Knowledge of features of inflammatory back pain in primary care in the West Midlands: a cross-sectional survey in the United Kingdom

The objective of this study was to assess current practice of our local general practitioners (GPs) in using clinical features, as well as radiological and laboratory investigations to assess patients with IBP. An online, observational questionnaire-based survey was done in 10 West Midlands CCGs including disparate geographical and socioeconomic areas. The survey consisted of 23 questions based on Calin, Berlin and ESSG Criteria for spondyloarthropathies. GPs were asked to rate the importance of a range of symptoms as indications of IBP IBP (10 point scale, range 1 –10), and what their views were on which were the most important treatments for patients with suspected inflammatory back pain(4 point scale, range 1–4). The 4 most important symptoms for predicting inflammatory back pain according to our local cohort of GPs were ‘morning stiffness’ ‘sleep disturbances caused by back pain’ ‘insidious onset’ and ‘age of onset’
Source: Rheumatology International - Category: Rheumatology Source Type: research

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Not only the experience of sporting activities and events, but also rehabilitation after sports injuries are changing due to cutting-edge technologies. In sports medicine, the future holds a shift towards prevention through genomics, nutrigenomics, countless trackers, and wearables, while there are many great technologies which aim to alleviate the pain and shorten the time of recovery – if, against all odds, a sports injury still happens. Technology will change the experience of sports injuries and rehabilitation When was the last time you went out for a run without Endomondo or had a bike tour without Strava? Have ...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Medicine AR exoskeleton genomics health sensors Healthcare nutrigenomics prevention rehabilitation sports sports medicine trackers virtual reality VR wearables Source Type: blogs
I could write about a BPS (biopsychosocial) model in every single post, but it’s time for me to explore other things happening in the pain management world, so this is my last post in this series for a while. But it’s a doozy! And thanks to Eric Bowman for sharing an incredibly relevant paper just in time for this post… One of the problems in pain management is that there are so many assessments carried out by the professionals seeing a person – but very little discussed about pulling this information together to create an overall picture of the person we’re seeing. And it’s this aspect...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Assessment Back pain Clinical reasoning Low back pain Pain conditions Professional topics Research Science in practice biopsychosocial disability function Health healthcare pain management rehabilitation Therapeutic approache Source Type: blogs
Part of the definition of pain is that it is “a sensory and emotional experience” – in other words, emotions of the negative kind are integral to the experience of pain. Is it any wonder that poets and authors have written so eloquently about the anguish of unrelieved pain? As I write this, I’ve been pondering the way “psychosocial” has been used when discussing pain, as if those factors aren’t experienced by “normal” people, as if the way we feel about pain and the way people who struggle with their pain feel are two entirely different things. Chris Eccleston, someone ...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: ACT - Acceptance & Commitment Therapy Chronic pain Coping strategies Occupational therapy Pain conditions Physiotherapy Professional topics Psychology Research Science in practice Therapeutic approaches biopsychosocial Clinical rea Source Type: blogs
Conclusion The results from this very small randomised controlled trial showed that people having LP therapy in addition to usual CFS/ME care had improved physical function, fatigue and anxiety symptoms at six months, and improved school attendance and depressive symptoms at 12 months. However, there are a number of limitations to this research that need to be considered: Participants in both groups improved, so both treatments were effective to some extent. This was a very small trial, and the results analysis involved fewer than the 100 people recruited. It would need to be repeated in a much larger group to demonstr...
Source: NHS News Feed - Category: Consumer Health News Tags: Medical practice Source Type: news
This study provides some support for using single item questions to identify those who need more in-depth assessment, and those who don’t need this level of attention. I like that! The idea that we can triage those who probably don’t need the whole toolbox hurled at them is a great idea. Perhaps the New Zealand politicians, as they begin the downhill towards general elections at the end of the year, could be asked to thoughtfully consider rational distribution of healthcare, and a greater emphasis on targeted use of allied health and expensive surgery.   Deyo, R. A., &Mirza, S. K. (2016). Herniated Lum...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Assessment Back pain Chronic pain Coping strategies Interdisciplinary teams News Pain conditions Professional topics Research biopsychosocial disability healthcare rehabilitation self management treatment Source Type: blogs
The Pain Catastrophising Scale is one of the more popular measures used in pain assessment. It’s popular because catastrophising (thinking the worst) has been identified as an especially important risk factor for slow recovery from pain (Abbott, Tyni-Lenne &Hedlund, 2010), for reporting high levels of pain intensity (Langley, 2011), and for ongoing disability (Elfving, Andersoon &Grooten, 2007). I could have cited hundreds more references to support these claims, BTW. The problem is, once the PCS is administered and scored: what then? What difference does it make in how we go about helping a person think a li...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Assessment Back pain Clinical reasoning Coping Skills Coping strategies Education Low back pain Pain conditions biopsychosocial Chronic pain Occupational therapy pain management rehabilitation Therapeutic approaches Source Type: blogs
Abstract Patients with cervical radiculopathy (CR) may present with accompanying symptoms of hyperalgesia, allodynia, heaviness in the arm, and non-segmental pain that do not appear to be related to a peripheral spinal nerve. These findings may suggest the presence of central or autonomic nervous system involvement, requiring a modified management approach. The purpose of this case report is to describe the treatment of a patient with signs of CR and upper extremity (UE) hyperalgesia who had a significant decrease in her UE pain and hypersensitivity after a single thoracic spine manipulation (TSM). A 48-year-old f...
Source: Physiotherapy Theory and Practice - Category: Physiotherapy Authors: Tags: Physiother Theory Pract Source Type: research
In my last post I wrote about the Pain Catastrophising Scale and a little about what the results might mean. I discussed the overall score suggesting a general tendency to “think the worst”, with the three subscales of magnifying or over-estimating the risk; ruminating or brooding on the experience; and helplessness or feeling overwhelmed and that there’s nothing to be done.  At the end of the post I briefly talked about how difficult it is to find a clinical reasoning model in physiotherapy or occupational therapy where this construct is integrated – making it difficult for us to know what to ...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Assessment Chronic pain Clinical reasoning Low back pain Occupational therapy Physiotherapy biopsychosocial pain management Psychology Therapeutic approaches treatment Source Type: blogs
Abstract Following spinal cord injury (SCI), chronic pain is a common secondary complication with neuropathic pain (NP) cited as one of the most distressing and debilitating conditions leading to poor quality of life, depression and sleep disturbances. Neuropathic pain presenting at or below the level of injury is largely refractory to current pharmacological and physical treatments. No consensus on the prevalence of NP post SCI currently exists, hence this systematic review was undertaken. The review comprised three phases: a methodological assessment of databases [PubMed, Embase, Web of Knowledge, Cumulative Index to Nur...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: Review Article Source Type: research
Abstract Following spinal cord injury (SCI), chronic pain is a common secondary complication with neuropathic pain (NP) cited as one of the most distressing and debilitating conditions leading to poor quality of life, depression and sleep disturbances. Neuropathic pain presenting at or below the level of injury is largely refractory to current pharmacological and physical treatments. No consensus on the prevalence of NP post SCI currently exists, hence this systematic review was undertaken. The review comprised three phases: a methodological assessment of databases [PubMed, Embase, Web of Knowledge, Cumulative Index to Nur...
Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: Review Article Source Type: research
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