Vitamin C and Back Pain, Really?

Pain is not a big killer like cancer or infectious diseases. However, back pain tops the scales of disease burden: when comorbidity is considered with disability-adjusted life years (DALYs)*– then back pain wins in almost every country (see Other musculoskeletal problems, including arthritis, also count among the … [Read more...]

Could Virtual Reality Dodgeball motivate fear-avoidant CLBP patients to move? Implications for future treatment.

Chronic low back pain (CLBP) is one of the most common musculoskeletal conditions health care professionals encounter. Unfortunately, despite ever increasing costs in regards to clinical management, the results remain underwhelming[1,2] giving CLBP an enigmatic nature. As a masters student I am interested in understanding how the neuromodulatory … [Read more...]

We should be worried about gravity?!?!

We all know how common back pain is and how back pain comprises a significant proportion of the 1 in 4 people with persistent pain. There is clearly an established link between the meaning of one’s pain and the fear it evokes, right?  Someone’s perception of what it happening in their back relates to their pain, right?  Castrophisation scales and … [Read more...]

Are cell-based therapies effective for low back pain?

In recent times, there has been a surge of interest in the use of cell-based therapies for the treatment of a range of musculoskeletal conditions, with many high profile sportspeople availing of these therapies (e.g here and here). Cell-based therapies can involve the use of chrondrocyte or mesenchymal stem cells. These are typically extracted from … [Read more...]

Get involved! Translating evidence into practice: Cognitive behavioural techniques for back pain

Translating research into clinical practice is a challenge for researchers in all fields. I work in the UK and funding bodies here appear to be keenly aware of this, and are increasingly providing opportunities to engage with this challenge through dissemination activities and improved research-clinician engagement, for example. Our group at the … [Read more...]

Giving patients the whole truth

I am guilty of being the eternal optimist in my practice. I can’t recall ever telling a patient that the outlook isn’t great for them, even though on many occasions, I had that sinking feeling in my gut. Many patients in pain are distressed enough – they don’t need me to give them more to worry about, do they? Maybe I’m not the only clinician who … [Read more...]

Spinal manipulative therapy, Graston technique® and placebo for long standing non-specific mid back pain

Few controlled trials have assessed the efficacy of spinal manipulative therapy (SMT) for mid back pain. In addition no high quality trials have been performed to test the efficacy and effectiveness of Graston Technique® (GT), an instrument-assisted soft tissue massage therapy. The objective of this study was to determine the efficacy of SMT and GT … [Read more...]

Why physical therapy treatments for low back pain may not be living up to their potential

Low back pain (LBP) is a leading contributor to people living with disability throughout the world,1 and the problem appears to be getting worse rather than better.2 Scientists and clinicians, therefore, need to improve treatment for LBP to shift this trend and reduce disability. People with LBP change how they control their posture for … [Read more...]

Diagnostic uncertainty and pain-related guilt: new treatment targets for low back pain?

Low back pain (LBP) is a highly prevalent condition, with a devastating impact on society and it is now recognized as the leading cause of disability worldwide (Lim et al., 2012). Research suggests that several psychological factors play an important role in LBP, and among the most robust factors are depression, catastrophic cognitions, fear of … [Read more...]

Low Back Pain Treatment in Primary Care

In general, most acute low back pain (LBP) recovers spontaneously within a few days or weeks. No active treatment has shown to actually shorten the time it takes for acute back pain to recover. The purpose of medication, manipulation, acupuncture, physiotherapy etc. is at best to ease the pain while one is waiting for nature to heal. And one should … [Read more...]