What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review

<jats:sec><jats:title>Objectives</jats:title><jats:p>To identify common recommendations for high-quality care for the most common musculoskeletal (MSK) pain sites encountered by clinicians in emergency and primary care (spinal (lumbar, thoracic and cervical), hip/knee (including osteoarthritis [OA] and shoulder) from contemporary, high-quality clinical practice guidelines (CPGs).</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Systematic review, critical appraisal and narrative synthesis of MSK pain CPG recommendations.</jats:p></jats:sec><jats:sec><jats:title>Eligibility criteria</jats:title><jats:p>Included MSK pain CPGs were written in English, rated as high quality, published from 2011, focused on adults and described development processes. Excluded CPGs were for: traumatic MSK pain, single modalities (eg, surgery), traditional healing/medicine, specific disease processes (eg, inflammatory arthropathies) or those that required payment.</jats:p></jats:sec><jats:sec><jats:title>Data sources</jats:title><jats:p>Four scientific databases (MEDLINE, Embase, CINAHL and Physiotherapy Evidence Database) and four guideline repositories.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>6232 records were identified, 44 CPGs were appraised and 11 were rated as high quality (low back pain: 4, OA: 4, neck: 2 and shoulder: 1). We identified 11 recommendations for MSK pain care: ensure care is patient centred, screen for red flag conditions, assess psychosocial factors, use imaging selectively, undertake a physical examination, monitor patient progress, provide education/information, address physical activity/exercise, use manual therapy only as an adjunct to other treatments, offer high-quality non-surgical care prior to surgery and try to keep patients at work.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>These 11 recommendations guide healthcare consumers, clinicians, researchers and policy makers to manage MSK pain. This should improve the quality of care of MSK pain.</jats:p></jats:sec>