Current clinical research, education and practice commonly approaches musculoskeletal pain conditions in silos. A focus on body regions such as knee, hip, neck, shoulder and back pain as separate entities is manifest by region-specific clinical guidelines, conferences and working groups. Emerging evidence demonstrates that musculoskeletal pain disorders are frequently comorbid and share common biopsychosocial risk profiles for pain and disability.1–5 There is broad consensus across clinical guidelines on the recommendations for best practice, irrespective of body region.3 We contend that a shift to focus on the person is needed. This best practice approach will encourage clinicians to (1) focus on patients’ context and modifiable biopsychosocial factors that influence their pain and disability3; (2) use education to facilitate active management approaches (targeted exercise therapy, physical activity and healthy lifestyle habits) and reduce reliance on passive interventions; and (3) consider evidence-based surgical procedures only for those with a clear indication and where guideline-based non-surgical approaches have been rigorously adhered to. To adopt a person-centred active approach to treating musculoskeletal pain and disability, clinicians should: ### 1. Screen for biopsychosocial factors and health comorbidities Clinicians need to communicate clearly with the patient to identify potential biopsychosocial drivers of …

中文翻译：

---

是时候超越“身体区域孤岛”来管理肌肉骨骼疼痛：改变临床实践的五项行动

当前的临床研究、教育和实践通常在筒仓中处理肌肉骨骼疼痛状况。特定区域的临床指南、会议和工作组表明，将膝盖、臀部、颈部、肩部和背部疼痛等身体部位作为单独的实体加以关注。新出现的证据表明，肌肉骨骼疼痛疾病经常合并症，并且在疼痛和残疾方面具有共同的生物心理社会风险特征。 1-5 临床指南对最佳实践的建议达成了广泛的共识，而不管身体部位如何。3 我们认为转向需要专注于人。这种最佳实践方法将鼓励临床医生 (1) 关注患者的背景和影响其疼痛和残疾的可改变的生物心理社会因素 3；(2) 通过教育促进主动管理方法（有针对性的运动疗法、体育锻炼和健康的生活习惯）并减少对被动干预的依赖；(3) 仅对有明确指征且严格遵守基于指南的非手术方法的患者才考虑循证外科手术。为了采用以人为本的积极方法来治疗肌肉骨骼疼痛和残疾，临床医生应该：### 1. 筛查生物心理社会因素和健康合并症 临床医生需要与患者进行清晰的沟通，以确定……的潜在生物心理社会驱动因素。(3) 仅对有明确指征且严格遵守基于指南的非手术方法的患者才考虑循证外科手术。为了采用以人为本的积极方法来治疗肌肉骨骼疼痛和残疾，临床医生应该：### 1. 筛查生物心理社会因素和健康合并症 临床医生需要与患者进行清晰的沟通，以确定……的潜在生物心理社会驱动因素。(3) 仅对有明确指征且严格遵守基于指南的非手术方法的患者才考虑循证外科手术。为了采用以人为本的积极方法来治疗肌肉骨骼疼痛和残疾，临床医生应该：### 1. 筛查生物心理社会因素和健康合并症 临床医生需要与患者进行清晰的沟通，以确定……的潜在生物心理社会驱动因素。