Surgical or non-surgical management for sciatica – what you need to know

Whilst low back pain (LBP) is the number one cause of disability worldwide, a small number of patients will suffer associated leg pain, generally due to a herniated intervertebral lumbar disc - commonly known as ’sciatica’. Responsible for less than five percent of all low-back presentations, lower limb pins and needles, tingling, numbness or … [Read more...]

GP management of back pain – challenges and opportunities

Low back pain is a very common reason to visit the doctor but previous studies have indicated that GP management of back pain is often inconsistent with evidence-based guidelines. We wanted to explore the beliefs of New Zealand GPs about back pain and how these influenced their management of patients with back pain. We found that GPs who … [Read more...]

A big belly isn’t necessarily a pain in the back

Over 80% of Australians experience back pain at some point in their lives, which is one of the most common reasons people miss work and seek health care. Despite the efforts of the scientific community to identify risks factors for back pain, the cause of this condition is still poorly understood. Knowing what causes low back pain might help us … [Read more...]

Treating more than just the back in chronic low back pain

'Physiotherapists may stigmatise or feel unprepared to treat people with low back pain and psychosocial factors that influence recovery: a systematic review' (Synnott et al, 2015) There is considerable evidence that when people have chronic low back pain (LBP), several factors can be involved in delaying their recovery and/or their ability to … [Read more...]

Core outcome domains for non-specific low back pain

In 1997, during the second International Forum on Primary Care Research for Low Back Pain (LBP) held in The Hague (Netherlands), a group of experienced clinical researchers gathered together and decided to formulate a standardised set of outcomes to be recommended to colleagues for use in LBP clinical research. These recommendations included five … [Read more...]

Self-management for people with back pain and osteoarthritis – reviewing the evidence

Osteoarthritis (OA) and chronic low back pain (CLBP) are two of the most common musculoskeletal pain conditions in the developed world (WHO, 2003). These conditions place a huge burden on both the health system, in terms of service demand, and the people with the condition, in terms of quality of life and personal wellbeing (Buchbinder et al., … [Read more...]

Is education reassuring?

Acute low back pain is inherently worrying; often there is no clear cause, no effective treatment, and a widely variable time frame in which you can expect to recover. Happily for many, the prognosis is good - they can expect to be a lot better within a matter of weeks. Sadly, for the others, we know all too well where that road can lead. One of … [Read more...]

Relationship between tactile acuity, clinical symptoms and perceived body image in patients with chronic low back pain

Some chronic low back pain (CLBP) patients report an expanded perceived image of the low back using words like: “My back feels like it’s swollen”. Altered perceived body image is associated with chronic pain conditions such as complex regional pain syndrome (CRPS) (Moseley, 2005; Lewis and Schweinhardt, 2012) and phantom limb pain (Flor et al., … [Read more...]

Classification of low back pain. Are we winning?

As clinicians we know that no two people with low back pain (LBP) are identical. However, if we looked at a large number of people with LBP, would we be able to see some patterns emerge? Or similarities that could allow us to group these people together based upon some characteristics of their presentations? The idea of classification systems for … [Read more...]

What’s the deal with all these screening studies?

The cost of chronic back pain and the limited resources that we have to deal with it, has led to many studies that attempt to ‘screen’ patients with low back pain in order to target treatment at the patients who need it most. I have had a clinical interest in this idea for some years and have spent the last 12 months with my head buried in the … [Read more...]