Low back pain treatments

http://www.PhysioDigest.com shares some clinical thoughts on the usefulness of Guidelines in Low Back Pain patient management. Because the recommendations are so broad and generic they lack specificity to direct clinical intervention. As clinicians we are then faced with the option of using interventions not recommended in the guidelines and without an evidence base. For me patient care is the priority and outcome is measured by patient satisfaction. Does it need to be more complicated?

Category:

Education

Tags:

• Back pain treatment
• management of low back pain
• back rehabilitation

[1gr8fl1]

As a physician with over 30 years of experience treating back pain patients and as a doctor whose back pain patients usually promptly improve without being sent to a therapist, I recognize the agenda of this You Tube presenter... and he is wrong.

Objective guidelines (such as recent back pain treatment guidelines from the American College of Physicians) based on many clinical objective studies have proven that what the presenter is peddling is NOT necessary for MOST patients who complain of ba

[physiodigest]

@1gr8fl1

I,m 25 years at this and I still don't thinks the guidelines (ACP's or the multitude of others) give much practical help or move the management strategy much furthur than was established in the 1990's. If all acute LBP was so "spontaenously resolving" why is there still an epedimic.? For the 85% of LBP which is not defined "hoping" it will go away is not a management plan - in fact many of these patients leave the medical system disillusioned. The problem is identifing right targets.

[sheehana79]

If physicians don't refer low back patients to qualified therapists they look for therapy esewhere. Many patients with more sinister, or even less sinister conditions such as ankylosing spondylitis may be missed ..Physicians recognise the use of Chartered Physiotherapists whose training enables us to try and place patients into sub groups which are suitable to be treated by us! Recognise our use and use us!i

[sheehana79]

I am a physio for 30 years treating lbp. If I get the sub group of really ' acute' discy type patient , and treat with the Mc Kenzie regime combined with Maitland PA's and rotations combined with advice about do's n don'ts I consider that many of this sub set of patients make a complete recovery with full range movement very quickly. Of course the sub set of these patients with neurological signs and symptoms get referred further if these signs and symptoms do not improve. ....

[sheehana79]

Most of the pain literature now talks about looking at sub groups of patients. The buzz word now seems to be that they are best treated by multimodal treatment...i.e. a combination of exercise with 'multimodal' therapies such as manipulation, heat, electrotherapy , mindfulness etc. Maybe if the correct sub set of patients were traeted with the correct therapy our results might be better!