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Jun 2020

Manual Therapy for MSK Pain

Introduction

Musculoskeletal (MSK) pain conditions are the biggest cause of disability internationally and a major societal burden. However, there is little guidance to assist primary care providers in implementing non-pharmacological treatments such as manual therapy in addition to, or as an alternative for, pharmacological treatment. 

This tool is designed to increase primary care provider confidence in implementing an evidence-based multimodal program of patient education, exercise and manual therapy for MSK pain. It will guide providers in the referral for manual therapy by a chiropractor, physiotherapist or registered massage therapist (RMT), and the evaluation of patient outcomes.

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Information

About the tool

The Manual Therapy as an Evidence-Based Referral for Musculoskeletal Pain Tool is designed to increase primary care provider confidence in implementing an evidence-based multimodal program of patient education, exercise and manual therapy for MSK pain. It will guide providers in the referral for manual therapy by a chiropractor, physiotherapist or registered massage therapist (RMT), and the evaluation of patient outcomes. The tool provides:

  • Information about best clinical practices including evaluating function and pain, patient education and exercise.
  • Steps for assessing manual therapy as an option with your patients.
  • Evidence for manual therapy techniques by pain condition.
  • Guidance on selecting a manual therapy provider.
  • Links to related clinical tools, supporting material, and patient resources.

The Manual Therapy as an Evidence-Based Referral for Musculoskeletal Pain Tool was developed using the Centre for Effective Practice’s (CEP’s) integrated knowledge translation approach. This approach ensures that providers are engaged throughout the development processes through the application of user-centered design methodology. Clinical leadership of the resource was provided by Dr. Janice Harvey. End users, clinical experts, and people with lived experience were also engaged to provide feedback.

The tool was funded by and developed in partnership with the Ontario Chiropractic Association.

Clinical Lead

  • Dr. Janice Harvey

    MD, CCFP(SEM), FCFP DIP. SPORT MED.

    Dr. Janice Harvey is a family physician with a special interest in sport and exercise medicine. She is a Physician Advisor in CPD at the College of Family Physicians of Canada as well as an Assistant Clinical Professor for the Department of Family Medicine at McMaster University. Dr. Harvey is also the Assistant Director of the Standardized Patient Program at the McMaster University Centre for Simulation Based Learning. 

    In the past, Dr. Harvey has been the Chair of the Ontario College of Family Physicians CME/CPD Committee, the president of the Canadian Academy of Sport and Exercise Medicine (CASEM) and the Chair of the OMA Sport Medicine executive.

    Currently, Dr. Harvey is the Canadian delegate for the World University Sport Federation (FISU) medical commission and the Medical Lead for the World Curling Federation.

Clinical Working Group

  • David Dos Santos, B.Sc., D.C., FCCPOR(C), FCCO(C)
  • Erica Weinberg, BSc, MSc, MPhil, MD
  • Lindsey Rebeiro, BScH, DC
  • Lynn K. Cooper, BES (patient with lived experience)

Target End User Feedback and Expert Opinion

We also sought target end user input to inform the content and would like to thank these individuals for their time. 

Thank you

Thank you to everyone who supported the development of these resources!


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