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Self-management — the muscle behind effective musculoskeletal care

Dr Mary Wyatt

Self-management of long-term musculoskeletal conditions 101 — the basics.

Musculoskeletal conditions are by far the most common type of work injury. Self-management is a key strategy for individuals with musculoskeletal conditions — particularly long term musculoskeletal problems — to improve their quality of life and reduce the burden on the healthcare system. 

This article explores the various aspects of self-management for musculoskeletal conditions.

What is self-management for musculoskeletal conditions? 

Self-management for musculoskeletal conditions refers to the actions and strategies that individuals with musculoskeletal conditions can use to manage their symptoms, prevent and manage flare-ups, improve their health and wellbeing and maintain their independence. 

It includes activities such as:

  • understanding the condition and its treatment options
  • adhering to medication regimes and treatment plans
  • identifying triggers that cause their condition to flare, to help prevent flare-ups from happening
  • learning how to manage both mild and more severe flare-ups
  • identifying everyday remedies they can use to lessen their symptoms — such as heat or ice, stretches, mindful approaches or when rest and when activity helps 
  • communicating effectively with healthcare professionals
  • accessing and using appropriate community resources
  • setting and working towards personal goals
  • modifying the work or home setup to make tasks easier and keep functional
  • learning techniques like pacing (avoiding a boom then bust cycle)
  • fostering motivation to exercise routinely, such as having an exercise buddy or a routine
  • using different manual handling techniques, such as a golfer's lift for picking up something on the ground.
Why is self-management important? 

Effective self-management of musculoskeletal conditions can lead to a number of benefits, including:

  • improved quality of life and physical function
  • reduced pain and disability
  • improved self-efficacy and mental well being 
  • lower healthcare costs
  • increased independence 
  • improved communication and collaboration with healthcare professionals.
What is self-management coaching? 

Self-management coaching for musculoskeletal conditions is a way of helping patients to take control of their own health and manage their conditions effectively. It involves a number of steps, including helping the patient to:

  • identify their barriers and goals
  • understand the nature of their condition, and how their thoughts, emotions and behaviours influence their condition
    identify strategies to reduce or avoid the exacerbation of symptoms through problem-solving
  • identify ways to measure the effectiveness of self-management

Coaching can help individuals with motivation for positive change. A coach can help the person identify and challenge unhelpful thoughts, beliefs and emotions that may be sabotaging their desired outcomes.

Barriers to self-management 

While self-management is important, there are many barriers to its routine use in health care:

  • Building a good therapeutic alliance: Clinicians need an understanding of the importance of self-management. Creating a good therapeutic alliance by listening, understanding, believing and including the patient in decisions is crucial to overcome barriers to self-management.
  • The time and effort needed to engage in self-management activities, and the time and effort required in the consultation to foster self-management. 
  • Lack of awareness: A common barrier to accessing self-management support resources is lack of awareness.
  • Physical symptoms: Physical symptoms such as pain is another barrier to accessing self-management support resources. People may be fearful about their condition and about making it worse.  
  • Lack of insurance support for self-management.  There may be small costs not included in the usual agreed list of funded treatments, or lack of willingness to pay for activities such as self-management coaching.  

Despite the known benefits of self-management, and the many different things people can do to give themselves the best chance of managing the pain and disability, there are personal and systemic reasons why this can be challenging to do. 

Educating people experience musculoskeletal conditions, and the healthcare professionals who care for them, is the first step.
  

Published 16 January, 2023 | Updated 17 January, 2023