A prospective randomized controlled study of auricular point acupressure to manage chronic low back pain in older adults: study protocol

This study aims to test auricular point acupressure (APA) as a non-invasive, nonpharmacological self-management strateg y to manage cLBP and to address current shortcomings of cLBP treatment.Methods/designFor this prospective randomized controlled study, participants will be randomly assigned to three groups: (1)APA group (active points related to cLBP), (2) Comparison group-1 (non-active points, unrelated to cLBP), and (3) Comparison group-2 (enhanced educational control, an educational booklet on cLBP will be given and the treatment used by participants for their cLBP will be recorded). The ecological momentary assessment smartphone app will be used to collect real-time cLBP outcomes and adherence to APA practice. Treatment and nonspecific psychological placebo effects will be measured via questionnaires for all participants. This proposed trial will evaluate the APA sustained effects for cLBP at 12-month follow-up. Monthly telephone follow-up will be used to collect study outcomes. Blood will be collected during study visits at baseline, post APA treatment, and follow-up study visits at 1, 3, 6, 9 and 12 months post completion of treatment for a total of seven assessments. Appointments will start between 9 and 11  am to control for circadian variation in cytokine levels.DiscussionThis study is expected to provide vital information on the efficacy, sustainability, and underlying mechanism of APA on cLBP necessary for APA to gain acceptance from both healthcare provid...
Source: Trials - Category: Research Source Type: clinical trials

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Authors: Hoffman EG, Jain D, Radcliff K, Fischer CR, Hilibrand AS, Razi AE Abstract Low back pain is one of the most common reasons for physician visits, leading to high heath care costs and disability. Patients may present to primary care physicians, pain management physicians, chiropractors, physical therapists, or surgeons with these complaints. A thorough history and physical examination coupled with judicious use of advanced imaging studies will aid in determining the etiology of the pain. As most cases of low back pain are self-limited and will not develop into chronic pain, nonsurgical treatment is the mains...
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research
AbstractLow back pain (LBP) is prevalent and may transition into chronic LBP (cLBP) with associated reduced quality of life, pain, and disability. Because cLBP affects a heterogenous population, rehabilitation efforts must be individualized to meet the needs of various patient populations as well as individuals. This narrative review evaluated the many approaches to LBP rehabilitation including treatment-based classifications and specific types of rehabilitation efforts from exercise and physical therapy to spinal manipulation and bracing. Clinicians caring for patients with LBP or cLBP must be aware of the various options...
Source: Pain and Therapy - Category: Anesthesiology Source Type: research
Conclusions: Diagnosing and treating chronic low back pain is compromised due to differing expectations and the communication barriers that exist between healthcare professionals and their patients. Primary healthcare professionals should be aware of the power of their explanations and recommendations to patients.Implications for RehabilitationPrimary healthcare professionals should negotiate treatments with patients and adapt them to their individual needs, according to a Patient-Centered approach and the biopsychosocial model of pain.Primary healthcare professionals should explain to patients the underlying mechanisms an...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Low back pain is the primary cause of adult disability worldwide and if poorly managed can precipitate the unnecessary use of opioids, diminish physical functioning, and lead to comorbid conditions interfering with patient quality of life. Providers who collaborate with a spinal interventionalist can effectively manage acute and chronic low back pain, improve physical functioning, and reduce the use of opioid analgesics. The implementation of specific spinal interventions, adjuvant analgesics, and collaboration with a multidisciplinary team can promote health and wellness for 1 of the most prevalent and debilitating global health conditions.
Source: The Journal for Nurse Practitioners - Category: Nursing Authors: Tags: Feature Article Source Type: research
CONCLUSION: Three sessions of thoracic manipulation, education, and exercise did not result in improved outcomes when compared to a sham manipulation, education, and exercise in individuals with chronic LBP. Future studies are needed to identify the most effective management strategies for the treatment of low back pain. Registered at clinicaltrials.gov (NCT02853357). LEVEL OF EVIDENCE: Therapy, level 1b. J Orthop Sports Phys Ther, Epub 6 Dec 2019. doi:10.2519/jospt.2020.8928. PMID: 31810405 [PubMed - as supplied by publisher]
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: J Orthop Sports Phys Ther Source Type: research
Authors: Namnaqani FI, Mashabi AS, Yaseen KM, Alshehri MA Abstract The aim of this study was to evaluate the effectiveness of the McKenzie method compared to manual therapy in the management of patients with chronic low back pain (CLBP). Randomised controlled trials evaluating the McKenzie method in treating CLBP in adults compared to manual therapy (MT) were searched in MEDLINE, CINAHL, Cochrane Library, and PEDro. The primary outcomes were pain and disability. Five trials were eligible for inclusion in the review, of which, most had a score of 8 out of 11 on the PEDro scale. At 2-3 months, all studies reported si...
Source: Journal of Musculoskeletal Neuronal Interactions - Category: Neurology Tags: J Musculoskelet Neuronal Interact Source Type: research
Abstract Nonspecific low back pain refers to a condition without a distinct etiology to explain its associated symptoms. This pain may become chronic and is a major cause of work loss around the world. Without a specific explanation for a patient's symptoms, the family physician is charged with providing reassurance, while also guiding the patient toward a return to function, which often includes maintaining employment. Evaluating for red flag signs and symptoms helps to eliminate concerning causes of low back pain, such as malignancy, fracture, infection, and cauda equina. Prescribing physical activity, including...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
CONCLUSIONS: We found that individual recovery expectations are probably strongly associated with future work participation (moderate-quality evidence) and may be associated with clinically important recovery outcomes (low-quality evidence). The association of recovery expectations with other outcomes of interest is less certain. Our findings suggest that recovery expectations should be considered in future studies, to improve prognosis and management of low back pain. PMID: 31765487 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Conclusions: VR has demonstrated effectiveness in reducing acute, experimental and chronic pain. This review describes the theoretical basis of the therapeutic effects of VR on CLBP via three distinct mechanisms: distraction, neuromodulation and graded exposure therapy. Furthermore, clinical application will be considered, including discussion of ethical issues associated with the technology.Implications for rehabilitationVirtual reality (VR) is suggested as an alternative for opioids in the management of acute and chronic pain.The therapeutic mechanisms of VR in chronic low back pain (CLBP) are equivocal but include distr...
Source: Disability and Rehabilitation. Assistive Technology. - Category: Rehabilitation Authors: Tags: Disabil Rehabil Assist Technol Source Type: research
Chronic low back pain (LBP) is a leading cause of disability worldwide. Biopsychosocial rehabilitation programs have been advocated for its management, especially since the widespread acceptance of the biopsyc...
Source: BMC Musculoskeletal Disorders - Category: Orthopaedics Authors: Tags: Research article Source Type: research
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