State of the Art

Physiotherapy support for self-management of persisting musculoskeletal pain disorders

Ina Diener
South African Journal of Physiotherapy | Vol 77, No 1 | a1564 | DOI: | © 2021 Ina Diener | This work is licensed under CC Attribution 4.0
Submitted: 23 February 2021 | Published: 29 October 2021

About the author(s)

Ina Diener, Department of Physiotherapy, Faculty of Health Sciences, Stellenbosch University, Stellenbosch, South Africa


Background: Musculoskeletal pain (MSKP) is an extremely common pain disorder in almost all populations. Self-management (SM) support is a programme to prepare people to self-manage their health condition effectively, while maintaining quality of life. SM is a cost-effective and context-specific strategy to address the global public health burden.

Objectives: Self-management needs a change in behaviour from seeking unnecessary medical care to safely self-managing symptoms. As changing individuals’ behaviour is challenging, the objective of my literature review was to identify the characteristics, in both therapist and patient, to successfully engage in SM.

Method: A narrative literature review, that could inform evidence-based support programmes for SM of MSKP.

Results: Studies on successful implementation of SM of MSKP do not report strong outcomes. However, in more recent years a few positive outcomes were reported, possibly as a result of research evidence for the application of psychosocial skills and contemporary pain neuroscience in the management of persistent MSKP.

Conclusion: Psychologically-informed physiotherapy, addressing psychosocial barriers to the maintenance of SM programmes, could facilitate more successful outcomes.

Clinical implications: Before engaging in a SM support programme, obstacles to behaviour change must be identified and addressed in a SM support programme, to facilitate individuals towards taking safe responsibility for their healthcare. Therapists working with patients with persistent MSKP, should upskill themselves to be in line with the latest pain and psychosocial research literature. Moreover, communication skills training seems to be a priority for effective SM support programmes.


self-management; self-management support; musculoskeletal pain; psychosocial barriers; behaviour change; psychologically informed physiotherapy


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Crossref Citations

1. Person-centered care for musculoskeletal pain: Putting principles into practice
Nathan Hutting, J.P. Caneiro, Otieno Martin Ong'wen, Maxi Miciak, Lisa Roberts
Musculoskeletal Science and Practice  vol: 62  first page: 102663  year: 2022  
doi: 10.1016/j.msksp.2022.102663