Management of Musculoskeletal Disorders (MSDs) In Thai Sub-district Health Promoting Hospitals

Abstract

Patients with musculoskeletal disorders (MSDs) account for one-fifth of the treatment
services received at sub-district health promoting hospitals (HPHs). Accurate and effective
treatment and services for patients with MSDs are important. This article provides management
guidance for initial decision-making for nurses in caring for MSDs patients at HPHs. The guidance
is derived from health assessments based on physical and psychosocial examinations with
additional testing using the Nordic questionnaire and pain score scales. In the present study,
MSDs were assessed based on symptoms, and patients were categorized into the following
three levels: Level 1 - a need for urgent referral to a secondary hospital in cases involving
emergency or dangerous conditions, Level 2 - a need for referral to a secondary hospital in
cases requiring complex diagnostics, and Level 3 - the ability to provide initial treatment in
a HPH. Primary care for MSDs can be provided by categorizing patients into the following
four frequently encountered pain groups: 1) shoulder pain; 2) muscular back pain; 3) joint
pain in the wrists and fingers, and 4) joint pain in the knees. The primary health care for
MSDs in HPHs is managed by advising a reduction in risk factors and relieving pain by drugbased regimens in HPHs based on the framework of Thai professional nursing law. Adequate
management of care will provide quality services that are more accurate and appropriate
for patients with MSDs.