Arthritis Research Campaign National Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom.
Phys Ther. 2009 Dec;89(12):1371-8. doi: 10.2522/ptj.20090003. Epub 2009 Oct 22.
Musculoskeletal problems are the most common cause of restriction in daily life in most countries. Most health care for musculoskeletal problems is provided in primary care settings, and back pain and joint problems together represent the largest workload of cases of chronic disease seen and managed there. This article reflects on aspects of the occurrence, natural history, prognosis, and management of common joint problems in primary care. Although the biomedical model has contributed to major advances, a model that embraces chronic pain management and its psychological and social components is needed. In particular, primary care is the ideal arena to achieve high-impact secondary prevention of pain and disability in people with osteoarthritis. Physical therapists are in a crucial position in primary care to provide support for self-management of this condition, especially for interventions related to exercise and behavioral change.
肌肉骨骼问题是大多数国家日常生活受限的最常见原因。大多数肌肉骨骼问题的医疗保健都是在初级保健环境中提供的,背痛和关节问题共同构成了那里所见和管理的慢性疾病病例中最大的工作量。本文反思了初级保健中常见关节问题的发生、自然病史、预后和管理的各个方面。尽管生物医学模型做出了重大贡献,但需要一种包含慢性疼痛管理及其心理和社会组成部分的模型。特别是,初级保健是实现骨关节炎患者疼痛和残疾的高影响力二级预防的理想领域。物理治疗师在初级保健中处于关键地位,可以为这种疾病的自我管理提供支持,特别是在与运动和行为改变相关的干预措施方面。