CIP Referral Triggers For Chronic Musculoskeletal Pain Beyond 52 Weeks

When recovery becomes persistent and complex: a CIP referral guide for case managers

Chronic musculoskeletal pain cases stall for predictable reasons: function plateaus, confidence drops, activity becomes inconsistent, care fragments across multiple providers and the plan becomes harder to execute. CIP is designed for this stage. It provides a coordinated, multidisciplinary reset focused on identifying the key drivers of persistent pain and low function, then rebuilding safe activity through structured progression and accountability.

This guide outlines who CIP can help, the referral triggers that indicate CIP is appropriate and what to expect once a client commences.

What CIP is Built To Do

CIP is a specialised multidisciplinary program for chronic or prolonged musculoskeletal pain, particularly for cases beyond 52 weeks post Date of Injury. The focus is functional restoration through a coordinated plan that addresses physical and psychological drivers of pain persistence, reduces unhelpful treatment noise and supports a practical pathway forward.

Who CIP Can Help?

CIP is a strong match for clients with chronicity and complexity, including:

Persistent pain with functional plateau

• Pain remains high or persistent with limited functional change

• Capacity gains are not sustained, with frequent flare-ups

• Activity levels remain low despite ongoing treatment

Deconditioning and reduced tolerance

• reduced strength, stamina and daily activity tolerance

• pacing problems and boom-bust activity cycles

• low load tolerance and difficulty building consistency

Multi-site or widespread MSK presentations

• pain across multiple body regions, not just one site

• symptoms that shift or generalise over time

• heightened protection, guarded movement and perceived vulnerability

High service use with low return

• multiple providers with inconsistent direction

• ongoing passive treatment without functional progression

• repeated investigations that do not change function

• difficulty translating treatment activity into measurable capacity gains

Psychological drivers maintaining pain

• fear-avoidance, low confidence, catastrophising

• frustration, disengagement, reduced self-efficacy

• sleep disruption and stress compounding pain experience

CIP is appropriate when one or more of these patterns are present:

Time-based trigger

• beyond 52 weeks post injury with limited functional improvement

Trajectory trigger

• repeated treatment changes without sustained functional gains

• flare-ups and setbacks dominate the recovery pattern

Complexity trigger

• high treatment volume with low functional return

• fragmented care and unclear ownership of a single functional plan

Participation trigger

• work restrictions are not progressing

• suitable duties have stalled due to capacity uncertainty and low confidence

What case managers can expect from CIP

CIP is designed to deliver clarity and coordinated direction. Case managers can expect:

• a consolidated view of the main drivers of persistent pain and low function

• a coordinated multidisciplinary plan with practical goals and progression steps

• structured review points and clear communication to maintain alignment

• recommendations that prioritise reactivation, pacing and function

• practical next steps to support decision making and progress suitable duties

CIP supports chronic MSK pain cases, particularly beyond 52 weeks, where function has plateaued and complexity is high. It provides a coordinated multidisciplinary reset that clarifies what is driving pain persistence, rebuilds safe activity and restores a practical pathway forward for the client and stakeholders.