Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults

Background Multidisciplinary biopsychosocial rehabilitation programs for neck and shoulder pain require substantial staff and financial resources. Despite questionable scientific evidence of their effectiveness, they are widely used. Neck and shoulder complaints are common among working age adults and they are often associated with physical work load and stress. Pain in the neck and shoulder area cause biopsychosocial difficulties for the patient, especially if disability due to pain is prolonged. To help patients with biopsychosocial problems, or to prevent their development, multidisciplinary biopsychosocial programs are used for rehabilitation for patients with neck and shoulder pain. Nevertheless, multidisciplinary treatment programmes are often laborious and rather long processes and require good collaboration between the patient, the rehabilitation team and the work place. Objectives The objective of this systematic review was to determine the effectiveness of multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults. Search methods The reviewed studies for this review were electronically identified from MEDLINE, EMBASE, PsycLIT, CENTRAL, Medic, the Science Citation Index, reference checking and consulting experts in the rehabilitation field. The original search was planned and performed for more broad area of musculoskeletal disorders. Trials on neck and shoulder pain were separated afterwards. The literature search was updated in November 2002 by electronically searching MEDLINE and EMBASE. Selection criteria From all references identified in our original search, we selected randomized controlled trials (RCTs) and non‐randomized controlled clinical trials (CCTs). Trials had to assess the effectiveness of biopsychosocial rehabilitation for working age adults suffering from neck and shoulder pain. The rehabilitation program was required to be multidisciplinary, i.e., it had to consist of a physician's consultation plus either a psychological, social or vocational intervention, or a combination of these. Data collection and analysis Four authors blinded to journal and author selected the trials that met the specified inclusion criteria. Two experts in the field of rehabilitation evaluated the clinical relevance and applicability of the findings of the selected studies for actual clinical use. Two other authors blinded to journal and author extracted the data and assessed the main results and the methodologica