Multidisciplinary Guideline for Aspecific CANS

    Publication date: 01 January 2009

    At the end of September 2012, administrative approval was given by all the organisations involved in the development of the multidisciplinary guideline for aspecific complaints of arm, neck and/or shoulder (CANS).


    In 2004, 11 medical and paramedical professional organisations reached consensus for a new terminology and subdivision of complaints of the arm, neck and/or shoulder (CANS), in order to replace the confusing term RSI (Repetitive Strain Injury). CANS is the new term for musculoskeletal upper extremity and neck complaints which are not caused by acute trauma or a systemic disease. This consensus was also expressed in the CANS model, in which a distinction is made between specific CANS (23 conditions) and aspecific CANS (Huisstede 2008). Up until now, no multidisciplinary guideline has been developed for the patient group with aspecific CANS.

    For this reason, a ZonMw (The Netherlands Organisation for Health Research and Development) grant was applied for in 2009, with the goal of developing a multidisciplinary guideline for aspecific CANS. This guideline aims to collect the available knowledge in the field of diagnosis, treatment, care and (secondary and tertiary) prevention of aspecific CANS. Starting point for the guideline development was an updated version of the CANS-model. This version now contains 35 specific diagnostic categories, next to aspecific CANS. A summary of evidence is included on how to diagnose these specific conditions or - by exclusion - aspecific CANS.

    Based on scientific insight and experiences from practice, recommendations are made concerning the management of care for patients with aspecific CANS. The guideline is intended to be used by all professionals from health -care and occupational care that were involved in the development. In this way communication and cooperation between the various professionals with different backgrounds that are involved in the care process can be improved. Furthermore, this guideline also aims to contribute to the improvement of communication between care-providers and patients.