The Journal of Bone and Joint Surgery (American). 2009;91:2014-2018.
doi:10.2106/JBJS.H.01512
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Current Concepts Review

Psychosocial Aspects of Disabling Musculoskeletal Pain

Ana-Maria Vranceanu, PhD1, Arthur Barsky, MD2 and David Ring, MD, PhD1

1 Orthopaedic Hand and Upper Extremity Services, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114. E-mail address for D. Ring: dring{at}partners.org
2 Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115

Disclosure: In support of their research in the past year, one or more of the authors received outside funding or grants (unrestricted, without clear designation) from Small Bone Innovations, Acumed, Tornier, Smith and Nephew, and Wright Medical (in excess of $10,000 in total). Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Psychosocial factors are important determinants of pain intensity and disability in patients with disabling musculoskeletal pain.

The psychosocial aspects of disabling musculoskeletal pain include cognitive (e.g., beliefs, expectations, and coping style), affective (e.g., depression, pain anxiety, heightened concern about illness, and anger), behavioral (e.g., avoidance), social (e.g., secondary gain), and cultural factors.

The effectiveness of cognitive behavioral therapy and other treatments that address the psychosocial aspects of disabling musculoskeletal pain has been confirmed in numerous high-quality studies.


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