Persistent musculoskeletal (MSK) pain is a worldwide health problem negatively impacting individuals' well-being and imposing substantial costs to society. MSK conditions have a multifactorial origin, influenced by multiple interacting factors, including genetics, psychological, social and biophysical factors, comorbidities and lifestyle (Hartvigsen et al., 2018). One contributor to the societal burden caused by MSK pain conditions is poor quality healthcare (Buchbinder et al., 2018). Common healthcare problems for MSK conditions include overuse of radiological imaging, surgery and opioids, and a failure to provide patients with education and advice (Lin et al., 2018). Furthermore non-evidence-based treatment approaches for MSK pain persist that emphasise passive management strategies and create unrealistic expectations for patients (Lewis & O’Sullivan, 2018).

The majority of persistent non-traumatic MSK disorders do not have a pathoanatomical diagnosis that adequately explains the individual’s pain experience and disability and are often resistant to current treatments (Lewis & O’Sullivan, 2018). When MSK pain conditions become persistent the focus should not be on providing a ‘cure’ but on providing a ‘management’ plan to control the disorder and limit its impact on the person’s well-being (Lewis & O’Sullivan, 2018). There is a need to reframe the care for non-traumatic persistent MSK pain conditions, in which building the individual’s self-efficacy to have more control and responsibility for their health is important (Lewis & O’Sullivan, 2018).

There is strong  evidence to support the use of self-management in many persistent conditions; however, for musculoskeletal disorders, the evidence is equivocal. There are low levels of reported participation in formal self-management programs and the group approach might fail in developing a meaningful therapeutic alliance (Beattie et al. 2016). Individual self-management support, as an overall approach to persistent MSK disorders and their multifactorial biopsychosocial origin, may contribute to more effective long-term management of these MSK conditions (Hutting, 2015). In this way, patients will feel empowered and have the skills and knowledge to actively manage their condition, even after the initial treatment period has ended (Hutting et al., 2019).

With their expertise in musculoskeletal disorders and the duration of patient contact, physical therapists are ideally positioned to support people with persistent musculoskeletal disorders in their self-management. Self-management support should focus on behavior change and an active lifestyle and should target attitude, self-efficacy, social influence, knowledge, and skills with regard to managing the condition (Hutting et al., 2019). To facilitate effective self-management, therapists should (1) help the patient to identify his or her barriers and goals, (2) assist in identifying optimal strategies to reduce or avoid symptom exacerbation through problem solving, and (3) support the patient to identify ways to measure the effectiveness of self-management (Hutting et al., 2019). Physical therapists should use a self-management approach to individualized (physical therapy) treatment for patients with persistent musculoskeletal disorders whenever possible (Hutting et al., 2019). In this presentation, theoretical methods and practical strategies for providing self-management support by physical therapists will be presented.