Integrating Mechanical Diagnosis and Therapy Within Multidisciplinary Biopsychosocial Care for Chronic Musculoskeletal Pain.

Abstract

Chronic musculoskeletal conditions such as osteoarthritis and fibromyalgia make up a major portion of the disability population worldwide. An interplay among biological, psychological, and social factors influences the symptoms of these disorders. Treating these disorders requires a multidisciplinary approach, as a unimodal approach fails to produce long-term functional improvement. This review studies the role of biopsychosocial care in chronic pain management with an emphasis on the indications and limitations of the McKenzie Method of Mechanical Diagnosis and Therapy (MDT). MDT was compared with the effectiveness of physical therapy, occupational therapy, medication management, and psychological interventions, and its effectiveness was also examined when integrated into a multidisciplinary rehabilitation model. MDT has a limited role in centrally mediated conditions such as fibromyalgia, but it is superior in situations controlled by mechanism. MDT increases self-management, lowers disability, and reduces one's dependence on passive therapies. MDT is best seen as a mechanism-specific, patient-centered intervention integrated into a biopsychosocial framework. Ideal long-term outcomes in chronic musculoskeletal pain involve the integration of progressive exercise, occupational therapy, psychological intervention, targeted mechanical therapy, and medication management.