self-efficacy. These can be assessed using a simple tool such as ACTUP (Turk) and by questionnaires such as the Orebro Musculoskeletal Questionnaire, the Fear Avoidance Beliefs Questionnaire, the Tampa Scale of Kinesiophobia and the Spinal / Hand Function Sort.

Question2

A number of psychological interventions are already widely used by musculoskeletal physiotherapists. What are these and how do they help?

Physiotherapists commonly use a number of psychological interventions in clinical practice. In addition to goal setting, and being good motivators, Physiotherapists help people understand their MSK problem and how to move better despite it. They advise when and how to protect tissues to facilitate healing and how movement helps to get the best repair. By doing this they reduce fear of movement and restore the patients self efficacy.

Find out more about the physiotherapist’s role in the management of obstacles to recovery (yellow flags) in patients with musculoskeletal disorders in August’s Physiotherapy Club webinar with Nicola Hunter, Director at Working Towards Wellbeing and Head of Practice at Bury Physio.

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