Faculty Advisor(s)

Tara Paradie

Document Type

Course Paper

Publication Date



© 2021 The Authors


Background: Musculoskeletal disorders, often well understood, are a leading cause of disability worldwide. Concomitant psychosocial factors add a layer of complexity to the treatment of musculoskeletal disorders. The purpose of this case report is to highlight the potential impact psychological factors have in the rehabilitation of musculoskeletal disorders, specifically the rehabilitation of a right hip flexor strain.
Case Description: The patient was a 75-year-old male referred to outpatient physical therapy for the assessment of a right hip flexor strain, presenting with psychosocial factors including anxiety and kinesiophobia. Procedural interventions included patient education, neuromuscular re-education, therapeutic exercise, and manual therapy, but lacked psychosocial assessment.
Outcomes: The patient was seen for 16 visits over eight week’s time, including the initial evaluation. His pain rating score improved from 8/10 on initial evaluation to 6/10 on discharge in accordance to the Numeric Pain Rating Scale (NPRS). After four weeks of continued physical therapy intervention after his re-evaluation, he was referred back to his primary care provider for further diagnostic testing as his progress began to plateau.
Discussion: This case report highlights how psychosocial factors such as kinesiophobia and anxiety can complicate patient care. While physical therapists are often well versed in the treatment of musculoskeletal disorders, numerous external factors make it difficult for physical therapists to properly assess psychosocial factors. Further research should be conducted regarding the importance of psychosocial assessment in the context of musculoskeletal disorder rehabilitation.


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