Objective Measurement of Musculoskeletal Pain: A Comprehensive Review

<b>Background:</b> Musculoskeletal (MSK) pain is a leading contributor to global disability and healthcare burdens. While self-reported pain scales remain the clinical standard, they are limited by subjectivity and inter-individual variability. Therefore, objective assessment tools are i...

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Main Author: Nahum Rosenberg
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/13/1581
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author Nahum Rosenberg
author_facet Nahum Rosenberg
author_sort Nahum Rosenberg
collection DOAJ
description <b>Background:</b> Musculoskeletal (MSK) pain is a leading contributor to global disability and healthcare burdens. While self-reported pain scales remain the clinical standard, they are limited by subjectivity and inter-individual variability. Therefore, objective assessment tools are increasingly sought to enhance diagnostic precision, guide treatment, and enable reproducible research outcomes. <b>Methods:</b> This comprehensive narrative review synthesizes evidence from physiological, behavioral, and neuroimaging approaches used to evaluate MSK pain objectively. Emphasis is placed on autonomic biomarkers (e.g., heart rate variability, skin conductance), facial expression analysis, electromyographic methods, and functional neuroimaging modalities such as fMRI and PET. Emerging applications of artificial intelligence and multimodal diagnostic strategies are also discussed. <b>Results:</b> Physiological signals provide quantifiable correlations of pain-related autonomic activity but are influenced by psychological and contextual factors. Behavioral analyses, including facial action coding systems and reflex testing, offer complementary, though complex, indicators. Neuroimaging techniques have identified pain-related brain patterns, yet clinical translation is limited by variability and standardization issues. Integrative approaches show promise for improving diagnostic validity. <b>Conclusions:</b> Objective assessment of MSK pain remains methodologically challenging but holds substantial potential for enhancing clinical diagnostics and personalized management. Future research should focus on multimodal integration, standardization, and translational feasibility to bridge the gap between experimental tools and clinical practice.
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spelling doaj-art-bd40ba1b002647d4adf22b681ebcf9242025-08-20T03:28:28ZengMDPI AGDiagnostics2075-44182025-06-011513158110.3390/diagnostics15131581Objective Measurement of Musculoskeletal Pain: A Comprehensive ReviewNahum Rosenberg0Specialists Center, National Insurance Institute, Pal Yam 8, Haifa 3309511, Israel<b>Background:</b> Musculoskeletal (MSK) pain is a leading contributor to global disability and healthcare burdens. While self-reported pain scales remain the clinical standard, they are limited by subjectivity and inter-individual variability. Therefore, objective assessment tools are increasingly sought to enhance diagnostic precision, guide treatment, and enable reproducible research outcomes. <b>Methods:</b> This comprehensive narrative review synthesizes evidence from physiological, behavioral, and neuroimaging approaches used to evaluate MSK pain objectively. Emphasis is placed on autonomic biomarkers (e.g., heart rate variability, skin conductance), facial expression analysis, electromyographic methods, and functional neuroimaging modalities such as fMRI and PET. Emerging applications of artificial intelligence and multimodal diagnostic strategies are also discussed. <b>Results:</b> Physiological signals provide quantifiable correlations of pain-related autonomic activity but are influenced by psychological and contextual factors. Behavioral analyses, including facial action coding systems and reflex testing, offer complementary, though complex, indicators. Neuroimaging techniques have identified pain-related brain patterns, yet clinical translation is limited by variability and standardization issues. Integrative approaches show promise for improving diagnostic validity. <b>Conclusions:</b> Objective assessment of MSK pain remains methodologically challenging but holds substantial potential for enhancing clinical diagnostics and personalized management. Future research should focus on multimodal integration, standardization, and translational feasibility to bridge the gap between experimental tools and clinical practice.https://www.mdpi.com/2075-4418/15/13/1581musculoskeletal painobjective assessmentbiomarkersheart rate variabilityfacial expressionneuroimaging
spellingShingle Nahum Rosenberg
Objective Measurement of Musculoskeletal Pain: A Comprehensive Review
Diagnostics
musculoskeletal pain
objective assessment
biomarkers
heart rate variability
facial expression
neuroimaging
title Objective Measurement of Musculoskeletal Pain: A Comprehensive Review
title_full Objective Measurement of Musculoskeletal Pain: A Comprehensive Review
title_fullStr Objective Measurement of Musculoskeletal Pain: A Comprehensive Review
title_full_unstemmed Objective Measurement of Musculoskeletal Pain: A Comprehensive Review
title_short Objective Measurement of Musculoskeletal Pain: A Comprehensive Review
title_sort objective measurement of musculoskeletal pain a comprehensive review
topic musculoskeletal pain
objective assessment
biomarkers
heart rate variability
facial expression
neuroimaging
url https://www.mdpi.com/2075-4418/15/13/1581
work_keys_str_mv AT nahumrosenberg objectivemeasurementofmusculoskeletalpainacomprehensivereview