People with low back pain want clear, consistent and personalised information on prognosis, treatment options and self-management strategies: a systematic review

ConclusionAvailable data suggest that the information needs of people with low back pain are centred around their desire for a diagnosis, potentially contributing to expectations for and overuse of imaging. People with low back pain expressed a strong desire for clear, consistent and personalised information on prognosis, treatment options and self-management strategies, related to healthcare and occupational issues. To correct unhelpful beliefs and optimise delivery of evidence-based therapy, patient and healthcare professional education (potentially by an integrated public health approach) may be warranted.
Source: Journal of Physiotherapy - Category: Physiotherapy Source Type: research

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CONCLUSIONS: The evidence from this systematic review is uncertain regarding the effect of therapeutic ultrasound on pain in individuals with chronic non-specific LBP. Whilst there is some evidence that therapeutic ultrasound may have a small effect on improving low back function in the short term compared to placebo, the certainty of evidence is very low. The true effect is likely to be substantially different. There are few high-quality randomised trials, and the available trials were very small. The current evidence does not support the use of therapeutic ultrasound in the management of chronic LBP. PMID: 32623724 ...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Abstract Low back pain (LBP) is the highest cause of years lived with a disability in Australia and the most frequent musculoskeletal condition for which patients seek primary care. The aims of this study were to: (1) evaluate the current practices and perspectives of Australian GPs and physiotherapists managing acute back pain; and (2) explore alignment of care with clinical guidelines. This was a prospective cross-sectional Internet survey conducted from March 2018 to May 2018 of experienced Australian GPs and physiotherapists. Descriptive statistics were used to analyse all quantitative outcomes. Two hundred pr...
Source: Primary Care - Category: Primary Care Authors: Tags: Aust J Prim Health Source Type: research
What we call a disease matters. It matters to the person because a diagnosis is a marker: this problem is known, it’s recognised, it’s real (Mengshoel, Sim, Ahlsen &Madden, 2017). It matters to the clinician, particularly medical practitioners, but also those clinicians working within a largely “disease-oriented” framework (for example, physiotherapists, osteopaths) (Haskins, Osmotherly, Rivett, 2015; Kennedy, 2017). It matters also to insurance companies, or funding providers – who is in, and who is out. The diagnostic label itself hides a great many assumptions. The ways in which diag...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Assessment Chronic pain Clinical reasoning Coping strategies Pain conditions Professional topics Uncategorized Source Type: blogs
Abstract The prolonged disability associated with musculoskeletal (MSK) pain represents an enormous health burden, for individuals as well as society. Promoting pain and disability management for patients with persistent MSK-related conditions can be very challenging for rehabilitation professionals. These often-complex conditions require the adoption of a biopsychosocial perspective in order to assess and address a vast array of potential factors affecting the patient. Fortunately, a self-management (SM) approach has been deemed effective in enhancing patients' control over their symptoms and disabilities. Howeve...
Source: Physiotherapy Theory and Practice - Category: Physiotherapy Authors: Tags: Physiother Theory Pract Source Type: research
Once you begin to dip your toes into psychological therapies, it doesn’t take long before you begin to see TLAs all over the place. So today I’m going to post on two things: some of the TLAs, and why or how we might consider using these approaches in pain rehabilitation. The first one is CBT, or cognitive behavioural therapy. CBT grew out of two movements: behaviour therapy (Skinner and the pigeons, rats and all that behaviour modification stuff), and cognitive therapy (Ellis and Beck and the “cognitive triad” – more on this later). When the two approaches to therapy are combined, we have c...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: ACT - Acceptance & Commitment Therapy Clinical reasoning Cognitive behavioral therapy Coping strategies Interdisciplinary teams Occupational therapy Physiotherapy Professional topics Psychology Research Science in practice Source Type: blogs
Today’s post is another one where there’s very little to guide my thinking… Have you ever wondered why we read so much research looking at the characteristics of the people who look for help with their pain – yet not nearly as much about us, the people who do the helping? There are studies about us – thanks Ben – and others! (Darlow, Dowell, Baxter, Mathieson, Perr &Dean, 2013; Farin, Gramm &Schmidt, 2013; Parsons, Harding, Breen, Foster, Pincus, Vogel &Underwood, 2007). We know some things are helpful for people with pain: things like listening capabilities (Matthias, Ba...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Coping strategies Pain conditions Professional topics Research Science in practice attitudes beliefs communication nocebo Source Type: blogs
This is a long…… readooops, sorry, not. Low back pain is, we know, the greatest contributor to days lived with disability (Rice, Smith &Blyth, 2016). And no-one anywhere in the world has found a good mix of services to reduce the number of days lived with disability as a result of this problem. And yet billions of dollars are used to fund research into the many contributors to a shift from acute low back pain to ongoing disability associated with low back pain. At the same time, treatments that directly target disability, rather than pain (a target considered the most important outcome by Sullivan a...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Low back pain Pain conditions Research Science in practice health funding health systems models of care Source Type: blogs
Conclusion. More pain sites, higher psychological distress, or lower work ability showed higher disability, more pain, and lower quality of life in patients with LBP. Only improvement in work ability was consistently related to successful outcomes. Level of Evidence: 2
Source: Spine - Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research
Purpose: Central and peripheral sensitisation is a major contributor to ongoing disability in chronic low back pain (LBP). Exercise as a management option is recommended in all clinical guidelines. In addition to its general effects, exercise induced hypoalgesia (EIH), referring to a temporary change in pain sensitivity, is a documented effect. Few studies to date have investigated EIH in patients with LBP, with some evidence for impaired EIH potentially driven by peripheral and central sensitisation.
Source: Physiotherapy - Category: Physiotherapy Authors: Tags: P175 Source Type: research
Today’s post is occasioned by reading several discussions on various forums where the term “pain science” and various adjectives to describe this kind of practice. For those who don’t want to read the rest of my ramblings: no, it’s not a thing, science is an approach to understanding phenomena, and I would have thought all health professionals would use a science-based approach to treatment. I went on to Google, as you do, to find out when this term began its rise in popularity. Google wasn’t particularly helpful but did show that it’s been around since 2004 at least, and seems to...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Assessment Chronic pain Clinical reasoning Education Low back pain Pain conditions Professional topics Research Science in practice biopsychosocial interprofessional multidimensional pain management pain science Source Type: blogs
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