Non-specific diagnostic labels for musculoskeletal conditions foster positive views about prognosis and non-invasive management but require clear explanation: a systematic review

Abstract

QUESTIONS: What are patient and public perceptions of diagnostic labels for musculoskeletal pain? How do these labels influence beliefs, emotions and treatment preferences? DESIGN: Systematic review and qualitative meta-synthesis. PARTICIPANTS: People with musculoskeletal pain or people presented with hypothetical vignettes of musculoskeletal pain. INTERVENTION: Diagnostic labels for musculoskeletal pain. OUTCOME MEASURES: Patient/public perceptions of diagnostic labels for musculoskeletal pain and the influence of these labels on beliefs, emotions and treatment preferences. RESULTS: Four major themes emerged. First, patients strongly valued diagnoses to validate their pain and guide treatment. Second, poor diagnostic explanations and use of medical jargon led to patient frustration and confusion. Third, specific diagnostic labels were validating but promoted fear and a biomedical view of pain, whereas non-specific labels were associated with less fear but higher confusion. Fourth, non-specific labels led to more positive views towards prognosis and non-invasive management but led some patients to believe that further investigations were needed. CONCLUSION: Patients have a strong desire for a diagnosis and may prefer specific diagnostic labels, but these can lead to patient harm. Non-specific labels, while less threatening, require clear explanations to avoid confusion. REGISTRATION: CRD42024592437.