ACADEMIA Letters Physiotherapy practice in persistent chronic musculoskeletal pain Thangamani Ramalingam Alagappan Chronic pain is defned as persistent nociception that lasts for more than three months. The new international classifcation of diseases ( ICD-11) categorization identifes two forms of chronic musculoskeletal pain (CMP), the primary and secondary. Chronic musculoskeletal pain is a condition or state of an individual that is not caused by a specifc disease. Chronic secondary musculoskeletal pain is a symptom of a larger condition somewhere else in the body that produces persistent nociception attributable to local or systemic reasons. It can be caused by infammation, structural abnormalities, or the biomechanical implications of nervous system abnormalities[1,2]. The fact that the incidence appears to have risen in recent years due to the impact of many variables such as changes in environmental exposure and other psychosocial risk factors, indicated that CMP is of high concern[3]. Pain sensitization, fear-avoidance, cognitive distortions, melancholy, sleep difculties, exhaustion, worry, pain catastrophes, and distress from the psychosocial dimensions of health all may contribute to chronic musculoskeletal pain, according to the literature and recent evidence. At this point, the major issue is to do very focused research to identify these risk factors and develop preventative measures[4,5]. Chronicity and disability are linked to low mood, somatization, and negative health attitudes about the causes and prognosis of chronic musculoskeletal pain, as well as societal beliefs[6]. There is moderate evidence that a multidisciplinary approach is more successful than no treatment or other active treatments at reducing pain in the short term in the management of chronic musculoskeletal pain. Chronic pain, by defnition, cannot be treated or cured in the conventional biomedical sense; rather, the patient in pain must be provided with the skills necessary to manage their long-term discomfort to an acceptable level. It is vital to give equal attention to the psychosocial complaints which usually invariably accompany long-term pain. Academia Letters, November 2021 Corresponding Author: Thangamani Ramalingam Alagappan, atramalingam@gmail.com Citation: Alagappan, T.R. (2021). Physiotherapy practice in persistent chronic musculoskeletal pain. Academia Letters, Article 4136. https://doi.org/10.20935/AL4136. 1 ©2021 by the author — Open Access — Distributed under CC BY 4.0