Treating more than just the back in chronic low back pain

Aoife Synnott

'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

Alessandro Chiarotto

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

Elaine Toomey

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?

Adrian Traeger Body In Mind

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

Tomohiko Nishigami

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?

Martin Rabey

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?

Emma Karran

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...]

Multidisciplinary rehabilitation for chronic low back pain

Steve Kamper

It is more or less well-accepted nowadays that back pain, particularly when chronic, is best understood within a biopsychosocial framework. The implication is that treatment is more likely to be successful if it includes components that target not only physical issues but also psychological and/or social factors. This is the premise that underpins … [Read more...]

Non-specific chronic back pain and hyperalgesia – A different story told by laser stimulation

Thomas Weiss

Despite our best scientific endeavors, what actually causes the pain in chronic low back pain (CLBP) often remains unclear. Approximately 85 % of chronic back pain patients are classified as having non-specific low back pain [1] because a definitive diagnosis cannot be given. That is, pain cannot be confidently attributed to known pathoanatomical, … [Read more...]

Can physical activity influence the course of low back pain?

Rafael Zambelli Pinto

It’s well known in the low back pain (LBP) field that conservative interventions have small to moderate effects at best.[1] Frustration with these small effects has prompted researchers to shift their attention to identifying prognostic factors. Prognostic factors are baseline factors that are associated with a worse or better disease outcome at a … [Read more...]