Abstract
Background: Psychosocial factors are well-known contributors to the suffering and disability associated with common musculoskeletal problems. How to identify salient obstacles to recovery or return to work, and how to manage them effectively remains difficult. This project interpreted the evidence base and presented it as solution-focused guidance for everyday practical use by the key players (clinicians, employers, funders, case managers, etc) to help people remain active and working.
Methods and Results: Two methods were used to identify evidence and practical advice, and synthesize this into use-able statements:
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existing reviews;
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an international think tank charged with producing updated reviews and identifying research gaps.
An extended conceptual development of a ‘flags framework’, based on the earlier approach of Yellow Flags, was used to prepare an easily understood and pragmatic approach. The framework integrates obstacles related to the person (yellow flags), the workplace (blue flags) and the context (black flags). A full-colour 32-page document suitable for distribution as both print and electronic media was developed. This contains a clear explanation of how to identify psychosocial flags, how to develop a plan to address them effectively, and how to take action to overcome the obstacles. Poster-style summaries for clinicians, the workplace, and the individual are included, and are available for download. International consultation was used to ensure system-independent applicability and language.
Conclusion: The new document provides practical guidance on identifying and managing psychosocial issues relevant to common musculoskeletal problems based on the latest evidence and conceptual approaches.
Conflict of Interest: none
Sources of Funding: Society for Back Pain Research, Faculty of Occupational Medicine, BackCare, Transport for London, Royal Mail, HCML, TSO
Correspondence should be addressed to: SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
