Early Musculoskeletal Pain Management in the General Practitioner's Office & E-Referral: A Multidisciplinary Expert Opinion.

Abstract

Purpose: Musculoskeletal pain (MP) is a significant burden in primary care, often presenting challenges for general practitioners (GPs) in providing timely and effective management. Despite MP's prevalence, GPs face limitations in diagnostic resources and access to specialists, which can delay intervention and increase the risk of pain chronicity. This multidisciplinary expert opinion aims to establish a structured approach for the management of MP within general practice, using three targeted algorithms: (1) early management of acute MP in the GP's office, (2) post-surgical MP management to support recovery, and (3) MP management following emergency discharge.

Patients and methods: A panel of GPs, physiatrists, and orthopedists collaborated to develop practical recommendations based on current clinical guidelines, emphasizing early diagnosis, initial pain control, and effective e-referral pathways. During an onsite meeting, they created an algorithm to identify waiting therapy for patients with pain, in order to help GPs in this difficult task.

Results: The first algorithm focuses on early intervention for acute MP in primary care, with recommendations for both pharmacological and non-pharmacological approaches. The second algorithm addresses post-surgical MP management to enhance recovery and reduce complications. The third algorithm outlines post-emergency management strategies, emphasizing immediate pain relief and integrating patient education to support home management. E-referral and teleconsultation are incorporated throughout to enhance care coordination.

Conclusion: These three algorithms provide a structured framework for MP management in primary care, placing GPs at the centre of early intervention. The inclusion of telemedicine and e-referral pathways allows for timely specialist input, ultimately aiming to improve patient outcomes and minimize chronic pain risks.