What We Know About the Timing and Site of Interventions for Soft-Tissue Injuries of the Low Back, Neck and Upper Extremity

INTRODUCTION Low back pain, neck pain and arm pain are among the most common causes of disability and handicap in industrialized countries. Taken together, they represent the majority of compensable injuries in Canada and the largest burden of cost and suffering [1]. Although they are poorly understood, they are most often changes in soft tissues i.e., muscles, tendons, ligaments, joints and nerves in contrast to fractures or other bony disorders. When linked to work, they are often termed Work Related Musculoskeletal Disorders (WMSD), although application of this term is often limited to non-traumatic neck and arm disorders. In the last two decades we have witnessed remarkable changes in the suggested approaches to treatment and work rehabilitation of those with soft tissue disorders, based on slowly accumulating evidence that issues of timing, site and type of interventions are crucial.