Each time we face our fear, we gain strength, courage, and confidence in the doing – Theodore Roosevelt

I’m not certain Theodore Roosevelt actually said that – but who cares?! It’s a great statement. For the person living with persistent pain, though, it can be the last thing you want to hear. After all, it’s tough enough getting up and just doing the normal things let alone challenge yourself! So… how can a health professional help? Let’s briefly recap. Self efficacy is the confidence I can do something successfully if I wanted to. It’s a robust predictor of many health behaviours including exercise, stopping smoking, eating healthily and coping well with persistent pain (Jackson, Wang, Wang &Fan, 2014; Williams &Rhodes, 2016). It was first introduced as a concept by Bandura as part of his theoretical model of behaviour change, and further discussed in an experimental study in a paper investigating systematic desensitisation processes, arguing that this approach to treatment created and strengthened expectations of personal efficacy (Bandura &Adams, 1977). Bandura argued that people develop a sense (expectation) of self efficacy from their own performance, watching others succeed, being persuaded by someone that yes indeed you have the skills to achieve, and also awareness of physiological arousal from which people can judge their own level of anxiety. Self efficacy is more than a simple “general confidence” construct, however. It’s far more selective than this. For example, although I believe I can succe...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Back pain Chronic pain Clinical reasoning Coping Skills Coping strategies Professional topics Research Resilience Science in practice biopsychosocial function healthcare pain management physiotherapy rehabilitation self effic Source Type: blogs

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Conclusion: In this multicentric observational study, referral to an FRP was linked to pain, self-reported physical activity and sick leave but not medical characteristics assessed. These findings confirm the bio-psycho-social approach of FRPs for cLBP.
Source: Annals of Physical and Rehabilitation Medicine - Category: Rehabilitation Source Type: research
Authors: Licciardone JC, Schmitt ME, Aryal S Abstract Context: Comparisons of osteopathic physicians (ie, DOs) and allopathic physicians (ie, MDs) on interpersonal manner, including empathy and communication style, have been limited by such methodologic issues as self-assessment and a focus on medical students rather than practicing physicians. Objective: To compare perceptions of the interpersonal manner, empathy, and communication style of DOs and MDs and corresponding clinical measures reported by their patients. Methods: A cross-sectional study of adults with subacute or chronic low back pain was conduc...
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
Study Design. A cross-sectional study. Objective. The aim of this study was to describe multi-dimensional profiles for people with chronic low back pain (CLBP) and to examine the associations between CLBP-related disability and individual, psychosocial and physical factors in a Saudi population. Summary of Background Data. CLBP-related disability is a multidimensional phenomenon. There is growing interest in exploring factors associated with CLBP-related disability in Saudi Arabia but research is limited in comparison to other countries. Methods. Participants completed questionnaires covering demographics, pain ...
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
AbstractObjectivesThis randomized controlled trial investigated the efficacy of cognitive functional therapy (CFT) compared with manual therapy and exercise (MT ‐EX) for people with non‐specific chronic low back pain (NSCLBP) at 3‐year follow‐up.MethodsHundred and twenty ‐one patients were randomized to CFT (n = 62) or MT‐EX (n = 59). Three‐year data were available for 30 (48.4%) participants in the CFT group, and 33 (55.9%) participants in the MT‐EX group. The primary outcomes were disability (Oswestry disability Index [ODI]) and pain intensity (numerical rating scale) and secondary out...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Conclusion: Genetic associations of diseases considerably vary across populations which necessitates health-related genotyping efforts especially for so far understudied populations. SOM portrayal represents novel promising methods in population genetic research with special strength in visualization-based comparison of SNP data. Introduction Non-communicable polygenic diseases such as cancers, neurodegeneration, cardiovascular, and metabolic disorders have become the most prevalent type worldwide and account for the majority of death events in developed and transition economy countries (Habib and Saha, 2010; Benzi...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
AbstractObjectivesThis randomized controlled trial investigated the efficacy of cognitive functional therapy (CFT) compared with manual therapy and exercise (MT ‐EX) for people with non‐specific chronic low back pain (NSCLBP) at 3‐year follow‐up.Methods121 patients were randomized to CFT (n=62) or MT ‐EX (n=59). 3‐year data were available for 30 (48.4%) participants in the CFT group, and 33 (55.9%) participants in the MT‐EX group. The primary outcomes were disability (Oswestry disability Index (ODI)) and pain intensity (numerical rating scale (NRS)) and secondary outcomes were anxiety/depr ession (Hopkins Sym...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
Abstract Among chronic low back pain (CLBP) patients, workers' compensation is associated with longer term prescription opioid analgesic use (OAU). The aim was to study the association between receiving Social Security Disability Insurance (SSDI) benefits and course of OAU. This prospective cohort study utilized data from primary care patients diagnosed with non-cancer CLBP. The outcomes were morphine equivalent dose (MED) - categorized as no OAU, 1-50mg MED, or>50mg MED - and change in MED over time using mixed multinomial logistic regression models. Covariates included sociodemographics, pain severity, pain m...
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Popul Health Manag Source Type: research
h L Abstract BACKGROUND: One model of care that has not been tested for chronic low back pain (LBP) is patient-led goal setting. We aimed to compare the clinical effectiveness and healthcare use of a patient-led goal setting approach (intervention) with simple advice to exercise (control) over 12 months. METHODS: An assessor-blinded randomised controlled trial. Intervention was education combined with patient-led goal setting compared with a control group receiving a standardised exercise programme. The primary outcomes were back pain disability and pain intensity. Secondary outcomes were quality of life, kin...
Source: British Journal of Sports Medicine - Category: Sports Medicine Authors: Tags: Br J Sports Med Source Type: research
The objectives of this study were to define the role for surgery in the treatment of chronic low back pain (cLBP) and to develop a new classification of cLBP based on the pattern of injury.HypothesisSurgery may benefit patients with cLBP, and a new classification based on the injury pattern may be of interest.MethodA systematic literature review was performed by searching Medline, the Cochrane Library, the French public health database (Banque de Données en Santé Publique), Science Direct, and the National Guideline Clearinghouse. The main search terms were “back pain” OR “lumbar” OR &...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Over the past few years I’ve been pondering the presumed gap between people living with pain and the people who “treat” or work with them.  Most of my readers will know that I live with widespread pain (aka fibromyalgia) or pain that is present in many parts of my body, and the associated other symptoms like DOMS that last for weeks not a day or two, and increased sensitivity to heat, cold, pressure, chilli, sound and so on. I first “came out” with my pain about 15 years ago: that is, I first disclosed to people I worked with that I had this weird ongoing pain – and finally joined...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Professional topics Research Therapeutic approaches inclusion inequality Source Type: blogs
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