Effect of biopsychosocial comprehensive chronic pain management physiotherapy Practice protocol in patients with Chronic Musculoskeletal Pain - a randomised trial

Abstract Background Chronic musculoskeletal pain (CMP) is a common condition treated by health care professionals including physiotherapists with increasing prevalence and causing disability and reduced quality of life. However, most of the treatments used are mainly biomedical yielding constrained outcomes and not in line with current clinical practice guidelines, which suggest the use of a biopsychosocial approach as the first-line treatment. A physiotherapy practice protocol based on neuro pain education, cognitive behaviour modification and self-management strategies is developed, which will be evaluated through a clinical trial and could transform the physiotherapy primary care practice according to the recommendations of the clinical practice guidelines. Methods A Randomised, single-centre clinical trial will be carried out to compare the effect of a Comprehensive chronic musculoskeletal Pain management (CCPM) which consists of 16 sessions weekly twice for 8 weeks Neuroscience Education program (4 sessions, 4 hrs)cognitive behaviour modification program(6 sessions,6 hrs),self-management strategies(4 sessions, 4 hrs) and revision of the program (2sessions, 2 hrs) along with usual care physiotherapy treatment for thrice weekly for 8weeks, with standardised physiotherapy thrice weekly for 8 weeks as control group. The study aims to evaluate the effect of CCPM intervention on central sensitisation, as well as on Fear avoidance, pain, disability, and pain self-efficacy The outcome variables will be measured at the beginning of the intervention and after 8 weeks Discussion The management of CMP pain can be improved by taking a multidisciplinary and holistic approach. However, the current healthcare system poses constraints to accessibility. It is necessary for physiotherapy practices to adopt a multi-dimensional pathway of treatment that considers all the bio-psychosocial factors during treatment sessions, rather than just following a bio-model pathway of management.Trial registration: CTRI/2023/05/053340 [Registered on: 31/05/2023] - Trial Registered Prospectively [https://ctri.nic.in/Clinicaltrials/main1.php?EncHid=96706.77723 ]