[The influence of diagnostic labels on treatment preferences of people with musculoskeletal pain : A systematic literature review].

Abstract

Background: Patients often report uncertainty about the information provided by physicians and physiotherapists, as well as difficulties in making decisions regarding medical interventions. Making autonomous and informed decisions requires clear explanations about the condition, its associated limitations, prognosis, and treatment options.

Objective: This systematic review aimed to investigate how common diagnostic labels for the same musculoskeletal pathology influence the perceived severity of a condition and patients' treatment preferences.

Methods: Systematic literature search in MEDLINE (via PubMed), the Cochrane Library, and the PEDro database.

Results: Healthy individuals as well as patients associate diagnostic labels suggesting pathoanatomical damage in musculoskeletal pain syndromes with more pain, greater disability, and a perceived need for advanced imaging and invasive interventions. Overall, there is a significant correlation between diagnostic labels and patients' treatment preferences.

Discussion: Diagnostic labels such as "low back pain episode," "persistent hip pain," and "bursitis," which do not suggest severe structural damage, are often associated with a better prognosis and less perceived need for invasive interventions or advanced imaging. In contrast, labels indicating structural damage (e.g., "degeneration") can trigger fear, avoidance behaviour, and catastrophizing. Using labels that promote self-efficacy and convey a positive prognosis could therefore be a valuable strategy to improve care for patients with musculoskeletal pain.

Conclusion: Severe-sounding diagnostic labels are associated with a preference for more invasive treatments, catastrophizing tendencies, and a perceived need for advanced imaging in individuals with musculoskeletal pain.